Ethnomedicinal Plants Used for the Treatment of Cardiovascular Diseases by Healers in the Southwestern State of Paraná, Brazil, and Their Validation Based on Scientific Pharmacological Data

Cardiovascular diseases are responsible for high morbidity and mortality rates worldwide. Among treatment options, medicinal plants are frequently used, especially in developing countries, such as Brazil. Despite social development that has been observed in the last decades, the use of medicinal plants is still driven by popular knowledge, especially by healers. The present study sought to identify medicinal species that are used for the treatment of cardiovascular diseases by healers in the microregion of Francisco Beltrão, Paraná, Brazil. The snowball technique was used to select informants, and data were collected through interviews. The research was performed in two stages: (1) a structured interview and (2) the collection and botanical identification of the species that were mentioned by the healers. Medicinal plants were classified into the following categories of cardiovascular agents: hypotensive and antihypertensive agents, lipid-lowering agents, diuretic agents, and cardiotonic agents. To analyze the data, the frequency was determined, Spearman correlations were calculated, and the informant consensus factor (ICF) and use value were obtained. Some characteristics, such as female gender and old age, were associated with knowledge about medicinal plants. Overall, 77 different species and 149 medicinal uses were cited by the healers. With regard to categories of use, the highest number of species was found among lipid-lowering plants, and the highest ICF was found for species that are used as cardiotonics. Moreover, a literature review indicated that among the cited species, several still lack studies that have proven their effects on the cardiovascular system. The traditional use of medicinal plants for the treatment of cardiovascular diseases is broad in the study regions. The present results are important for clarifying popular knowledge in this region and providing a framework for selecting species with potential for the development of new pharmacological studies.

Inhibitory effect of Scutia buxifolia extracts, fractions, and ursolic acid on Na(+), K(+)-ATPase activity in vitro in membranes purified from rat hearts

ETHNOPHARMACOLOGICAL RELEVANCE

Scutia buxifolia is a tree native to South America and is used as a cardiotonic agent; however, this property has not been associated with a clear mechanism or a specific compound.

AIM OF THE STUDY

Given the importance of Na(+),K(+)-ATPase as a drug target in the treatment of heart failure, this study aimed to investigate the possible inhibitory effect of S. buxifolia crude extract and fractions (dichloromethane, ethyl acetate, and butanolic fractions), and identified compounds with effects on the activity of Na(+),K(+)-ATPase in vitro.

MATERIALS AND METHODS

First, we characterized the crude extract and fractions by high-performance liquid chromatography, and then monitored their effects on the activity of Na(+),K(+)-ATPase obtained from heart muscle and brain membranes of adult male Wistar rats.

RESULTS

We identified gallic acid, chlorogenic acid, caffeic acid, rutin, quercitrin, quercetin, and ursolic acid in S. buxifolia stem bark and leaves; quercitrin and ursolic acid were the main compounds in the ethyl acetate and dichloromethane fractions from leaves and stem bark. The crude extract (3 and 30mg/ml), and the ethyl acetate and dichloromethane fractions (0.1 and 1mg/ml) of both the stem bark and leaves inhibited Na(+),K(+)-ATPase activity in heart and brain samples. We found that, of the identified compounds, only ursolic acid (0.1mg/ml) was able to diminish Na(+), K(+)-ATPase activity in heart and brain samples.

CONCLUSIONS

These data indicated that the cardiotonic effects of S. buxifolia may be due to the inhibition of Na(+),K(+)-ATPase activity in heart muscle, supporting the popular use of this plant as a treatment for heart failure.

Khamiras, a natural cardiac tonic: An overview

The Unani system of Medicine (Unanipathy), which originated in Greece, is based on the principles proposed by Galen, a Greek practitioner. Since then, many Arab and Persian scholars have contributed to the system. Among them Ibn-e-Sina, an Arab philosopher and Physicist who wrote ‘Kitab-al-shifa’ are worth mentioning. This system has an extensive and inspiring record in India. It was introduced in India around the tenth century A.D with the spread of Islamic civilization. At present, Unanipathy has become an important part of the Indian system of Medicine. Unani medicines have been used since ancient times, as medicines for the treatment of various ailments. In spite of the great advances observed in modern medicine in recent decades, Unani drugs still make an important contribution to healthcare. The Unani system of medicine is matchless in treating chronic diseases like arthritis, asthma, mental, cardiac, and digestive disorders, urinary infections, and sexual diseases. The medicines administered go well with the temperament of the patient, thus speeding up the process of recovery and also reducing the risk of drug reaction. The Unani system of medicine recognizes the influence of the surroundings and ecological conditions on the state of health of human beings. The system aims at restoring the equilibrium of various elements and faculties of the human body. It has laid down six essential prerequisites for the prevention of diseases and places great emphasis, on the one hand, on the maintenance of proper ecological balance, and on the other, on keeping water, food, and air free from pollution. These essentials, known as ‘Asbab-e-Sitta Zarooriya’, are air, food, and drink, bodily movement and repose, psychic movement and repose, sleep and wakefulness, and excretion and retention. The Unani system is a secular system in temperament and is popular among the masses. In Unani medicine, although the general preference is for single drugs, compound formulations are also used in the treatment of various complex and chronic disorders. In the light of the present knowledge, this review is a small effort to discuss the efficacious nature of ‘Khamira’, a semi-solid preparation, which is traditionally used for cardiac ailments, such as, palpitations, weakness of the heart, and so on. On the basis of their constituents these are named as, Khamira Aabresham, Khamira Gaozaban, Khamira Marwareed, and so on. Khameeras are also used as general tonics for other vital organs like the liver and brain. In view of the increasing number of cardiac diseases, a thorough evaluation of this ancient work on Khamira is of special significance.