Ethnobotany of Anti-hypertensive Plants Used in Northern Pakistan

Plants Used for Treating Hypertension Among Ethnic Groups in Northern Thailand

The incidence of hypertension (HT) is rapidly increasing globally, and it is considered to be a critical public health problem. Due to the demand for medication and because various side effects of anti-hypertensive drugs have been reported, complementary and alternative therapies, including Thai Indigenous medicine (TIM), should be explored for treating HT. Medicinal plants traditionally used by multiple cultures over long time periods in HT treatment are more likely to be pharmacologically active and might provide useful data, leading to anti-hypertensive drug discovery. Ethnomedicinal field observations were undertaken with 41 key informants in eleven villages in Chiang Mai province from December 2022 to November 2023. In addition, we gathered data on traditional plants used for treating HT among 12 ethnic groups from 41 original references published between 1987 and 2023, covering nine provinces in northern Thailand. Important species among plants used for treating hypertension were identified by calculating their relative frequency of citation (RFC). In total, we found 237 plant species that were used for treating HT. Of these, 173 species had already been reported in the literature, and 96 species were documented in our fieldwork. There were 30 plant species from our field survey that overlapped with species accounted for in the literature. Fabaceae was the plant family with the most species (23 sp, 10%) used for treating HT. The most commonly used species was Blumea balsamifera (L.) DC. (Asteraceae), and it had the highest recorded RFC value of 0.1979. There were 64 plant species that were reported for the first time for HT treatment among ethnic groups in northern Thailand. Of the recorded species, 24 were particularly promising in the treatment of HT, and their efficacy was confirmed by comparing our results to previous studies of plants with anti-hypertensive properties.

Indigenous medicinal plants used in folk medicine for malaria treatment in Kwara State, Nigeria: an ethnobotanical study

BACKGROUND

Folk medicine is crucial to healthcare delivery in the underdeveloped countries. It is frequently used as a primary treatment option or as a complementary therapy for malaria. Malaria is a deadly disease which greatly threatens global public health, claiming incredible number of lives yearly. The study was aimed at documenting the medicinal plants used for malaria treatment in folk medicine in Kwara State, Nigeria.

METHODS

Ethnobotanical information was collected from selected consenting registered traditional medicine practitioners (TMPs) through oral face-to-face interviews using in-depth, semi-structured interview guide. The ethnobotanical data were analysed, and descriptive statistical methods were used to compile them.

RESULTS

Sixty-two indigenous medicinal plants, including 13 new plants, used for malaria treatment were identified in this study. The TMPs preferred decoction in aqueous solvent (34%) and steeping in decaffeinated soft drink (19%) for herbal preparations. Oral administration (74%) was the main route of administration, while leaves (40%) and stem barks (32%) were the most dominant plant parts used in herbal preparations. The most cited families were Fabaceae (15%) and Rutaceae (6%), while Mangifera indica (77.14%), Enantia chlorantha (65.71%), Alstonia boonei (57.14%) followed by Cymbopogon citratus (54.29%) were the most used plants. Besides, the antimalarial activities of many of the plants recorded and their isolated phytocompounds have been demonstrated. Furthermore, the conservation status of 4 identified plants were Vulnerable.

CONCLUSION

The study showed strong ethnobotanical knowledge shared by the TMPs in the State and provides preliminary information that could be explored for the discovery of more potent antimalarial compounds.

Assessment of Antidiabetic Potential and Phytochemical Profiling of Viscum album, a Traditional Antidiabetic Plant

The traditional antidiabetic plant Viscum album (V. album) was collected from the oak plant in the wild at Maidan, Khyber District, of Pakistan, for assessment of its antidiabetic potential and phytochemical profile. Lowering of blood glucose level, antioxidant effect, lipids profile, liver function marker enzymes, and kidney function markers were evaluated in extract and glibenclamide treated groups, in normal as well as in diabetic control groups. An elevated level of blood glucose level, lipids (Cholesterol, TG, LDL), liver function marker enzymes (ALT, AST, ALP), and kidney function markers (bilirubin, creatinine, urea) were observed in alloxan-induced diabetic rats; however, a HDL level was decreased. Administration of V. album hydroalcoholic extract for 28 days renovated significantly ( $p<0.05$ ) all the above biochemical parameters. The antioxidant enzymes SOD, CAT, and GPX were also considerably restored. In vitro, antioxidant assay indicated that the extract of 2,000 µg/mL scavenges free radicals of DPPH 68.4%, ABTS 69.5%, and H2O2 50.6%. The extracts revealed the presence of saponins, flavonoids, alkaloids, terpene, tannins, phenols, protein, amino acids, sterols, and glycosides. The extract has shown phenolic contents 421 ± 4.8 mg GAE/100 g d. w and flavonoids content 127 ± 1.4 mg equiv. Rut/100 g d. w. The findings of this research recommend V. album could be a potent source of natural antidiabetic constituents.

Nutmeg (Myristica fragrans Houtt.) essential oil: A review on its composition, biological, and pharmacological activities

Myristica fragrans (Houtt.) is an evergreen tree native to the Maluku Islands, Indonesia. M. fragrans kernel is extensively used in Indian traditional medicines to treat various diseases. Several studies attempt to compile and interpret the pharmacological potential of Myristica fragrans (Houtt.) aqueous and various chemical extracts. Thus, the pharmacological potential of nutmeg essential oil has not been reviewed phytochemically and pharmacologically. Therefore, the present study aimed to share appropriate literature evidence regarding the plant essential oil chemical composition and therapeutic potential of Myristica fragrans essential oil (MFEO). MFEO of leaf, mace, kernel, and seed were used worldwide as potential Ayurvedic medicine and fragrance. MFEO extracted by various methods and oil yield was 0.7–3.2, 8.1–10.3, 0.3–12.5, and 6.2–7.6% in leaf, mace, seed, and kernel. The primary chemical constituents of MFEO were sabinene, eugenol, myristicin, caryophyllene, β‐myrcene, and α‐pinene. Clinical and experimental investigations have confirmed the antioxidant, antimicrobial, antiinflammatory, anticancer, antimalarial, anticonvulsant, hepatoprotective, antiparasitic, insecticidal, and nematocidal activities of MFEO. It is the first attempt to compile oil yield, composition, and the biological activities of MFEO. In future, several scientific investigations are required to understand the mechanism of action of MFEO and their bioactive constituents.

Medicinal Animals and Plants as Alternative and Complementary Medicine in Southern Regions of Khyber Pakhtunkhwa, Pakistan

Background: Local communities use animals and plants as common traditional therapies for various diseases. The study aimed to document animals and animal-plant mixture recipes that are used as alternative and complementary medicine in southern regions of Khyber Pakhtunkhwa, Pakistan.

Methods: The data were collected (2017–2018) in three remote areas (Dera Ismail Khan, Bannu, and Lakki Marwat) through questionnaires and face-to-face interviews with local inhabitants. Data on ethnomedicinal uses and cultural values of animal products or parts and their mixture with plants were analyzed using various indices such as frequency of citation (FC), informant consensus (FIC), and fidelity level (FL) to find the highly preferred species in the area.

Results: A total of 185 informants (117 females and 68 males) were interviewed. The study documented 32 animal species, vertebrates (n = 24) and invertebrates (n = 8), for curing 37 types of diseases. Mammals (n = 13) were among the most commonly utilized species followed by birds (n = 8), arthropods (n = 7), reptiles (n = 2), and fishes and annelids (n = 1 each). Among the reported animals, Herpestes edwardsi (mongoose), Macaca mulatta (monkey), Labeo rohita (rohu), Oryctolagus cuniculus (rabbit), and Streptopelia decaocto (dove) were the newly reported species used as alternative medicine. The meat of Capra hircus (goat), monkey, and rabbit was used to treat chronic diseases such as hepatitis C, cancer, epilepsy, and asthma. A total of 17 plants belonging to 15 botanical families were used in combination with animal parts/products. The commonly used families were Piperaceae (31%) followed by Apiaceae (27%). The notable plant species in combination with animal products were Curcuma longa, Piper nigrum, Coriandrum sativum, Brassica rapa, and Phoenix dactylifera. Seeds were the highest used part in animal-plant mixture recipes. Gallus gallus (chicken) and Columba livia (pigeon) secured the highest (FC = 28) and (FL = 80%), respectively. FIC results had shown the highest degree of consensus for general body weakness (FIC = 0.88) and pyrexia (FIC = 0.86).

Conclusion: Our findings suggest that local communities in the southern regions of Khyber Pakhtunkhwa have substantial knowledge about the formulation of ethnomedicines from both flora and fauna that need urgent documentation to avoid eroding and for conservational purposes. The newly reported phytozootherapeutic recipes and animal species can potentially be a source of pharmacologically active constituents and should be checked experimentally for further confirmation.

Phytochemical evaluation and anticancer activity of rambutan (Nephelium lappaceum) fruit endocarp extracts against human hepatocellular carcinoma (HepG-2) cells

The current investigation was taken to screen the phytoconstituents present in fruit endocarp various extracts of Nephelium lappaceum commonly called as Rambutan fruit and its anticancer property against human hepatocellular carcinoma (HepG-2) cells. Different analytical techniques including qualitative phytochemical analysis, cell viability assay (MTT), apoptotic nuclear staining (DAPI), DNA fragmentation assay, Attenuated total reflection (ATR) and Gas chromatography–mass spectrometry (GC–MS) spectral analysis were carried out. ATR and GC–MS study revealed the presence of functional groups and 9 compounds, respectively in methanol endocarp extract. The results obtained depicts that methanol endocarp extract profoundly controlled cell proliferation and caused shrinkage of HepG-2 cells from polygonal to spherical shape. DAPI staining revealed that methanol endocarp extract caused increased fragmentation of nucleus and DNA fragmentation, which can be taken as a sign of apoptosis. The anticancer potential of methanol fruit endocarp extract of Nephelium lappaceum than other extracts and could be used successfully in future drug delivery systems and other biomedical concerns.

Nephroprotective effect of persimmon leaves (Diospyros kaki L.f.) against CCl4-induced renal toxicity in Swiss Albino rats

Diospyros kaki L.f. fruit and leaves are traditionally used for the treatment of hypertension, angina, internal hemorrhage, antithrombotic and anti-inflammatory effects.In the current study, the protective effects of ethyl acetate (Per-1), n-butanol (Per-2), and aqueous (Per-3) fractions of Diospyros kaki leaves against carbon tetrachloride (CCl₄) induced nephrotoxicity in Swiss albino rats were tested. Animal were divided into nine groups; each group consists of six animals. The groups were : group I was untreated and kept as control, group II was treated with CCl₄ only, group III (silymarin with CCl₄); group IV (Per-1 100 mg/kg with CCl₄);group V (Per-1 200 mg/kg with CCl₄); group VI (Per-2 100 mg/kg with CCl₄); group VII (Per-2 200 mg/kg with CCl₄); group VIII (Per-3 100 mg/kg with CCl₄); and group IX (Per-3 200 mg/kg with CCl₄). Silymarin was used as standard drug. All tested fractions were found active (except Per-1 at low dose of 100 mg/kg) with significant value (p < 0.001) compared to CCl₄ only group. Serum creatinine, malondialdehyde (MDA), and uric acid were significantly (p < 0.001) lowered in group VII-IX as compared to CCl₄ only group. Similarly, total protein (TP) and non-protein sulfhydryls(NP-SH) level in kidney tissues were significantly (p < 0.001) elevated in the same groups compared to CCl₄ only group. Further to check the cardio-protective potential, biochemical parameters such as LDH, creatine kinase, TP, MDA, and NP-SH levels in myocardial tissues were also estimated.These findings confirmed that the n-butanol and aqueous fractions are active and recommended for further bioactive phytoconstituents screening. Repeated column chromatography on silica gel G and sephadex-LH-20 of the active n-butanol fraction, four flavonoids were isolated. Based on the spectroscopic NMR data, compounds were identified as kaempferol (1), quercetin (2), astragalin (3), and rutin (4).

Vhavenda Herbal Remedies as Sources of Antihypertensive Drugs: Ethnobotanical and Ethnopharmacological Studies

Hypertension is a dominant risk factor for the development of cardiovascular, kidney, and eye diseases. In Africa, it increasingly leads to hospitalisation and a strain on the public health system. However, rather than modern medicine, African traditional healers are the first choice for most South Africans. Therefore, this study is aimed at gathering information on herbal remedies traditionally used for the treatment of high blood pressure in Vhavenda, South Africa, and comparing this information with reports in the literature regarding plants used to manage high blood pressure. An ethnobotanical survey was carried out in Vhembe district and its environs with 53 herbalists and indigenous people aged between 36 and 66 years from January to October 2019 using a semistructured questionnaire. The plants were collected with each respondent; they were authenticated and kept in herbarium. A total of 51 different plants were mentioned as being most commonly used for hypertension treatment. Of these, 44 plants were identified, with those from the Fabaceae family followed by plants from the Celastraceae family being commonly mentioned. Of these, the Elaeodendron transvaalense, Tabernaemontana elegans, Elephantorrhiza elephantina, and Aloe vossii were commonly cited species. According to the literature data, most of the identified plants are yet to be scientifically investigated for the treatment of hypertension, whereas only preliminary investigations have been carried out on other plants, suggesting that these preliminary investigations may have highlight promising antihypertensive activities in vitro that are indicative of their potential as antihypertensive drugs. Therefore, there is a need to scientifically investigate the antihypertensive potentials of these plants as a potential source of antihypertensive treatment and compounds.

An ethnobotanical study of medicinal plants used by the Tengger tribe in Ngadisari village, Indonesia

The people of Tengger, Indonesia have used plants as traditional medicine for a long time. However, this local knowledge has not been well documented until recently. Our study aims to understand the utilization of plants in traditional medicine by the people of Tengger, who inhabit the Ngadisari village, Sukapura District, Probolinggo Regency, Indonesia. We conducted semi-structured and structured interviews with a total of 52 informants that represented 10% of the total family units in the village. The parameters observed in this study include species use value (SUV), family use value (FUV), plant part use (PPU), and the relative frequency of citation that was calculated based on fidelity level (FL). We successfully identified 30 species belonging to 28 genera and 20 families that have been used as a traditional medicine to treat 20 diseases. We clustered all the diseases into seven distinct categories. Among the recorded plant families, Poaceae and Zingiberaceae were the most abundant. Plant species within those families were used to treat internal medical diseases, respiratory-nose, ear, oral/dental, and throat problems. The plant species with the highest SUV was Foeniculum vulgare Mill. (1.01), whereas the Aloaceae family (0.86) had the highest FUV. Acorus calamus L. (80%) had the highest FL percentage. The leaves were identified as the most used plant part and decoction was the dominant mode of a medicinal preparation. Out of the plants and their uses documented in our study, 26.7% of the medicinal plants and 71.8% of the uses were novel. In conclusion, the diversity of medicinal plant uses in the Ngadisari village could contribute to the development of new plant-based drugs and improve the collective revenue of the local society.

A Review on the Potential Use of Medicinal Plants From Asteraceae and Lamiaceae Plant Family in Cardiovascular Diseases

Cardiovascular diseases are one of the most prevalent diseases worldwide, and its rate of mortality is rising annually. In accordance with the current condition, studies on medicinal plants upon their activity on cardiovascular diseases are often being encouraged to be used in cardiovascular disease management, due to the availability of medicinal values in certain dedicated plants. This review was conducted based on two plant families, which are Asteraceae and Lamiaceae, to study on their action in cardiovascular disease relieving activities, to review the relationship between the phytochemistry of Asteraceae and Lamiaceae families and their effect on cardiovascular diseases, and to study their toxicology. The medicinal plants from these plant family groups are collected based on their effects on the mechanisms that affect the cardiovascular-related disease which are an antioxidant activity, anti-hyperlipidemic or hypocholesterolemia, vasorelaxant effect, antithrombotic action, and diuresis effect. In reference to various studies, the journals that conducted in vivo or in vitro experiments, which were used to prove the specific mechanisms, are included in this review. This is to ensure that the scientific value and the phytochemicals of the involved plants can be seen based on their activity. As a result, various plant species from both Asteraceae and Lamiaceae plant family have been identified and collected based on their study that has proven their effectiveness and uses in cardiovascular diseases. Most of the plants have an antioxidant effect, followed by anti-hyperlipidemia, vasorelaxant, antithrombotic, and diuretic effect from the most available to least available studies, respectively. These are the mechanisms that contribute to various cardiovascular diseases, such as heart attack, stroke, coronary heart disease, and hypertension. Further studies can be conducted on these plant species by identifying their ability and capability to be developed into a new drug or to be used as a medicinal plant in treating various cardiovascular diseases.

Phytotherapy of Hypertension: An Updated Overview

BACKGROUND

Cardiovascular disorders are the leading cause of morbidity and mortality throughout the globe. Hypertension is the main risk factor that contributes to the development of many diseases. The use of herbal therapies, medicinal plants and their derivatives for the remedy and management of hypertension is well-recognized and popular among a wide part of the world population.

METHODS

The aim of the current review was to collect, treat, and critically analyze the published research studies relative to experimental and clinical investigations which have studied the blood pressure lowering abilities of medicinal plant derivatives in the last decade. This review was organized into three principal axes; the first axis was attributed to the in vivo and in vitro experimental studies; the second treated the clinical trials; while, the last one is devoted to analyze the mechanisms of action underlying the therapeutic antihypertensive effectiveness of phytochemicals.

RESULTS

Different types of extracts and isolated molecules obtained from a large variety of species demonstrated their efficiency in improving the increase of blood pressure either experimentally or clinically. Medicinal species such as garlic (Allium sativum), celery (Apium graveolens), Black Cumin (Nigella sativa) and Ginseng (Panax) are among the most common and therapeutically used plant derivatives for controlling hypertension while Asteraceae, Apiaceae and Rosaceae are among the botanical families which were frequently studied in the last decade. Isolated compounds such as allicin and apigenin have received more interest in this field. Recent evidence from clinical trials suggests that a wide variety of herbal preparations and plant extracts or natural isolated compounds have a favorable therapeutic impact on blood flow. Interestingly, phytochemicals can either act directly on blood vessels via a vasorelaxant effect involving a variety of signaling cascades or indirectly through inhibiting or stimulating diversity of systems such as angiotensin-converting enzyme (ACE), renin-angiotensin system (RAS) or the diuretic activity. Hence, based on the findings of the present review medicinal plant derivatives could be used as preventive and curative agents in the case of cardiovascular disorders, particularly hypertension and could play a promoting function for the discovery of new antihypertensive agents.

CONCLUSION

The analysis of the published data shows that a great effort remains to be done to investigate the medicinal plants cited as antihypertensive through published ethnopharmacological surveys. The analysis of the literature in this field shows the lack of standardization at the level of experimental study methods as well as the need to study purified molecules. Moreover, the mechanistic studies when they exist remain in the whole partial. On the other hand, few advanced clinical studies have been conducted. Finally, the determination of the efficacy/safety ratio remains absent in almost all studies.

An ethnobotanical study of medicinal plants used to treat skin diseases in northern Pakistan

Background

Skin diseases are a major health concern especially in association with human immune deficiency syndrome and acquired an immune deficiency. The aim of this study was to document the ethnomedicinal information of plants used to treat skin diseases in Northern Pakistan. This is the first quantitative ethnobotanical study of therapeutic herbs utilized by the indigenous people of Northern Pakistan for skin diseases.

Methods

Interviews were taken to obtain information from 180 participants. Quantitative methods including fidelity level (FL), Frequency of citation (FC), Use-value (UV), Jaccard indices (JI), Family importance value (FIV), Relative frequency of citation (RFC) and Chi-square test were applied. Medicinal plants uses are also compared with 50 national and international publications.

Results

In this study, we recorded 106 plant species belonged to 56 floral families for treatment of skin ailments. The dominant life form reported was herb while the preferred method of utilization was powder, along with leaf as the most used plant part. RFC ranges from 0.07 to 0.25% whereas the highest FIV was recorded for family Pteridaceae. FL values range from 36.8 to 100%. The study reported 88% of new plant reports for the treatment of skin diseases.

Conclusion

The present study revealed the importance of several plants used to treat skin diseases by the local communities of Northern Pakistan. The available literature supported the evidence of plant dermatological properties. Plants having high UV and RFC can be considered for further scientific analysis. There is dire need to create awareness among local, government and scientific communities for the preservation of medicinal species and ethnomedicinal knowledge in Northern Pakistan.

Electronic supplementary material

The online version of this article (10.1186/s12906-019-2605-6) contains supplementary material, which is available to authorized users.

Ethnopharmacological Survey of Herbal Remedies Used for the Treatment of Cancer in the Greater Casablanca-Morocco

Medicinal plants played an important role in traditional medicine for the treatment of diseases since antiquities. The aim of the study is to carry out an ethnobotanical survey on medicinal plants used traditionally in cancer treatment in the region of Greater Casablanca-Morocco, and to enhance the traditional herbal medicine knowledge. 110 traditional healers in the study area were interviewed face to face to response a survey questionnaire including the names of plants used in cancer treatment, used parts, methods of preparation, and route of administration. Indices of Fidelity Level (FL), Use Value (UV), and Relative Frequency of Citation (RFC) were calculated to identify the most effective plants used for cancer treatment. Eight species were specified including Aristolochia baetica, Aristolochia paucinervis, Bryonia dioica, Aquilaria malaccensis, Marrubium vulgare, Lavandula maroccana, Ephedra alata, and Euphorbia resinifera belonging to 7 families. Aristolochiaceae, Aquilariaceae, and Cucurbitaceae were the most useful families in cancer treatment with high significant indices of UV, FL, and RFC with values of 1, 100%, and 1, respectively. Roots and leaves were the most commonly used plant parts. Decoction and powder mixed with honey were the frequently used method for remedies preparation. The present study showed that the people living in Morocco's economic capital are still highly dependent on traditional herbal medicine for the treatment of cancer. Therefore, it seems that herbal medicine still plays a crucial role in the primary healthcare system for the local population. During this survey, it was reported that even some plant families are highly toxic for humans like Aristolochiaceae that are frequently used in cancer treatment in the study area. As many people still rely on natural traditional medicine considering (it is safe with no side effects), so combined effort between all social categories including scientists and traditional healers should be established for involving the scientific validity of the used plants in the treatment of diseases.

Antihypertensive Indigenous Lebanese Plants: Ethnopharmacology and a Clinical Trial

Hypertension is highly prevalent among the Lebanese adult population and is indeed the major cause of mortality in Lebanon. Traditional use of antihypertensive medicinal plants has long been practiced. The aim of this study is to document this traditional knowledge and clinically test the antihypertensive capacity of three of the most commonly used wild plant species Mentha longifolia, Viola odorata and Urtica dioica. Ethno-pharmacological data was collected by personal interviews with herbalists and traditional healers using a semi structured survey questionnaire and assessing relative frequency of citation (RFC). The clinical study was conducted by a randomized, blind, placebo-controlled trial in 29 subjects with mild hypertension distributed in four groups, three plant extract treatments and one placebo. Systolic (SBP) and diastolic blood pressures (DBP) as well as mean arterial blood pressures (MAP) were monitored at weeks 4, 8, 12 and 16 during the treatment with 300 mL/day of plant extract. Results showed that M. longifolia, U. dioica and V. odorata exhibited the highest values of RCF (0.95) followed by Allium ampeloprasum (0.94), Apium graveolens (0.92) and Crataegus azarolus (0.90). The clinical trial revealed dose- and duration-dependent significant reductions in SBP, DBP and MAP of subjects treated with M. longifolia, U. dioica or V. odorata. Our findings indicate that extracts of these plants present an effective, safe and promising potential as a phyto-therapuetical approach for the treatment of mild hypertension. More research on the phytochemistry, pharmacological effects and the underlying mechanisms is necessary.