Asian Journal of Research in Cardiovascular Diseases

Medicinal Plants with Antihypertensive Activity: A Review

Felix Keneolisa Asogwa *

Department of Pharmacology, Enugu State University of Science and Technology Agbani, Enugu State, Nigeria.

Ugwu Obiora Celestine

Department of Pharmacology, Enugu State University of Science and Technology Agbani, Enugu State, Nigeria.

Ali Ibeabuchi Jude

Department of Pharmaceutical Chemistry, Enugu State University of Science and Technology Agbani, Enugu State, Nigeria.

*Author to whom correspondence should be addressed.

---

Abstract

The medical term for elevated blood pressure is hypertension (HTN). It is risky because it puts too much strain on the heart and causes atherosclerosis, which is the hardening of the arteries, in addition to raising the risk of heart disease and stroke. Other diseases like, congestive heart failure, renal disease, and blindness can also arise due to HTN. Standard antihypertensive drugs frequently have a number of adverse effects. About 75-80%of the world's population, mostly in underdeveloped nations, use herbal medicines for primary health care because of its higher tolerance by the human body and fewer adverse effects. Research on native plants with hypotensive and antihypertensive therapeutic benefits has received a lot of focused attention during the past three decades. It has been prove by previous researchers that some of these medicinal herbs have hypotensive and antihypertensive properties. To evaluate the efficacy and clarify the safety profile of such herbal treatments for their antihypertensive potential, more scientific study along with Ayurveda expertise must combined with modern medicine.

Keywords: Antihypertensive, hypertension, medicinal plants

---

---

---

References

Li W, Zhao J, Song L, Chen S, Liu X, Wu S. Combined effects of carotid plaques and hypertension on the risk of cardiovascular disease and all‐cause mortality. Clin Cardiol. 2020;43(7):715–22.

Ge Z, Hao Y, Cao J, Li J, Chen J, Huang J, et al. Does cigarette smoking exacerbate the effect of blood pressure on the risk of cardiovascular and all-cause mortality among hypertensive patients? J Hypertens. 2012;30(12):2307–13.

Mills KT, Stefanescu A, He J. The global epidemiology of hypertension. Nat Rev Nephrol. 2020;16(4):223–37.

Mills KT, Bundy JD, Kelly TN, Reed JE, Kearney PM, Reynolds K, et al. Global disparities of hypertension prevalence and control: a systematic analysis of population-based studies from 90 countries. Circulation. 2016;134(6): 441–50.

Samadian F, Dalili N, Jamalian A. Lifestyle modifications to prevent and control hypertension. Iran J Kidney Dis. 2016;10(5).

Schutte AE, Srinivasapura Venkateshmurthy N, Mohan S, Prabhakaran D. Hypertension in low-and middle-income countries. Circ Res. 2021;128(7):808–26.

Bowry ADK, Lewey J, Dugani SB, Choudhry NK. The burden of cardiovascular disease in low-and middle-income countries: epidemiology and management. Can J Cardiol. 2015;31(9): 1151–9.

Guwatudde D, Nankya-Mutyoba J, Kalyesubula R, Laurence C, Adebamowo C, Ajayi I, et al. The burden of hypertension in sub-Saharan Africa: a four-country cross sectional study. BMC Public Health. 2015;15:1–8.

Bedane SN. Out of pocket expenditures among hypertensive patients and their households who visit public hospitals in Addis Ababa, Ethiopia, 2016. Heal Econ Outcome Res Open Access. 2018;4(1): 1–7.

Ogah OS, Rayner BL. Recent advances in hypertension in sub-Saharan Africa. Heart. 2013;99(19):1390–7.

Desormais I, Amidou SA, Houehanou YC, Houinato SD, Gbagouidi GN, Preux PM, et al. The prevalence, awareness, management and control of hypertension in men and women in Benin, West Africa: the TAHES study. BMC Cardiovasc Disord. 2019;19(1):1–12.

Mv SP, Mwinuka VJ. Prevalence of Controlled Systemic Hypertension and its Associated Risk Factors among Hypertensive Patients at Mbeya Zonal Referral Hospital, Tanzania. Syst Rev Pharm. 2021;12(11):3686–90.

Ajayi TO, Moody JO, Anthony CS. Ethnobotanical survey of plants used in the management of hypertension in Ibadan North Local Government Area of Oyo State, Nigeria. Niger J Pharm Res. 2019; 15(1):61–73.

Adeloye D, Basquill C, Aderemi A V, Thompson JY, Obi FA. An estimate of the prevalence of hypertension in Nigeria: a systematic review and meta-analysis. J Hypertens. 2015;33(2):230–42.

Princewel F, Cumber SN, Kimbi JA, Nkfusai CN, Keka EI, Viyoff VZ, et al. Prevalence and risk factors associated with hypertension among adults in a rural setting: the case of Ombe, Cameroon. Pan Afr Med J. 2019;34.

Khan QA, Khan AA, Jabeen A, Jahangir U, Khalid M, Ansari S. Essential hypertension: a co relational approach in Unani medicine. Int J Pharmacogn. 2016; 3(6):240–5.

Tabassum N, Ahmad F. Role of natural herbs in the treatment of hypertension. Pharmacogn Rev. 2011;5(9):30.

Barton M, Husmann M, Meyer MR. Accelerated vascular aging as a paradigm for hypertensive vascular disease: prevention and therapy. Can J Cardiol. 2016;32(5):680–6.

Zhu Y, Gu X, Xu C. Mitochondrial DNA 7908–8816 region mutations in maternally inherited essential hypertensive subjects in China. BMC Med Genomics. 2018;11(1):1–11.

Nandhini S. Essential hypertension-a review article. J Pharm Sci Res. 2014; 6(9):305.

Saxena T, Ali AO, Saxena M. Pathophysiology of essential hypertension: an update. Expert Rev Cardiovasc Ther. 2018;16(12):879–87.

Ferder L, Ferder MD, Inserra F. The role of high-fructose corn syrup in metabolic syndrome and hypertension. Curr Hypertens Rep. 2010;12:105–12.

Le MT, Frye RF, Rivard CJ, Cheng J, McFann KK, Segal MS, et al. Effects of high-fructose corn syrup and sucrose on the pharmacokinetics of fructose and acute metabolic and hemodynamic responses in healthy subjects. Metabolism. 2012;61(5): 641–51.

Hegde S, Ahmed I, Aeddula N. Secondary hypertension. StatPearls. 2023;

Zhang M, Wong HS, Malakar RD, Puar TH. Secondary Causes of Hypertension: An Overview. Hypertens Cardiovasc Dis Asia. 2022;197–207.

Anthony J, Sliwa K. Decompensated heart failure in pregnancy. Card Fail Rev. 2016;2(1):20.

Singh M, Mensah GA, Bakris G. Pathogenesis and clinical physiology of hypertension. Cardiol Clin. 2010;28(4): 545–59.

Pimenta E, Oparil S. Role of aliskiren in cardio-renal protection and use in hypertensives with multiple risk factors. Vasc Health Risk Manag. 2009;453–63.

Tuck ML. The sympathetic nervous system in essential hypertension. Am Heart J. 1986;112(4):877–86.

Takahashi H. Sympathetic hyperactivity in hypertension. Nihon Rinsho. 2008;66(8): 1495–502.

Sharma I, Parashar B, Dhamija HK, Sharma R. An ayurvedic arena for hypertension treatment. Asian J Pharm Res. 2012;2(2):54–8.

Ghadieh AS, Saab B. Evidence for exercise training in the management of hypertension in adults. Can Fam Physician. 2015;61(3):233–9.

Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Böhm M, et al. 2013 ESH/ESC practice guidelines for the management of arterial hypertension: ESH-ESC the task force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Blood Press. 2014;23(1):3–16.

Düsing R. Overcoming barriers to effective blood pressure control in patients with hypertension. Curr Med Res Opin. 2006; 22(8):1545–53.

Singh P, Mishra A, Singh P, Goswami S, Singh A, Tiwari KD. Hypertension and herbal plant for its treatment: a review. Indian J Res Pharm Biotechnol. 2015; 3(5):358.

Sultana S, Muhammad Asif H. Medicinal plants combating against hypertension: A green antihypertensive approach. Pak J Pharm Sci. 2017;30(6).

Rastogi S, Pandey MM, Rawat AKS. Traditional herbs: a remedy for cardiovascular disorders. Phytomedicine. 2016;23(11):1082–9.

Nasri H, Baradaran A, Shirzad H, Rafieian-Kopaei M. New concepts in nutraceuticals as alternative for pharmaceuticals. Int J Prev Med. 2014;5(12):1487.

Abubakar MG, Ukwuani AN, Mande UU. Antihypertensive activity of Hibiscus Sabdariffa aqueous calyx extract in Albino rats. Sky J Biochem Res. 2015;4(3): 16–20.

Farnsworth NR, Akerele O, Bingel AS, Soejarto DD, Guo Z. Medicinal plants in therapy. Bull World Health Organ. 1985; 63(6):965.

Arias-Durán L, Estrada-Soto S, Hernández-Morales M, Millán-Pacheco C, Navarrete-Vázquez G, Villalobos-Molina R, et al. Antihypertensive and vasorelaxant effect of leucodin and achillin isolated from Achillea millefolium through calcium channel blockade and NO production: In vivo, functional ex vivo and in silico studies. J Ethnopharmacol. 2021;273: 113948.

Nwokocha CR, Ozolua RI, Owu DU, Nwokocha MI, Ugwu AC. Antihypertensive properties of Allium sativum (garlic) on normotensive and two kidney one clip hypertensive rats. Niger J Physiol Sci. 2011;26(2):213–8.

El-Saber Batiha G, Magdy Beshbishy A, G. Wasef L, Elewa YHA, A. Al-Sagan A, Abd El-Hack ME, et al. Chemical constituents and pharmacological activities of garlic (Allium sativum L.): A review. Nutrients. 2020;12(3):872.

Cahyawati PN. A Mini Review: Efek Farmakologi Andrographis Paniculata (Sambiloto). WICAKSANA J Lingkung dan Pembang. 2021;5(1):19–24.

Verma T, Sinha M, Bansal N, Yadav SR, Shah K, Chauhan NS. Plants used as antihypertensive. Nat Products Bioprospect. 2021;11:155–84.

Sokpe A, Mensah MLK, Koffuor GA, Thomford KP, Arthur R, Jibira Y, et al. Hypotensive and antihypertensive properties and safety for use of Annona muricata and Persea americana and their combination products. Evidence-Based Complement Altern Med. 2020;2020:1–13.

Adefegha SA, Oyeleye SI, Oboh G. Distribution of phenolic contents, antidiabetic potentials, antihypertensive properties, and antioxidative effects of soursop (Annona muricata L.) fruit parts in vitro. Biochem Res Int. 2015;2015.

Makarova EI, Bokov DO, Sergunova E V, Chevidaev V V, Kakhramanova SD, Bessonov V V, et al. Apium graveolens L.: A phytochemical and pharmacological review. Res J Pharm Technol. 2022;15(2):927–34.

Siddesha JM, Angaswamy N, Vishwanath BS. Phytochemical screening and evaluation of in vitro angiotensin-converting enzyme inhibitory activity of Artocarpus altilis leaf. Nat Prod Res. 2011;25(20):1931–40.

Xingfei L, Shunshun P, Wenji Z, Lingli S, Qiuhua L, Ruohong C, et al. Properties of ACE inhibitory peptide prepared from protein in green tea residue and evaluation of its anti-hypertensive activity. Process Biochem. 2020;92:277–87.

Upadhyay RK. Kareel plant: A natural source of medicines and nutrients. Int J Green Pharm. 2011;5(4).

Gilani AH, Jabeen Q, Ghayur MN, Janbaz KH, Akhtar MS. Studies on the antihypertensive, antispasmodic, bronchodilator and hepatoprotective activities of the Carum copticum seed extract. J Ethnopharmacol. 2005;98(1–2):127–35.

Ahmad S, Hassan A, Abbasi WM, Rehman T. Phytochemistry and pharmacological potential of Cassia absus–a review. J Pharm Pharmacol. 2018;70(1):27–41.

Ntchapda F, Barama J, Azambou DRK, Etet PFS, Dimo T. Diuretic and antioxidant activities of the aqueous extract of leaves of Cassia occidentalis (Linn.) in rats. Asian Pac J Trop Med. 2015;8(9):685–93.

Shivaprasad HN, Pandit S, Bhanumathy M, Manohar D, Jain V, Thandu SA, et al. Ethnopharmacological and phytomedical knowledge of Coleus forskohlii: an approach towards its safety and therapeutic value. Orient Pharm Exp Med. 2014;14(4):301–12.

Khatoon T, Naskar A, Datta K, Kumar D, Kaur G, Karmakar P, et al. A Short Review on Role of Some Natural Herbs in the Treatment of Hypertension. Asian J Pharm Res Dev. 2022;10(3):88–93.

Mahleyuddin NN, Moshawih S, Ming LC, Zulkifly HH, Kifli N, Loy MJ, et al. Coriandrum sativum L.: A review on ethnopharmacology, phytochemistry, and cardiovascular benefits. Molecules. 2021;27(1):209.

Wang T, Zhang P, Zhao C, Zhang Y, Liu H, Hu L, et al. Prevention effect in selenite-induced cataract in vivo and antioxidative effects in vitro of Crataegus pinnatifida leaves. Biol Trace Elem Res. 2011;142:106–16.

Ndjenda Ii MK, Nguelefack-Mbuyo EP, Atsamo AD, Fofie CK, Fodem C, Nguemo F, et al. Antihypertensive Effects of the Methanol Extract and the Ethyl Acetate Fraction from Crinum zeylanicum (Amaryllidaceae) Leaves in L-NAME-Treated Rat. Evidence-Based Complement Altern Med. 2021;2021.

Hosseini A, Razavi BM, Hosseinzadeh H. Saffron (Crocus sativus) petal as a new pharmacological target: A review. Iran J Basic Med Sci. 2018;21(11):1091.

Srivastava R, Ahmed H, Dixit RK, Saraf SA. Crocus sativus L.: a comprehensive review. Pharmacogn Rev. 2010;4(8): 200.

Dzeufiet PDD, Mogueo A, Bilanda DC, Aboubakar B-FO, Tédong L, Dimo T, et al. Antihypertensive potential of the aqueous extract which combine leaf of Persea americana Mill.(Lauraceae), stems and leaf of Cymbopogon citratus (DC) Stapf.(Poaceae), fruits of Citrus medical L.(Rutaceae) as well as honey in ethanol and sucrose experiment. BMC Complement Altern Med. 2014;14:1–12.

Gilani AH, Shaheen F, Saeed SA, Bibi S, Sadiq M, Faizi S. Hypotensive action of coumarin glycosides from Daucus carota. Phytomedicine. 2000;7(5):423–6.

Hansen K, Nyman U, Smitt UW, Adsersen A, Gudiksen L, Rajasekharan S, et al. In vitro screening of traditional medicines for anti-hypertensive effect based on inhibition of the angiotensin converting enzyme (ACE). J Ethnopharmacol. 1995;48(1): 43–51.

Kamyab R, Namdar H, Torbati M, Ghojazadeh M, Araj-Khodaei M, Fazljou SMB. Medicinal plants in the treatment of hypertension: A review. Adv Pharm Bull. 2021;11(4):601.

Rawat P, Singh PK, Kumar V. Anti-hypertensive medicinal plants and their mode of action. J Herb Med. 2016; 6(3):107–18.

Baradaran A, Nasri H, Rafieian-Kopaei M. Oxidative stress and hypertension: Possibility of hypertension therapy with antioxidants. J Res Med Sci Off J Isfahan Univ Med Sci. 2014;19(4):358.

Mans DRA, Sallevelt SCEH, Soekhoe R, Bipat R, Toelsie JR. Evaluation of plants with presumed antihypertensive properties for their potential to decrease peripheral resistance using isolated guinea pig aortic rings pre-contracted with phenylephrine. Acad J Suriname. 2010;1(1):15–9.

Silva S do N, Abreu IC, Freire SM de F, Cartágenes M do S de S, Ribeiro RM, Castro AS de, et al. Antispasmodic effect of Jatropha gossypiifolia is mediated through dual blockade of muscarinic receptors and Ca2+ channels. Rev Bras Farmacogn. 2011;21:715–20.

Wu Q, Patocka J, Nepovimova E, Kuca K. Jatropha gossypiifolia L. and its biologically active metabolites: A mini review. J Ethnopharmacol. 2019;234:197–203.

Vergara-Galicia J, Ortiz-Andrade R, Rivera-Leyva J, Castillo-España P, Villalobos-Molina R, Ibarra-Barajas M, et al. Vasorelaxant and antihypertensive effects of methanolic extract from roots of Laelia anceps are mediated by calcium-channel antagonism. Fitoterapia. 2010; 81(5):350–7.

Lim TK. Lavandula stoechas. In: Edible Medicinal and Non Medicinal Plants: Volume 8, Flowers. Springer; 2014. p. 192–201.

Talha J, Priyanka M, Akanksha A. Hypertension and herbal plants. Int Res J Pharm. 2011;2(8):26–30.

Wright CI, Van-Buren L, Kroner CI, Koning MMG. Herbal medicines as diuretics: a review of the scientific evidence. J Ethnopharmacol. 2007;114(1):1–31.

Das SK, Das B, Jena AB, Pradhan C, Sahoo G, Dandapat J. Therapeutic Potential and Ethnopharmacology of Dominant Mangroves of Bhitarkanika National Park, Odisha, India. Chem Biodivers. 2022;19(3):e202100857.

Manohar SM. A Review of the Botany, Phytochemistry and Pharmacology of Mangrove Lumnitzera racemosa Willd. Pharmacogn Rev. 2021;15(30).

Phachonpai W. Antihypertensive and vasoprotective effects of Clausena lansium fruits extract in L-NAME induced hypertensive rats. Pak J Pharm Sci. 2020;

Nguelefack-Mbuyo PE, Nguelefack TB, Dongmo AB, Afkir S, Azebaze AGB, Dimo T, et al. Anti-hypertensive effects of the methanol/methylene chloride stem bark extract of Mammea africana in L-NAME-induced hypertensive rats. J Ethnopharmacol. 2008;117(3):446–50.

Kumolosasi E, Wei CC, Abdullah AZ, Abd Manap NS, Lee WL, Yousuf MH, et al. Antihypertensive activities of standardised Moringa oleifera Lam.(merunggai) extracts in spontaneously hypertensive rats. Sains Malays. 2021;50(3):769–78.

Aekthammarat D, Pannangpetch P, Tangsucharit P. Moringa oleifera leaf extract lowers high blood pressure by alleviating vascular dysfunction and decreasing oxidative stress in L-NAME hypertensive rats. Phytomedicine. 2019; 54:9–16.

Ma K, Wang Y, Wang M, Wang Z, Wang X, Ju X, et al. Antihypertensive activity of the ACE–renin inhibitory peptide derived from Moringa oleifera protein. Food Funct. 2021;12(19):8994–9006.

Ivanov M, Vajic U-J, Mihailovic-Stanojevic N, Miloradovic Z, Jovovic D, Grujic-Milanovic J, et al. Highly potent antioxidant Olea europaea L. leaf extract affects carotid and renal haemodynamics in experimental hypertension: the role of oleuropein. EXCLI J. 2018;17:29.

Susalit E, Agus N, Effendi I, Tjandrawinata RR, Nofiarny D, Perrinjaquet-Moccetti T, et al. Olive (Olea europaea) leaf extract effective in patients with stage-1 hypertension: comparison with Captopril. Phytomedicine. 2011;18(4):251–8.

Bello I, Usman NS, Dewa A, Abubakar K, Aminu N, Asmawi MZ, et al. Blood pressure lowering effect and vascular activity of Phyllanthus niruri extract: The role of NO/cGMP signaling pathway and β-adrenoceptor mediated relaxation of isolated aortic rings. J Ethnopharmacol. 2020;250:112461.

Maimoona A, Naeem I, Saddiqe Z, Jameel K. A review on biological, nutraceutical and clinical aspects of French maritime pine bark extract. J Ethnopharmacol. 2011; 133(2):261–77.

Ng CF, Koon CM, Cheung DWS, Lam MY, Leung PC, Lau CBS, et al. The anti-hypertensive effect of Danshen (Salvia miltiorrhiza) and Gegen (Pueraria lobata) formula in rats and its underlying mechanisms of vasorelaxation. J Ethnopharmacol. 2011;137(3):1366–72.

Bebrevska L, Foubert K, Hermans N, Chatterjee S, Van Marck E, De Meyer G, et al. In vivo antioxidative activity of a quantified Pueraria lobata root extract. J Ethnopharmacol. 2010;127(1):112–7.

Mayasankaravalli C, Deepika K, Lydia DE, Agada R, Thagriki D, Govindasamy C, et al. Profiling the phyto-constituents of Punica granatum fruits peel extract and accessing its in-vitro antioxidant, anti-diabetic, anti-obesity, and angiotensin-converting enzyme inhibitory properties. Saudi J Biol Sci. 2020;27(12):3228–34.

Kaur A. Pharmacobotanical and pharmacological evaluation of ayurvedic crude drug: Rauwolfia serpentina (Apocynaceae). Int J Green Pharm. 2017;11(04).

Shah SMA, Naqvi SAR, Munir N, Zafar S, Akram M, Nisar J. Antihypertensive and antihyperlipidemic activity of aqueous methanolic extract of Rauwolfia serpentina in albino rats. Dose-Response. 2020; 18(3):1559325820942077.

Elleuch M, Bedigian D, Zitoun A. Sesame (Sesamum indicum L.) seeds in food, nutrition, and health. In: Nuts and seeds in health and disease prevention. Elsevier; 2011. p. 1029–36.

Mushtaq A, Hanif MA, Ayub MA, Bhatti IA, Jilani MI. Sesame. In: Medicinal Plants of South Asia. Elsevier; 2020. p. 601–15.

Ibarrola DA, Arrua W, Gonzalez JE, Escobar MSS, Centurión J, Benitez AMC, et al. The antihypertensive and diuretic effect of crude root extract and saponins from Solanum sisymbriifolium Lam., in L-NAME-induced hypertension in rats. J Ethnopharmacol. 2022;298:115605.

Babich O, Larina V, Krol O, Ulrikh E, Sukhikh S, Gureev MA, et al. In Vitro Study of Biological Activity of Tanacetum vulgare Extracts. Pharmaceutics. 2023;15(2):616.

Ishaq S, Jafri L. Biomedical importance of cocoa (Theobroma cacao): significance and potential for the maintenance of human health. Matrix Sci Pharma. 2017; 1(1):1–5.

Loh YC, Ch’ng YS, Tan CS, Ahmad M, Asmawi MZ, Yam MF. Mechanisms of action of Uncaria rhynchophylla ethanolic extract for its vasodilatory effects. J Med Food. 2017; 20(9):895–911.

Ndagijimana A, Wang X, Pan G, Zhang F, Feng H, Olaleye O. A review on indole alkaloids isolated from Uncaria rhynchophylla and their pharmacological studies. Fitoterapia. 2013;86:35–47.

Poruthukaren KJ, Palatty PL, Baliga MS, Suresh S. Clinical evaluation of Viscum album mother tincture as an antihypertensive: a pilot study. J Evid Based Complementary Altern Med. 2014; 19(1):31–5.

Yeh H, Chuang C, Chen H, Wan C, Chen T, Lin L. Bioactive components analysis of two various gingers (Zingiber officinale Roscoe) and antioxidant effect of ginger extracts. LWT-Food Sci Technol. 2014; 55(1):329–34.

Dhanik J, Arya N, Nand V. A review on Zingiber officinale. J Pharmacogn Phytochem. 2017;6(3):174–84.