Effects of artichoke on blood pressure: A systematic review and meta-analysis

Exploring the Cardiovascular Potential of Artichoke-A Comprehensive Review

Cardiovascular disease remains a leading cause of morbidity and mortality worldwide, requiring both pharmacological and lifestyle-based preventive strategies. Artichoke (Cynara cardunculus L. var. scolymus) has gained attention for its health benefits, including choleretic and lipid-lowering activities. However, its cardiovascular effects remain underdiscussed. This paper provides a critical review of the current literature on the cardiovascular effects of artichoke, with a focus on its underlying mechanisms of action and clinical efficacy. Experimental studies assessing artichoke's effects on endothelial function, vascular smooth muscle relaxation, and modulation of the renin-angiotensin-aldosterone axis were assessed. Additionally, clinical studies, systematic reviews, and meta-analyses investigating its antihypertensive effects were reviewed. Artichoke and its bioactive components, particularly flavonoids and caffeoylquinic acids, enhance endothelial-dependent and -independent vasorelaxation and inhibit angiotensin-converting enzyme activity. Although clinical studies indicate improvements in flow-mediated dilation, they report only modest reductions in blood pressure, with high variability in formulations, dosages, and patient populations. While artichoke supplementation may support blood pressure regulation and endothelial health, current evidence suggests it should be considered an adjunct rather than a replacement for conventional antihypertensive therapy. Standardized formulations and well-controlled clinical studies will be required to clarify its therapeutic role.

Evaluating Bioactive-Substance-Based Interventions for Adults with MASLD: Results from a Systematic Scoping Review

Objective: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a chronic condition affecting a broad population. This review aimed to identify and summarize the current evidence on bioactive-substance-based interventions for adults with MASLD, formerly known as nonalcoholic fatty liver disease (NAFLD), covering publications from 2000 to 2023. Methods: A search was conducted across six databases (MEDLINE, CINAHL, Cochrane CENTRAL, Cochrane Database of Systematic Reviews, Food Science Source, and SPORTDiscus) for randomized controlled trials and other study types (e.g., prospective cohort studies and systematic reviews), reflecting the scoping nature of this review. The search was limited to studies in adults (>18 years old), with an intervention of interest and at least one comparator group. Results: A total of 4572 articles were retrieved, with 201 full-text articles screened for eligibility. Of these, 131 primary studies and 49 systematic reviews were included in the scoping review. The most studied bioactive substances were Curcumin (Turmeric) (n = 25), Silymarin (Milk Thistle) (n = 17), Resveratrol (n = 10), Coffee (n = 7), Green Tea (n = 5), and Berberine (n = 5 each). Moreover, 46 studies reported on 36 other bioactive substances with 2 or fewer articles each. Among the included systematic reviews, 13 focused on Curcumin, 12 on Coffee or Tea, 10 on bioactive substance combinations, 6 on Resveratrol, and 2 each on Silymarin and Artichoke Leaf. The included studies showed substantial heterogeneity in reported outcomes, which primarily focused on hepatic health, body weight, adverse events, glycemic control, blood lipids, and body composition. Conclusions: This scoping review highlights a range of bioactive substances used in the treatment of MASLD. While evidence is abundant for bioactive substances like Curcumin and Silymarin, further research and synthesis of findings is necessary to establish the clinical efficacy of all bioactive substances.

An Overview of the Versatility of the Parts of the Globe Artichoke (Cynara scolymus L.), Its By-Products and Dietary Supplements

Cynara scolymus, also known as the globe artichoke or artichoke, is grown as a food, mainly in the Mediterranean, Canary Islands, and Egypt, as well as in Asia and South America. It has also been associated with various health benefits and is used in plant-based dietary supplements and herbal infusions. Its edible parts, consisting of the head or capitula, flower, and leaves, have shown various biological activities, including anti-cancer, hepatoprotective and antimicrobial potential. The leaves are mainly used in infusions and extracts for their health-promoting properties, although all their edible parts may also be consumed as fresh, frozen, or canned foods. However, its primary health-promoting activity is associated with its antioxidant potential, which has been linked to its chemical composition, particularly its phenolic compounds (representing 96 mg of gallic acid equivalent per 100 g of raw plant material) and dietary fiber. The main phenolic compounds in the heads and leaves are caffeic acid derivatives, while the flavonoids luteolin and apigenin (both present as glucosides and rutinosides) have also been identified. In addition, heat-treated artichokes (i.e., boiled, steamed or fried), their extracts, and waste from artichoke processing also have antioxidant activity. The present paper reviews the current literature concerning the biological properties of different parts of C. scolymus, its by-products and dietary supplements, as well as their chemical content and toxicity. The literature was obtained by a search of PubMed/Medline, Google Scholar, Web of Knowledge, ScienceDirect, and Scopus, with extra papers being identified by manually reviewing the references.

Evidence on the use of alternative substances and therapies in hypertension

OBJECTIVE

Review of some of the best-known biological and non-biological complementary/alternative therapies/medicines (CAM) and their relationship with blood pressure (BP) and hypertension (HT).

SEARCH STRATEGY

Narrative review assessing a recent series of systematic reviews, meta-analyses, and clinical trials published in recent years, focusing on the effects of CAM on BP and HT.

SELECTION OF STUDIES

We searched EMBASE, MEDLINE, Cochrane Library and Google Scholar, obtaining a total of 4336 articles, finally limiting the search to 181 after applying filters.

SYNTHESIS OF RESULTS

Some studies on biological therapies show some usefulness in BP reduction with an adequate benefit-risk balance, although there is a scarcity of high-quality trials that support these results. Some mind-body therapies have shown hypothetical benefit; in contrast, others lack robust evidence.

CONCLUSIONS

Although some therapies present a reasonable risk-benefit ratio, they should in no case replace pharmacological treatment when indicated.

The Effect of Herbal Supplements on Blood Pressure: Systematic Review and Meta-Analysis

Herbal supplements rich in phenolic compounds are evidenced to have a protective effect against cardiovascular diseases. Therefore, they are suggested to be included in diets for people with hypertension (HT). HT is a global health problem and is estimated to affect billions of people until the end of 2025. For this reason, every possible and effective solution preventing HT should be considered. The aim was to perform an updated meta-analysis and review of recently published studies to evaluate the effect of selected herbal supplements on blood pressure reduction. We searched the PubMed database with specified selection criteria, analysing the RCT studies from 2011 to 2021. A total of 31 studies were included in the analysis, and the meta-analysis was conducted on the data from 16 of them. The general effect size of all the supplements via placebo was d = 1.45, p < 0.05 for systolic blood pressure (SBP) and d = 0.31, p < 0.05 for diastolic blood pressure (DBP). The meta-analysis and review of the literature demonstrated that herbal supplements, such as resveratrol, cherry juice, beetroot juice, bergamot extracts, barberry, and pycnogenol, can be effective in blood pressure reduction and cardiovascular prevention, but attention should be paid to their appropriate dosage due to the possibility of side effects from the digestive system.