, Volume 71, Issue 15, pp 1989–2008 | Cite as

Therapeutic Potential of Ginseng in the Management of Cardiovascular Disorders

  • Morris KarmazynEmail author
  • Melissa Moey
  • Xiaohong Tracey Gan
Review Article


Although employed in Asian societies for thousands of years, the use of ginseng as an herbal medication for a variety of disorders has increased tremendously worldwide in recent years. Ginseng belongs to the genus Panax, of which there exists a variety, generally reflecting their geographic origin. North American ginseng (Panax quinquefolius) and Asian ginseng (Panax ginseng) are two such varieties possessing a plethora of pharmacological properties, which are attributed primarily to the presence of different ginsenosides that bestow these ginsengs with distinct pharmacodynamic profiles.

The many cardiovascular benefits attributed to ginseng include cardioprotection, antihypertensive effects, and attenuation of myocardial hypertrophy and heart failure. Experimental studies have revealed a number of beneficial properties of ginseng, particularly in the area of cardiac protection, where ginseng and ginsenosides have been shown to protect the ischaemic and reperfused heart in a variety of experimental models. Emerging evidence also suggests that ginseng attenuates myocardial hypertrophy, thus blunting the remodelling and heart failure processes. However, clinical evidence of efficacy is not convincing, likely owing primarily to the paucity of well designed, randomized, controlled clinical trials. Adding to the complexity in understanding the cardiovascular effects of ginseng is the fact that each of the different ginseng varieties possesses distinct cardiovascular properties, as a result of their respective ginsenoside composition, rendering it difficult to assign a general, common cardiovascular effect to ginseng. Additional challenges include the identification of mechanisms (likely multifaceted) that account for the effects of ginseng and determining which ginsenoside(s) mediate these cardiovascular properties. These concerns notwithstanding, the potential cardiovascular benefit of ginseng is worthy of further studies in view of its possible development as a cardiovascular therapeutic agent, particularly as adjunctive therapy to existing medications.


Ginsenosides Mitochondrial Permeability Transitional Pore Ginseng Root Ginseng Extract Korean Ginseng 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Studies originating from the authors’ laboratory were funded by the Canadian Institutes of Health Research and the Ontario Ginseng Innovation and Research Consortium (OGIRC). M. Moey is supported by OGIRC. M. Karmazyn holds a Tier 1 Canada Research Chair in Experimental Cardiology.


  1. 1.
    Predy GN, Goel V, Lovlin R, et al. Efficacy of an extract of North American ginseng containing poly-furanosyl-pyranosyl-saccharides for preventing upper respiratory tract infections: a randomized controlled trial. CMAJ 2005; 173: 1043–8PubMedCrossRefGoogle Scholar
  2. 2.
    Chu SF, Zhang JT. New achievements in ginseng research and its future prospects. Chin J Integr Med 2009; 15: 403–8PubMedCrossRefGoogle Scholar
  3. 3.
    Hu SY. The genus Panax (ginseng) in Chinese medicine. Econ Bot 1976; 30: 11–28CrossRefGoogle Scholar
  4. 4.
    Goldstein B. Ginseng: its history, dispersion and folk tradition. Am J Chin Med 1975; 3: 223–34PubMedCrossRefGoogle Scholar
  5. 5.
    Ligor T, Ludwiczuk A, Wolski T, et al. Isolation and determination of ginsenosides in American ginseng leaves and root extracts by LC-MS. Anal Bioanal Chem 2005; 383: 1098–105PubMedCrossRefGoogle Scholar
  6. 6.
    Liu GY, Li XW, Wang NB, et al. Three new dammarane-type triterpene saponins from the leaves of Panax ginseng C.A. Meyer. J Asian Nat Prod Res 2010; 12: 865–73CrossRefGoogle Scholar
  7. 7.
    Attele AS, Zhou YP, Xie JT, et al. Antidiabetic effects of Panax ginseng berry extract and the identification of an effective component. Diabetes 2002; 51: 1851–8PubMedCrossRefGoogle Scholar
  8. 8.
    Dey L, Xie JT, Wang A, et al. Anti-hyperglycemic effects of ginseng: comparison between root and berry. Phytomedicine 2003; 10: 600–5PubMedCrossRefGoogle Scholar
  9. 9.
    Chan TWD, But PPH, Cheng SW, et al. Differentiation and authentication of Panax ginseng, Panax quinquefolius and ginseng products by using HPLC/MS. Anal Chem 2000; 72: 1281–7PubMedCrossRefGoogle Scholar
  10. 10.
    Mar C, Bent S. An evidence-based review of the 10 most commonly used herbs. West J Med 1999; 171: 168–71PubMedGoogle Scholar
  11. 11.
    Carlson AW. Ginseng: America’s botanical drug connection to the orient. Econ Bot 1986; 40: 233–49CrossRefGoogle Scholar
  12. 12.
    Appleby JH. Ginseng and the Royal Society. Notes Rec R Soc Lond 1983; 37: 121–45PubMedCrossRefGoogle Scholar
  13. 13.
    Wood WB, Roh BL, White RP. Cardiovascular actions of Panax ginseng in dogs. Jpn J Pharmacol 1964; 14: 284–94PubMedCrossRefGoogle Scholar
  14. 14.
    Hah JS, Kang BS, Kang DH. Effect of Panax ginseng alcohol extract on cardiovascular ginseng. Yonsei Med J 1978; 19: 11–8PubMedGoogle Scholar
  15. 15.
    Hwang IG, Kim HY, Joung EM, et al. Changes in ginsenosides and antioxidant activity of Korean ginseng (Panax ginseng C.A. Meyer) with heating temperature and pressure. Food Sci Biotechnol 2010; 19: 941–9Google Scholar
  16. 16.
    Jia L, Zhao Y. Current evaluation of the millennium phytomedicine. Ginseng (I): etymology, pharmacognosy, phytochemistry, market and regulations. Curr Med Chem 2009; 16: 2475–84Google Scholar
  17. 17.
    Jia L, Zhao Y, Liang XJ. Current evaluation of the millennium phytomedicine. Ginseng (II): collected chemical entities, modern pharmacology, and clinical applications emanated from traditional Chinese medicine. Curr Med Chem 2009; 16: 2924–42Google Scholar
  18. 18.
    Qi LW, Wang CZ, Yuan CS. Isolation and analysis of ginseng: advances and challenges. Nat Prod Rep 2011; 28: 467–95PubMedCrossRefGoogle Scholar
  19. 19.
    Attele AS, Wu JA, Yuan CS. Ginseng pharmacology: multiple constituents and multiple actions. Biochem Pharmacol 1999; 58: 1685–93PubMedCrossRefGoogle Scholar
  20. 20.
    Lü JM, Yao Q, Chen C. Ginseng compounds: an update on their molecular mechanisms and medical applications. Current Vasc Pharmacol 2009; 7: 293–302CrossRefGoogle Scholar
  21. 21.
    Li W, Fitzloff JF. Determination of 24(R)-pseudoginsenoside F11 in North American ginseng using high performance liquid chromatography with evaporative light scattering detection. J Pharm Biomed Anal 2001; 25: 257–65PubMedCrossRefGoogle Scholar
  22. 22.
    Schlag EM, McIntosh MS. Ginsenoside content and variation among and within American ginseng (Panax quinquefolius L.) populations. Phytochemistry 2006; 67: 1510–9PubMedCrossRefGoogle Scholar
  23. 23.
    Assinewe VA, Baum BR, Gagnon D, et al. Phytochemistry of wild populations of Panax quinquefolius L. (North American ginseng). J Agric Food Chem 2003; 51: 4549–53PubMedCrossRefGoogle Scholar
  24. 24.
    Tanaka H, Fukuda N, Shoyama Y. Identification and differentiation of Panax species using ELISA, RAPD and eastern blotting. Phytochem Anal 2006; 17: 46–55PubMedCrossRefGoogle Scholar
  25. 25.
    Kim HY, Kang KS, Yamabe N, et al. Comparison of the effects of Korean ginseng and heat-processed Korean ginseng on diabetic oxidative stress. Am J Chin Med 2008; 36: 989–1004PubMedCrossRefGoogle Scholar
  26. 26.
    Kim GN, Lee JS, Song JH, et al. Heat processing decreases Amadori products and increases total phenolic content and antioxidant activity of Korean red ginseng. J Med Food 2010; 13: 1478–84PubMedCrossRefGoogle Scholar
  27. 27.
    Lee HS, Lee HJ, Yu HJ, et al. A comparison between high hydrostatic pressure extraction and heat extraction of ginsenosides from ginseng (Panax ginseng CA Meyer). J Sci Food Agric 2011; 91: 1466–73PubMedCrossRefGoogle Scholar
  28. 28.
    Lee SM, Shon HJ, Choi CS, et al. Ginsenosides from heat processed ginseng. Chem Pharm Bull (Tokyo) 2009; 57: 92–4CrossRefGoogle Scholar
  29. 29.
    Park IH, Kim NY, Han SB, et al. Three new dammarane glycosides from heat processed ginseng. Arch Pharm Res 2002; 25: 428–32PubMedCrossRefGoogle Scholar
  30. 30.
    Kim WY, Kim JM, Han SB, et al. Steaming of ginseng at high temperature enhances biological activity. J Nat Prod 2000; 63: 1702–4PubMedCrossRefGoogle Scholar
  31. 31.
    Kang KS, Kim HY, Baek SH, et al. Study on the hydroxyl radical scavenging activity changes of ginseng and ginsenoside-Rb2 by heat processing. Biol Pharm Bull 2007; 30: 724–8PubMedCrossRefGoogle Scholar
  32. 32.
    Lee DC, Lee MO, Kim CY, et al. Effect of ether, ethanol, and aqueous extracts of ginseng on cardiovascular function in dogs. Can J Comp Med 1981; 45: 182–7PubMedGoogle Scholar
  33. 33.
    Gafner S, Bergeron C, McCollom MM, et al. Evaluation of the efficiency of three different solvent systems to extract triterpene saponins from roots of Panax quinquefolius using high-performance liquid chromatography. J Agric Food Chem 2004; 52: 1546–50PubMedCrossRefGoogle Scholar
  34. 34.
    King ML, Adler SR, Murphy LL. Extraction-dependent effects of American ginseng (Panax quinquefolium) on human breast cancer cell proliferation and estrogen receptor activation. Integr Cancer Ther 2006; 5: 236–43PubMedCrossRefGoogle Scholar
  35. 35.
    Kim EH, Jang MH, Shin CH, et al. Protective effect of aqueous extract of Ginseng radix against 1-methyl-4-phenylpyridinium-induced apoptosis in PC12 cells. Biol Pharm Bull 2003; 26: 1668–73PubMedCrossRefGoogle Scholar
  36. 36.
    Peralta EA, Murphy LL, Minnis J, et al. American ginseng inhibits induced COX-2 and NFKB activation in breast cancer cells. J Surg Res 2009; 157: 261–7PubMedCrossRefGoogle Scholar
  37. 37.
    Huang YC, Chen CT, Chen SC, et al. A natural compound (ginsenoside Re) isolated from Panax ginseng as a novel angiogenic agent for tissue regeneration. Pharm Res 2005; 22: 636–46PubMedCrossRefGoogle Scholar
  38. 38.
    Morisaki N, Watanabe S, Tezuka M, et al. Mechanism of angiogenic effects of saponin from ginseng Radix rubra in human umbilical vein endothelial cells. Br J Pharmacol 1995; 115: 1188–93PubMedCrossRefGoogle Scholar
  39. 39.
    Kim YM, Namkoong S, Yun YB, et al. Water extract of Korean read ginseng stimulates angiogenesis by activating the PI3K/Akt-dependent ERK1/2 and eNOS pathways in human umbilical vein endothelial cells. Biol Pharm Bull 2007; 30: 1674–9PubMedCrossRefGoogle Scholar
  40. 40.
    Kim H, Chen X, Gillis CN. Ginsenosides protect pulmonary vascular endothelium against free radical-induced injury. Biochem Biophys Res Commun 1992; 189: 670–6PubMedCrossRefGoogle Scholar
  41. 41.
    Kwan CY, Zhang WB, Sim SM, et al. Vascular effects of Siberian ginseng (Eleutherococcus senticosus): endothelium-dependent NO- and EDHF-mediated relaxation depending on vessel size. Naunyn Schmiedebergs Arch Pharmacol 2004; 369: 473–80PubMedCrossRefGoogle Scholar
  42. 42.
    Kwan CY, Kwan TK. Effects of Panax notoginseng saponins on vascular endothelial cells in vitro. Acta Pharmacol Sin 2000; 21: 1101–5PubMedGoogle Scholar
  43. 43.
    Cai BX, Li XY, Chen JH, et al. Ginsenoside-Rd, a new voltage-independent Ca2+ entry blocker, reverses basilar hypertrophic remodeling in stroke-prone renovascular hypertensive rats. Eur J Pharmacol 2009; 606: 142–9PubMedCrossRefGoogle Scholar
  44. 44.
    Lee MO, Clifford DH, Kim CY, et al. Effects of the first (ether) extract of ginseng on the cardiovascular dynamics of dogs during halothane anesthesia. Comp Med East West 1978; 6: 115–21PubMedGoogle Scholar
  45. 45.
    Jeon BH, Kim CS, Kim HS, et al. Effect of Korean red ginseng on blood pressure and nitric oxide production. Acta Pharmacol Sin 2000; 21: 1095–100PubMedGoogle Scholar
  46. 46.
    Jeon BH, Kim CS, Park KS, et al. Effect of Korea red ginseng on the blood pressure in conscious hypertensive rats. Gen Pharmacol 2000; 35: 135–41PubMedCrossRefGoogle Scholar
  47. 47.
    Li Z, Chen X, Niwa Y, et al. Involvement of Ca2+-activated K+ channels in ginsenosides-induced aortic relaxation in rats. J Cardiovasc Pharmacol 2001; 37: 41–7PubMedCrossRefGoogle Scholar
  48. 48.
    Toda N, Ayajiki K, Fujioka H, et al. Ginsenoside potentiates NO-mediated neurogenic vasodilatation of monkey cerebral arteries. J Ethnopharmacol 2001; 76: 109–13PubMedCrossRefGoogle Scholar
  49. 49.
    Kim ND, Kim EM, Kang KW, et al. Ginsenoside Rg3 inhibits phenylephrine-induced vascular contraction through induction of nitric oxide synthase. Br J Pharmacol 2003; 140: 661–70PubMedCrossRefGoogle Scholar
  50. 50.
    Kim ND, Kang SY, Park JH, et al. Ginsenoside Rg3 mediates endothelium-dependent relaxation in response to ginsenosides in rat aorta: role of K+ channels. Eur J Pharmacol 1999; 367: 41–9PubMedCrossRefGoogle Scholar
  51. 51.
    Kim ND, Kang SY, Kim MJ, et al. The ginsenoside Rg3 evokes endothelium-independent relaxation in rat aortic rings: role of K+ channels. Eur J Pharmacol 1999; 367: 51–7PubMedCrossRefGoogle Scholar
  52. 52.
    Yu J, Eto M, Akishita M, et al. Signaling pathway of nitric oxide production induced by ginsenoside Rb1 in human aortic endothelial cells: a possible involvement of androgen receptor. Biochem Biophys Res Commun 2007; 353: 764–9PubMedCrossRefGoogle Scholar
  53. 53.
    Persson IA, Dong L, Persson K. Effect of Panax ginseng extract (G115) on angiotensin-converting enzyme (ACE) activity and nitric oxide (NO) production. J Ethnopharmacol 2006; 105: 321–5PubMedCrossRefGoogle Scholar
  54. 54.
    Guan YY, Zhou JG, Zhang Z, et al. Ginsenoside-Rd from panax notoginseng blocks Ca2+ influx through receptor- and store-operated Ca2+ channels in vascular smooth muscle cells. Eur J Pharmacol 2006; 548: 129–36PubMedCrossRefGoogle Scholar
  55. 55.
    Maffei Facino R, Carini M, Aldini G, et al. Panax ginseng administration in the rat prevents myocardial ischemia-reperfusion damage induced by hyperbaric oxygen: evidence for an antioxidant intervention. Planta Med 1999; 65: 614–9PubMedCrossRefGoogle Scholar
  56. 56.
    Kim TH, Lee SM. The effects of ginseng total saponin, panaxadiol and panaxatriol on ischemia/reperfusion injury in isolated rat heart. Food Chem Toxicol 2010; 48: 1516–20PubMedCrossRefGoogle Scholar
  57. 57.
    Liu Z, Li Z, Liu X. Effect of ginsenoside Re on cardiomyocyte apoptosis and expression of Bcl-2/Bax gene after ischemia and reperfusion in rats. J Huazhong Univ Sci Technolog Med Sci 2002; 22: 305–9PubMedCrossRefGoogle Scholar
  58. 58.
    Wang Z, Li M, Wu WK, et al. Ginsenoside Rb1 preconditioning protects against myocardial infarction after regional ischemia and reperfusion by activation of phosphatidylinositol-3-kinase signal transduction. Cardiovasc Drugs Ther 2008; 22: 443–52PubMedCrossRefGoogle Scholar
  59. 59.
    Guan L, Li W, Liu Z. Effect of ginsenoside-Rb1 on cardiomyocyte apoptosis after ischemia and reperfusion in rats. J Huazhong Univ Sci Technolog Med Sci 2002; 22: 212–5PubMedCrossRefGoogle Scholar
  60. 60.
    Kong HL, Li ZQ, Zhao YJ, et al. Ginsenoside Rb 1 protects cardiomyocytes against CoCl2-induced apoptosis in neonatal rats by inhibiting mitochondria permeability transition pore opening. Acta Pharmacol Sin 2010; 31: 687–95PubMedCrossRefGoogle Scholar
  61. 61.
    Wu Y, Xia ZY, Dou J, et al. Protective effect of ginsenoside Rb1 against myocardial ischemia/reperfusion injury in streptozotocin-induced diabetic rats. Mol Biol Rep 2011 Oct; 38(7): 4327–35PubMedCrossRefGoogle Scholar
  62. 62.
    Zhu D, Wu L, Li CR, et al. Ginsenoside Rg1 protects rat cardiomyocyte from hypoxia/reoxygenation oxidative injury via antioxidant and intracellular calcium homeostasis. J Cell Biochem 2009; 108: 117–24PubMedCrossRefGoogle Scholar
  63. 63.
    Wang XD, Gu TX, Shi EY, et al. Effect and mechanism of panaxoside Rg1 on neovascularization in myocardial infarction rats. Chin J Integr Med 2010; 16: 162–6PubMedCrossRefGoogle Scholar
  64. 64.
    Wu W, Zhang XM, Liu PM, et al. Effects of Panax notoginseng saponin Rg1 on cardiac electrophysiological properties and ventricular fibrillation threshold in dogs. Zhongguo Yao Li Xue Bao 1995; 6: 459–63Google Scholar
  65. 65.
    Bai CX, Sunami A, Namiki T, et al. Electrophysiological effects of ginseng and ginsenoside Re in guinea pig ventricular myocytes. Eur J Pharmacol 2003; 476: 35–44PubMedCrossRefGoogle Scholar
  66. 66.
    Maslov LN, Lishmanov YB, Arbuzov AG, et al. Antiar-rhythmic activity of phytoadaptogens in short-term ischemia-reperfusion of the heart and postinfarction cardiosclerosis. Bull Exp Biol Med 2009; 147: 331–4PubMedCrossRefGoogle Scholar
  67. 67.
    Wang YG, Zima AV, Ji X, et al. Ginsenoside Re suppresses electromechanical alternans in cat and human cardiomyocytes. Am J Physiol Heart Circ Physiol 2008; 295: H851–9PubMedCrossRefGoogle Scholar
  68. 68.
    Murphy E, Steenbergen C. Mechanisms underlying acute protection from cardiac ischemia-reperfusion injury. Physiol Rev 2008; 88: 581–609PubMedCrossRefGoogle Scholar
  69. 69.
    Schmitt CA, Dirsch VM. Modulation of endothelial nitric oxide by plant-derived products. Nitric Oxide 2009; 21: 77–91PubMedCrossRefGoogle Scholar
  70. 70.
    Chen X. Cardiovascular protection by ginsenosides and their nitric oxide releasing action. Clin Exp Pharmacol Physiol 1996; 23: 728–32PubMedCrossRefGoogle Scholar
  71. 71.
    Gillis CN. Panax ginseng pharmacology: a nitric oxide link? Biochem Pharmacol 1997; 54: 1–8PubMedCrossRefGoogle Scholar
  72. 72.
    Achike FI, Kwan CY. Nitric oxide, human diseases and the herbal products that affect the nitric oxide signalling pathway. Clin Exp Pharmacol Physiol 2003; 30: 605–15PubMedCrossRefGoogle Scholar
  73. 73.
    Scott GI, Colligan PB, Ren BH, et al. Ginsenosides Rb1 and Re decrease cardiac contraction in adult rat ventricular myocytes: role of nitric oxide. Br J Pharmacol 2001; 134: 1159–65PubMedCrossRefGoogle Scholar
  74. 74.
    Bai CX, Takahashi K, Masumiya H, et al. Nitric oxide-dependent modulation of the delayed rectifier K+ current and the L-type Ca2+ current by ginsenoside Re, an ingredient of Panax ginseng, in guinea-pig cardiomyocytes. Br J Pharmacol 2004; 142: 567–75PubMedCrossRefGoogle Scholar
  75. 75.
    Furukawa T, Bai CX, Kaihara A, et al. Ginsenoside Re, a main phytosterol of Panax ginseng, activates cardiac potassium channels via a nongenomic pathway of sex hormones. Mol Pharmacol 2006; 70: 1916–24PubMedCrossRefGoogle Scholar
  76. 76.
    Leung KW, Cheng YK, Mak NK, et al. Signaling pathway of ginsenoside-Rg1 leading to nitric oxide production in endothelial cells. FEBS Lett 2006; 580: 3211–6PubMedCrossRefGoogle Scholar
  77. 77.
    Yi XQ, Li T, Wang JR, et al. Total ginsenosides increase coronary perfusion flow in isolated rat hearts through activation of PI3K/Akt-eNOS signaling. Phytomedicine 2010; 17: 1006–15PubMedCrossRefGoogle Scholar
  78. 78.
    Kitts DD, Wijewickreme AN, Hu C. Antioxidant properties of a North American ginseng extract. Mol Cell Biochem 2000; 203: 1–10PubMedCrossRefGoogle Scholar
  79. 79.
    Wang CZ, Mehendale SR, Yuan CS, et al. Commonly used antioxidant botanicals: active constituents and their potential role in cardiovascular illness. Am J Chin Med 2007; 35: 543–58PubMedCrossRefGoogle Scholar
  80. 80.
    Fu Y, Ji LL. Chronic ginseng consumption attenuates ageassociated oxidative stress in rats. J Nutr 2003; 133: 3603–9PubMedGoogle Scholar
  81. 81.
    Li J, Ichikawa T, Jin Y. An essential role of Nrf2 in American ginseng-mediated anti-oxidative actions in cardiomyocytes. J Ethnopharmacol 2010; 130: 222–30PubMedCrossRefGoogle Scholar
  82. 82.
    Xie JT, Shao ZH, Vanden Hoek TL, et al. Antioxidant effects of ginsenoside Re in cardiomyocytes. Eur J Pharmacol 2006; 532: 201–7PubMedCrossRefGoogle Scholar
  83. 83.
    Liu Q, Kou JP, Yu BY. Ginsenoside Rg1 protects against hydrogen peroxide-induced cell death in PC12 cells via inhibiting NF-κB activation. Neurochem Int 2011; 58: 119–25PubMedCrossRefGoogle Scholar
  84. 84.
    Shao ZH, Xie JT, Vanden Hoek TL, et al. Antioxidant effects of American ginseng berry extract in cardiomyocytes exposed to acute oxidant stress. Biochim Biophys Acta 2004; 1670: 165–71PubMedCrossRefGoogle Scholar
  85. 85.
    Regula KM, Kirshenbaum LA. Apoptosis of ventricular myocytes: a means to an end. J Mol Cell Cardiol 2005; 38: 3–13PubMedCrossRefGoogle Scholar
  86. 86.
    Zheng SY, Sun J, Zhao X, et al. Protective effect of shen-fu on myocardial ischemia-reperfusion injury in rats. Am J Chin Med 2004; 32: 209–20PubMedCrossRefGoogle Scholar
  87. 87.
    Wang YL, Wang CY, Zhang BJ, et al. Shenfu injection suppresses apoptosis by regulation of Bcl-2 and caspase-3 during hypoxia/reoxygenation in neonatal rat cardiomyocytes in vitro. Mol Biol Rep 2009; 36: 365–70PubMedCrossRefGoogle Scholar
  88. 88.
    Javadov S, Karmazyn M. Mitochondrial permeability transition pore opening as an endpoint to initiate cell death and as a putative target for cardioprotection. Cell Physiol Biochem 2007; 20: 1–22PubMedCrossRefGoogle Scholar
  89. 89.
    Kong HL, Wang JP, Li ZQ, et al. Anti-hypoxic effect of ginsenoside Rbl on neonatal rat cardiomyocytes is mediated through the specific activation of glucose transporter-4 ex vivo. Acta Pharmacol Sin 2009; 30: 396–403PubMedCrossRefGoogle Scholar
  90. 90.
    Wu Y, Xia ZY, Meng QT, et al. Shen-Fu injection preconditioning inhibits myocardial ischemia-reperfusion injury in diabetic rats: activation of eNOS via the PI3K/Akt pathway. J Biomed Biotechnol 2011; 2011: 1–9Google Scholar
  91. 91.
    Wang N, Minatoguchi S, Arai M, et al. Sheng-Mai-San is protective against post-ischemic myocardial dysfunction in rats through its opening of the mitochondrial KATP channels. Circ J 2002; 66: 763–8PubMedCrossRefGoogle Scholar
  92. 92.
    Chen CF, Chiou WF, Zhang JT. Comparison of the pharmacological effects of Panax ginseng and Panax quinquefolium. Acta Pharmacol Sin 2008; 29: 1103–8PubMedCrossRefGoogle Scholar
  93. 93.
    Lee JS, Choi HS, Kang SW, et al. Therapeutic effect of Korean red ginseng on inflammatory cytokines in rats with focal cerebral ischemia/reperfusion injury. Am J Chin Med 2011; 39: 83–94PubMedCrossRefGoogle Scholar
  94. 94.
    Roger VL, Go AS, Lloyd-Jones DM, et al. Heart disease and stroke statistics. 2011 update: a report from the American Heart Association. Circulation 2011; 123: e18–209PubMedCrossRefGoogle Scholar
  95. 95.
    Frey N, Katus HA, Olsen EN, et al. Hypertrophy of the heart: a new therapeutic target? Circulation 2004; 109: 1580–9PubMedCrossRefGoogle Scholar
  96. 96.
    Guo J, Gan XT, Haist JV, et al. Ginseng inhibits cardiomyocyte hypertrophy and heart failure via NHE-1 inhibition and attenuation of calcineurin activation. Circ Heart Fail 2011; 4: 79–88PubMedCrossRefGoogle Scholar
  97. 97.
    Jiang QS, Huang XN, Yang GZ, et al. Inhibitory effect of ginsenoside Rb1 on calcineurin signal pathway in cardiomyocyte hypertrophy induced by prostaglandin F2al-pha. Acta Pharmacol Sin 2007; 28: 1149–54PubMedCrossRefGoogle Scholar
  98. 98.
    Chan P, Kao PF, Tomlinson B. Cardiovascular effects of trilinolein, a natural triglyceride isolated from the herb sanchi (Panax notoginseng). Acta Cardiol Sin 2005; 21: 71–6Google Scholar
  99. 99.
    Chen SC, Cheng JJ, Hsieh MH, et al. Molecular mechanism of the inhibitory effect of trilinolein on endothelin-1-induced hypertrophy of cultured neonatal rat cardiomyocytes. Planta Med 2005; 71: 525–9PubMedCrossRefGoogle Scholar
  100. 100.
    Deng J, Wang YW, Chen WM, et al. Role of nitric oxide in ginsenoside Rg1-induced protection against left ventricular hypertrophy produced by abdominal aorta coarctation in rats. Biol Pharm Bull 2010; 33: 631–5PubMedCrossRefGoogle Scholar
  101. 101.
    Deng J, Lv XT, Wu Q, et al. Ginsenoside Rg1 inhibits rat left ventricular hypertrophy induced by abdominal aorta coarctation: involvement of calcineurin and mitogen-activated protein kinase signalings. Eur J Pharmacol 2009; 608: 42–7PubMedCrossRefGoogle Scholar
  102. 102.
    Qin N, Gong QH, Wei LW, et al. Total ginsenosides inhibit the right ventricular hypertrophy induced by monocrota-line in rats. Biol Pharm Bull 2008; 31: 1530–1135PubMedCrossRefGoogle Scholar
  103. 103.
    Jiang QS, Huang XN, Dai ZK, et al. Inhibitory effect of ginsenoside Rb1 on cardiac hypertrophy induced by monocrotaline in rat. J Ethnopharmacol 2007; 111: 567–72PubMedCrossRefGoogle Scholar
  104. 104.
    Panther F, Williams T, Ritter O. Inhibition of the calcineurin-NFAT signalling cascade in the treatment of heart failure. Recent Pat Cardiovasc Drug Discov 2009; 4: 180–6PubMedCrossRefGoogle Scholar
  105. 105.
    Karmazyn M, Kilić A, Javadov S. The role of NHE-1 in myocardial hypertrophy and remodeling. J Mol Cell Cardiol 2008; 44: 647–53PubMedCrossRefGoogle Scholar
  106. 106.
    Moey M, Rajapurohitam V, Zeidan A, et al. Ginseng (Panax quinquefolius) attenuates leptin-induced cardiac hypertrophy through inhibition of p115RhoGEF-RhoA/ ROCK-dependent MAPK pathway activation. J Pharmacol Exp Ther. Epub 2011 Aug 29Google Scholar
  107. 107.
    Gagnier JJ, DeMelo J, Boon H, et al. Quality of reporting of randomized controlled trials of herbal medicine interventions. Am J Med 2006; 119: 800.e1-1 1PubMedCrossRefGoogle Scholar
  108. 108.
    Gagnier JJ, Moher D, Boon H, et al. Randomized controlled trials of herbal interventions underreport important details of the intervention. J Clin Epidemiol 2011; 64: 760–9PubMedCrossRefGoogle Scholar
  109. 109.
    Wang L, Li Y, Li J, et al. Quality of reporting of trial abstracts needs to be improved: using the CONSORT for abstracts to assess the four leading Chinese medical journals of traditional Chinese medicine. Trials 2010; 11: 75PubMedCrossRefGoogle Scholar
  110. 110.
    Volger BK, Pittler MH, Ernst E. The efficacy of ginseng: a systematic review of randomized clinical trials. Eur J Clin Pharmacol 1999; 55: 567–75CrossRefGoogle Scholar
  111. 111.
    Yi SW, Sull JW, Hong JS, et al. Association between ginseng intake and mortality: Kangwha cohort study. J Altern Complement Med 2009; 15: 921–8PubMedCrossRefGoogle Scholar
  112. 112.
    Caron MF, Hotsko AL, Robertson S, et al. Electrocardiographic and hemodynamic effects of Panax ginseng. Ann Pharmacother 2002; 36: 758–63PubMedCrossRefGoogle Scholar
  113. 113.
    Yuan J, Guo W, Yang B, et al. 116 cases of coronary angina pectoris treated with powder composed of radix ginseng, radix notoginseng and succinum. J Tradit Chin Med 1997; 17: 14–7PubMedGoogle Scholar
  114. 114.
    Ahn CM, Hong SJ, Choi SC, et al. Red ginseng extract improves coronary flow reserve and increases absolute numbers of various circulating angiogenic cells in patients with first ST-segment elevation acute myocardial infarction. Phytother Res 2011; 25: 239–49PubMedGoogle Scholar
  115. 115.
    Zheng CD, Min S. Cardioprotection of Shenfu injection against myocardial ischemia/reperfusion injury in open heart surgery. Chin J Integr Med 2008; 14: 10–6PubMedCrossRefGoogle Scholar
  116. 116.
    Cheng TO. Ginseng: is there a use in clinical medicine [letter]? Postgrad Med J 1989; 65: 427PubMedCrossRefGoogle Scholar
  117. 117.
    Sung J, Han KH, Zo JH, et al. Effects of red ginseng upon vascular endothelial function in patients with essential hypertension. Am J Chin Med 2000; 28: 205–16PubMedCrossRefGoogle Scholar
  118. 118.
    Han KH, Choe SC, Kim HS, et al. Effect of red ginseng on blood pressure in patients with essential hypertension and white coat hypertension. Am J Chin Med 1998; 26: 199–209PubMedCrossRefGoogle Scholar
  119. 119.
    Jovanovski E, Jenkins A, Dias AG, et al. Effects of Korean red ginseng (Panax ginseng C.A. Mayer) and its isolated ginsenosides and polysaccharides on arterial stiffness in healthy individuals. Am J Hypertens 2010; 23: 469–72Google Scholar
  120. 120.
    Laurent S, Boutouyrie P, Asmar R, et al. Aortic stiffness is an independent predictor of all-cause and cardiovascular mortality in hypertensive patients. Hypertension 2001; 37: 1236–41PubMedCrossRefGoogle Scholar
  121. 121.
    Rhee MY, Kim YS, Bae JH, et al. Effect of Korean red ginseng on arterial stiffness in subjects with hypertension. J Altern Complement Med 2011; 17: 45–9PubMedCrossRefGoogle Scholar
  122. 122.
    Stavro PM, Woo M, Heim TF, et al. North American ginseng exerts a neutral effect on blood pressure in individuals with hypertension. Hypertension 2005; 46: 406–11PubMedCrossRefGoogle Scholar
  123. 123.
    Stavro PM, Woo M, Leiter LA, et al. Long-term intake of North American ginseng has no effect on 24-hour blood pressure and renal function. Hypertension 2006; 47: 791–6PubMedCrossRefGoogle Scholar
  124. 124.
    Cui X, Sakaguchi T, Ishizuka D, et al. Orally administered ginseng extract reduces serum total cholesterol and triglycerides that induce fatty liver in 66% hepatectomized rats. J Int Med Res 1998; 26: 181–7PubMedGoogle Scholar
  125. 125.
    Xia W, Sun C, Zhao Y, et al. Hypolipidemic and anti-oxidant activities of Sanchi (Radix Notoginseng) in rats fed with a high fat diet. Phytomedicine 2011; 18: 516–20PubMedCrossRefGoogle Scholar
  126. 126.
    Cicero AF, Vitale G, Savino G, et al. Panax notoginseng (Burk.) effects on fibrinogen and lipid plasma level in rats fed on a high-fat diet. Phytother Res 2003; 17: 174–8PubMedCrossRefGoogle Scholar
  127. 127.
    Yamamoto M, Uemura T, Nakama S, et al. Serum HDL-cholesterol-increasing and fatty liver-improving actions of Panax ginseng in high cholesterol diet-fed rats with clinical effect on hyperlipidemia in man. Am J Chin Med 1983; 11: 96–101PubMedCrossRefGoogle Scholar
  128. 128.
    Inoue M, Wu CZ, Dou DQ, et al. Lipoprotein lipase activation by red ginseng saponins in hyperlipidemia model animals. Phytomedicine 1999; 6: 257–65PubMedCrossRefGoogle Scholar
  129. 129.
    Cho WC, Chung WS, Lee SK, et al. Ginsenoside Re of Panax ginseng possesses significant antioxidant and anti-hyperlipidemic efficacies in streptozotocin-induced diabetic rats. Eur J Pharmacol 2006; 550: 173–9PubMedCrossRefGoogle Scholar
  130. 130.
    Kwak YS, Kyung JS, Kim JS, et al. Anti-hyperlipidemic effects of red ginseng acidic polysaccharide from Korean red ginseng. Biol Pharm Bull 2010; 33: 468–72PubMedCrossRefGoogle Scholar
  131. 131.
    Ismail MF, Gad MZ, Hamdy MA. Study of the hypolipidemic properties of pectin, garlic and ginseng in hypercho-lesterolemic rabbits. Pharmacol Res 1999; 39: 157–66PubMedCrossRefGoogle Scholar
  132. 132.
    Kim SH, Park KS. Effects of Panax ginseng extract on lipid metabolism in humans. Pharmacol Res 2003; 48: 511–3PubMedCrossRefGoogle Scholar
  133. 133.
    Shin SK, Kwon JH, Jeong YJ, et al. Supplementation of cheonggukjang and red ginseng cheonggukjang can improve plasma lipid profile and fasting blood glucose concentration in subjects with impaired fasting glucose. J Med Food 2011; 14: 108–13PubMedCrossRefGoogle Scholar
  134. 134.
    Yu JY, Jin YR, Lee JJ, et al. Antiplatelet and antithrombotic activities of Korean Red Ginseng. Arch Pharm Res 2006; 29: 898–903PubMedCrossRefGoogle Scholar
  135. 135.
    Teng CM, Kuo SC, Ko FN, et al. Antiplatelet actions of panaxynol and ginsenosides isolated from ginseng. Biochim Biophys Acta 1989; 990: 315–20PubMedCrossRefGoogle Scholar
  136. 136.
    Park HJ, Rhee MH, Park KM, et al. Effect of non-saponin fraction from Panax ginseng on cGMP and thromboxane A2 in human platelet aggregation. J Ethnopharmacol 1995; 49: 157–62PubMedCrossRefGoogle Scholar
  137. 137.
    Kuo SC, Teng CM, Lee JC, et al. Antiplatelet components in Panax ginseng. Planta Med 1990; 56: 164–7PubMedCrossRefGoogle Scholar
  138. 138.
    Klepser TB, Klepser ME. Unsafe and potentially safe herbal therapies. Am J Health Syst Pharm 1999; 15: 125–38Google Scholar
  139. 139.
    Coon JT, Ernst E. Panax ginseng: a systematic review of adverse effects and drug interactions. Drug Saf 2002; 25: 323–44PubMedCrossRefGoogle Scholar
  140. 140.
    Ernst E. The efficacy of herbal medicine: an overview. Fundam Clin Pharmacol 2005; 19: 405–9PubMedCrossRefGoogle Scholar
  141. 141.
    Lee JY, Lim KM, Kim SY, et al. Vascular smooth muscle dysfunction and remodeling induced by ginsenoside Rg3, a bioactive component of ginseng. Toxicol Sci 2010; 117: 505–14PubMedCrossRefGoogle Scholar
  142. 142.
    Chan LY, Chiu PY, Lau TK. Embryotoxicity study of gisensoide Rc and Re in in vitro rat whole embryo culture. Reprod Toxicol 2004; 19: 131–4PubMedCrossRefGoogle Scholar
  143. 143.
    Liu P, Yin H, Xu Y, et al. Effects of ginsenoside Rg1 on postimplantation rat and mouse embryos cultured in vitro. Toxicol In Vitro 2006; 20: 234–8PubMedCrossRefGoogle Scholar
  144. 144.
    Shin S, Jang JY, Park D, et al. Korean red ginseng extract does not cause embryo-fetal death or abnormalities in mice. Birth Defects Res B Dev Reprod Toxicol 2010; 89: 78–85PubMedGoogle Scholar
  145. 145.
    Martínez-Mir I, Rubio E, Morales-Olivas FJ, et al. Transient ischemic attack secondary to hypertensive crisis related to Panax ginseng. Ann Pharmacother 2004; 38: 1967–72Google Scholar
  146. 146.
    Torbey E, Abi Rafeh N, Khoueiry G, et al. Ginseng: a potential cause of long QT. J Electrocardio 2011; 44: 357–8CrossRefGoogle Scholar
  147. 147.
    Liao WI, Lin YY, Chu SJ, et al. Bradyarrhythmia caused by ginseng in a patient with chronic kidney disease. Am J Emerg Med 2010; 28: 538.e5-6PubMedGoogle Scholar
  148. 148.
    Williamson EM. Drug interactions between herbal and prescription medicines. Drug Saf 2003; 26: 1075–92PubMedCrossRefGoogle Scholar
  149. 149.
    Izzo AA, Di Carlo G, Borrelli F, et al. Cardiovascular pharmacotherapy and herbal medicines: the risk of drug interaction. Int J Cardiol 2005; 98: 1–14PubMedCrossRefGoogle Scholar
  150. 150.
    Hu Z, Yang X, Ho PC, et al. Herb-drug interactions: a literature review. Drugs 2005; 65(9): 1239–82PubMedCrossRefGoogle Scholar
  151. 151.
    Izzo AA, Ernst E. Interactions between herbal medicines and prescribed drugs: an updated systematic review. Drugs 2009; 69(13): 1777–98PubMedCrossRefGoogle Scholar
  152. 152.
    Mills E, Wu P, Johnston BC, et al. Natural health product-drug interactions: a systematic review of clinical trials. Ther Drug Monit 2005; 27: 549–57PubMedCrossRefGoogle Scholar
  153. 153.
    Greenblatt DJ, von Molkte LL. Interaction of warfarin with drugs, natural substances and foods. J Clin Pharmacol 2005; 45: 127–32PubMedCrossRefGoogle Scholar
  154. 154.
    Yuan CS, Wei G, Dey L, et al. Brief communication: American ginseng reduces warfarin’s effect in health patients: a randomized, controlled trial. Ann Intern Med 2004; 141: 23–7PubMedGoogle Scholar
  155. 155.
    Jiang X, Blair EY, McLachlan AJ. Investigation of the effects of herbal medicines on warfarin response in healthy subjects: a population pharmacokinetic-pharmacodynamic modeling approach. J Clin Pharmacol 2006; 46: 1370–8PubMedCrossRefGoogle Scholar
  156. 156.
    Lee SH, Ahn YM, Ahn SY, et al. Interaction between warfarin and Panax ginseng in ischemic stroke patients. J Altern Complement Med 2008; 14: 715–21PubMedCrossRefGoogle Scholar
  157. 157.
    Lee YH, Lee BK, Choi YJ, et al. Interaction between warfarin and Korean red ginseng in patients with cardiac valve replacement. Int J Cardiol 2010; 145: 275–6PubMedCrossRefGoogle Scholar
  158. 158.
    McRae S. Elevated serum digoxin levels in a patient taking digoxin and Siberian ginseng. CMAJ 1996; 155: 293–5PubMedGoogle Scholar
  159. 159.
    Dasgupta A, Wu S, Actor J, et al. Effect of Asian and Siberian ginseng on serum digoxin measurement by five digoxin immunoassays: significant variation in digoxin-like immunoreactivity among commercial ginsengs. Am J Clin Pathol 2003; 119: 198–303Google Scholar
  160. 160.
    Buettner C, Yeh GY, Phillips RS, et al. Systematic review of the effects of ginseng on cardiovascular risk factors. Ann Pharmacother 2006; 40: 83–95PubMedGoogle Scholar

Copyright information

© Adis Data Information BV 2011

Authors and Affiliations

  • Morris Karmazyn
    • 1
    Email author
  • Melissa Moey
    • 1
  • Xiaohong Tracey Gan
    • 1
  1. 1.Department of Physiology and Pharmacology, Schulich School of Medicine and DentistryUniversity of Western OntarioLondonCanada

Personalised recommendations