Skip to main content
SpringerLink
Log in

Therapeutic Potential of Ginseng in the Management of Cardiovascular Disorders

  • Review Article
  • Published:
Drugs Aims and scope Submit manuscript

Abstract

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Table I
Table II

Similar content being viewed by others

References

  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: 1043–8

    Article  PubMed  Google Scholar 

  2. Chu SF, Zhang JT. New achievements in ginseng research and its future prospects. Chin J Integr Med 2009; 15: 403–8

    Article  PubMed  CAS  Google Scholar 

  3. Hu SY. The genus Panax (ginseng) in Chinese medicine. Econ Bot 1976; 30: 11–28

    Article  Google Scholar 

  4. Goldstein B. Ginseng: its history, dispersion and folk tradition. Am J Chin Med 1975; 3: 223–34

    Article  PubMed  CAS  Google Scholar 

  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: 1098–105

    Article  PubMed  CAS  Google Scholar 

  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: 865–73

    Article  CAS  Google Scholar 

  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: 1851–8

    Article  PubMed  CAS  Google Scholar 

  8. Dey L, Xie JT, Wang A, et al. Anti-hyperglycemic effects of ginseng: comparison between root and berry. Phytomedicine 2003; 10: 600–5

    Article  PubMed  CAS  Google Scholar 

  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: 1281–7

    Article  PubMed  CAS  Google Scholar 

  10. Mar C, Bent S. An evidence-based review of the 10 most commonly used herbs. West J Med 1999; 171: 168–71

    PubMed  CAS  Google Scholar 

  11. Carlson AW. Ginseng: America’s botanical drug connection to the orient. Econ Bot 1986; 40: 233–49

    Article  Google Scholar 

  12. Appleby JH. Ginseng and the Royal Society. Notes Rec R Soc Lond 1983; 37: 121–45

    Article  PubMed  CAS  Google Scholar 

  13. Wood WB, Roh BL, White RP. Cardiovascular actions of Panax ginseng in dogs. Jpn J Pharmacol 1964; 14: 284–94

    Article  PubMed  CAS  Google Scholar 

  14. Hah JS, Kang BS, Kang DH. Effect of Panax ginseng alcohol extract on cardiovascular ginseng. Yonsei Med J 1978; 19: 11–8

    PubMed  CAS  Google Scholar 

  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: 941–9

    CAS  Google Scholar 

  16. Jia L, Zhao Y. Current evaluation of the millennium phytomedicine. Ginseng (I): etymology, pharmacognosy, phytochemistry, market and regulations. Curr Med Chem 2009; 16: 2475–84

    CAS  Google Scholar 

  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: 2924–42

    CAS  Google Scholar 

  18. Qi LW, Wang CZ, Yuan CS. Isolation and analysis of ginseng: advances and challenges. Nat Prod Rep 2011; 28: 467–95

    Article  PubMed  CAS  Google Scholar 

  19. Attele AS, Wu JA, Yuan CS. Ginseng pharmacology: multiple constituents and multiple actions. Biochem Pharmacol 1999; 58: 1685–93

    Article  PubMed  CAS  Google Scholar 

  20. Lü JM, Yao Q, Chen C. Ginseng compounds: an update on their molecular mechanisms and medical applications. Current Vasc Pharmacol 2009; 7: 293–302

    Article  Google Scholar 

  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: 257–65

    Article  PubMed  CAS  Google Scholar 

  22. Schlag EM, McIntosh MS. Ginsenoside content and variation among and within American ginseng (Panax quinquefolius L.) populations. Phytochemistry 2006; 67: 1510–9

    Article  PubMed  CAS  Google Scholar 

  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: 4549–53

    Article  PubMed  CAS  Google Scholar 

  24. Tanaka H, Fukuda N, Shoyama Y. Identification and differentiation of Panax species using ELISA, RAPD and eastern blotting. Phytochem Anal 2006; 17: 46–55

    Article  PubMed  CAS  Google Scholar 

  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: 989–1004

    Article  PubMed  CAS  Google Scholar 

  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: 1478–84

    Article  PubMed  CAS  Google Scholar 

  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: 1466–73

    Article  PubMed  CAS  Google Scholar 

  28. Lee SM, Shon HJ, Choi CS, et al. Ginsenosides from heat processed ginseng. Chem Pharm Bull (Tokyo) 2009; 57: 92–4

    Article  CAS  Google Scholar 

  29. Park IH, Kim NY, Han SB, et al. Three new dammarane glycosides from heat processed ginseng. Arch Pharm Res 2002; 25: 428–32

    Article  PubMed  CAS  Google Scholar 

  30. Kim WY, Kim JM, Han SB, et al. Steaming of ginseng at high temperature enhances biological activity. J Nat Prod 2000; 63: 1702–4

    Article  PubMed  CAS  Google Scholar 

  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: 724–8

    Article  PubMed  CAS  Google Scholar 

  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: 182–7

    PubMed  CAS  Google Scholar 

  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: 1546–50

    Article  PubMed  CAS  Google Scholar 

  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: 236–43

    Article  PubMed  Google Scholar 

  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: 1668–73

    Article  PubMed  CAS  Google Scholar 

  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: 261–7

    Article  PubMed  CAS  Google Scholar 

  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: 636–46

    Article  PubMed  CAS  Google Scholar 

  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: 1188–93

    Article  PubMed  CAS  Google Scholar 

  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: 1674–9

    Article  PubMed  CAS  Google Scholar 

  40. Kim H, Chen X, Gillis CN. Ginsenosides protect pulmonary vascular endothelium against free radical-induced injury. Biochem Biophys Res Commun 1992; 189: 670–6

    Article  PubMed  CAS  Google Scholar 

  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: 473–80

    Article  PubMed  CAS  Google Scholar 

  42. Kwan CY, Kwan TK. Effects of Panax notoginseng saponins on vascular endothelial cells in vitro. Acta Pharmacol Sin 2000; 21: 1101–5

    PubMed  CAS  Google Scholar 

  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: 142–9

    Article  PubMed  CAS  Google Scholar 

  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: 115–21

    PubMed  CAS  Google Scholar 

  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: 1095–100

    PubMed  CAS  Google Scholar 

  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: 135–41

    Article  PubMed  CAS  Google Scholar 

  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: 41–7

    Article  PubMed  CAS  Google Scholar 

  48. Toda N, Ayajiki K, Fujioka H, et al. Ginsenoside potentiates NO-mediated neurogenic vasodilatation of monkey cerebral arteries. J Ethnopharmacol 2001; 76: 109–13

    Article  PubMed  CAS  Google Scholar 

  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: 661–70

    Article  PubMed  CAS  Google Scholar 

  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: 41–9

    Article  PubMed  CAS  Google Scholar 

  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: 51–7

    Article  PubMed  CAS  Google Scholar 

  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: 764–9

    Article  PubMed  CAS  Google Scholar 

  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: 321–5

    Article  PubMed  Google Scholar 

  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: 129–36

    Article  PubMed  CAS  Google Scholar 

  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: 614–9

    Article  PubMed  CAS  Google Scholar 

  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: 1516–20

    Article  PubMed  CAS  Google Scholar 

  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: 305–9

    Article  PubMed  Google Scholar 

  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: 443–52

    Article  PubMed  CAS  Google Scholar 

  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: 212–5

    Article  PubMed  CAS  Google Scholar 

  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: 687–95

    Article  PubMed  CAS  Google Scholar 

  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): 4327–35

    Article  PubMed  CAS  Google Scholar 

  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: 117–24

    Article  PubMed  CAS  Google Scholar 

  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: 162–6

    Article  PubMed  CAS  Google Scholar 

  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: 459–63

    Google Scholar 

  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: 35–44

    Article  PubMed  CAS  Google Scholar 

  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: 331–4

    Article  PubMed  CAS  Google Scholar 

  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: H851–9

    Article  PubMed  CAS  Google Scholar 

  68. Murphy E, Steenbergen C. Mechanisms underlying acute protection from cardiac ischemia-reperfusion injury. Physiol Rev 2008; 88: 581–609

    Article  PubMed  CAS  Google Scholar 

  69. Schmitt CA, Dirsch VM. Modulation of endothelial nitric oxide by plant-derived products. Nitric Oxide 2009; 21: 77–91

    Article  PubMed  CAS  Google Scholar 

  70. Chen X. Cardiovascular protection by ginsenosides and their nitric oxide releasing action. Clin Exp Pharmacol Physiol 1996; 23: 728–32

    Article  PubMed  CAS  Google Scholar 

  71. Gillis CN. Panax ginseng pharmacology: a nitric oxide link? Biochem Pharmacol 1997; 54: 1–8

    Article  PubMed  CAS  Google Scholar 

  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: 605–15

    Article  PubMed  CAS  Google Scholar 

  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: 1159–65

    Article  PubMed  CAS  Google Scholar 

  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: 567–75

    Article  PubMed  CAS  Google Scholar 

  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: 1916–24

    Article  PubMed  CAS  Google Scholar 

  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: 3211–6

    Article  PubMed  CAS  Google Scholar 

  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: 1006–15

    Article  PubMed  CAS  Google Scholar 

  78. Kitts DD, Wijewickreme AN, Hu C. Antioxidant properties of a North American ginseng extract. Mol Cell Biochem 2000; 203: 1–10

    Article  PubMed  CAS  Google Scholar 

  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: 543–58

    Article  PubMed  CAS  Google Scholar 

  80. Fu Y, Ji LL. Chronic ginseng consumption attenuates ageassociated oxidative stress in rats. J Nutr 2003; 133: 3603–9

    PubMed  CAS  Google Scholar 

  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: 222–30

    Article  PubMed  CAS  Google Scholar 

  82. Xie JT, Shao ZH, Vanden Hoek TL, et al. Antioxidant effects of ginsenoside Re in cardiomyocytes. Eur J Pharmacol 2006; 532: 201–7

    Article  PubMed  CAS  Google Scholar 

  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: 119–25

    Article  PubMed  CAS  Google Scholar 

  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: 165–71

    Article  PubMed  CAS  Google Scholar 

  85. Regula KM, Kirshenbaum LA. Apoptosis of ventricular myocytes: a means to an end. J Mol Cell Cardiol 2005; 38: 3–13

    Article  PubMed  CAS  Google Scholar 

  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: 209–20

    Article  PubMed  Google Scholar 

  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: 365–70

    Article  PubMed  CAS  Google Scholar 

  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: 1–22

    Article  PubMed  CAS  Google Scholar 

  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: 396–403

    Article  PubMed  CAS  Google Scholar 

  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: 1–9

    Google Scholar 

  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: 763–8

    Article  PubMed  Google Scholar 

  92. Chen CF, Chiou WF, Zhang JT. Comparison of the pharmacological effects of Panax ginseng and Panax quinquefolium. Acta Pharmacol Sin 2008; 29: 1103–8

    Article  PubMed  CAS  Google Scholar 

  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: 83–94

    Article  PubMed  Google Scholar 

  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: e18–209

    Article  PubMed  Google Scholar 

  95. Frey N, Katus HA, Olsen EN, et al. Hypertrophy of the heart: a new therapeutic target? Circulation 2004; 109: 1580–9

    Article  PubMed  Google Scholar 

  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: 79–88

    Article  PubMed  CAS  Google Scholar 

  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: 1149–54

    Article  PubMed  CAS  Google Scholar 

  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: 71–6

    Google Scholar 

  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: 525–9

    Article  PubMed  CAS  Google Scholar 

  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: 631–5

    Article  PubMed  CAS  Google Scholar 

  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: 42–7

    Article  PubMed  CAS  Google Scholar 

  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: 1530–1135

    Article  PubMed  CAS  Google Scholar 

  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: 567–72

    Article  PubMed  CAS  Google Scholar 

  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: 180–6

    Article  PubMed  CAS  Google Scholar 

  105. Karmazyn M, Kilić A, Javadov S. The role of NHE-1 in myocardial hypertrophy and remodeling. J Mol Cell Cardiol 2008; 44: 647–53

    Article  PubMed  CAS  Google Scholar 

  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 29

  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 1

    Article  PubMed  Google Scholar 

  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: 760–9

    Article  PubMed  Google Scholar 

  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: 75

    Article  PubMed  Google Scholar 

  110. Volger BK, Pittler MH, Ernst E. The efficacy of ginseng: a systematic review of randomized clinical trials. Eur J Clin Pharmacol 1999; 55: 567–75

    Article  Google Scholar 

  111. Yi SW, Sull JW, Hong JS, et al. Association between ginseng intake and mortality: Kangwha cohort study. J Altern Complement Med 2009; 15: 921–8

    Article  PubMed  Google Scholar 

  112. Caron MF, Hotsko AL, Robertson S, et al. Electrocardiographic and hemodynamic effects of Panax ginseng. Ann Pharmacother 2002; 36: 758–63

    Article  PubMed  Google Scholar 

  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: 14–7

    PubMed  CAS  Google Scholar 

  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: 239–49

    PubMed  Google Scholar 

  115. Zheng CD, Min S. Cardioprotection of Shenfu injection against myocardial ischemia/reperfusion injury in open heart surgery. Chin J Integr Med 2008; 14: 10–6

    Article  PubMed  Google Scholar 

  116. Cheng TO. Ginseng: is there a use in clinical medicine [letter]? Postgrad Med J 1989; 65: 427

    Article  PubMed  CAS  Google Scholar 

  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: 205–16

    Article  PubMed  CAS  Google Scholar 

  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: 199–209

    Article  PubMed  CAS  Google Scholar 

  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: 469–72

    CAS  Google Scholar 

  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: 1236–41

    Article  PubMed  CAS  Google Scholar 

  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: 45–9

    Article  PubMed  Google Scholar 

  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: 406–11

    Article  PubMed  CAS  Google Scholar 

  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: 791–6

    Article  PubMed  CAS  Google Scholar 

  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: 181–7

    PubMed  CAS  Google Scholar 

  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: 516–20

    Article  PubMed  CAS  Google Scholar 

  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: 174–8

    Article  PubMed  CAS  Google Scholar 

  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: 96–101

    Article  PubMed  CAS  Google Scholar 

  128. Inoue M, Wu CZ, Dou DQ, et al. Lipoprotein lipase activation by red ginseng saponins in hyperlipidemia model animals. Phytomedicine 1999; 6: 257–65

    Article  PubMed  CAS  Google Scholar 

  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: 173–9

    Article  PubMed  CAS  Google Scholar 

  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: 468–72

    Article  PubMed  CAS  Google Scholar 

  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: 157–66

    Article  PubMed  CAS  Google Scholar 

  132. Kim SH, Park KS. Effects of Panax ginseng extract on lipid metabolism in humans. Pharmacol Res 2003; 48: 511–3

    Article  PubMed  CAS  Google Scholar 

  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: 108–13

    Article  PubMed  Google Scholar 

  134. Yu JY, Jin YR, Lee JJ, et al. Antiplatelet and antithrombotic activities of Korean Red Ginseng. Arch Pharm Res 2006; 29: 898–903

    Article  PubMed  CAS  Google Scholar 

  135. Teng CM, Kuo SC, Ko FN, et al. Antiplatelet actions of panaxynol and ginsenosides isolated from ginseng. Biochim Biophys Acta 1989; 990: 315–20

    Article  PubMed  CAS  Google Scholar 

  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: 157–62

    Article  PubMed  CAS  Google Scholar 

  137. Kuo SC, Teng CM, Lee JC, et al. Antiplatelet components in Panax ginseng. Planta Med 1990; 56: 164–7

    Article  PubMed  CAS  Google Scholar 

  138. Klepser TB, Klepser ME. Unsafe and potentially safe herbal therapies. Am J Health Syst Pharm 1999; 15: 125–38

    Google Scholar 

  139. Coon JT, Ernst E. Panax ginseng: a systematic review of adverse effects and drug interactions. Drug Saf 2002; 25: 323–44

    Article  PubMed  CAS  Google Scholar 

  140. Ernst E. The efficacy of herbal medicine: an overview. Fundam Clin Pharmacol 2005; 19: 405–9

    Article  PubMed  CAS  Google Scholar 

  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: 505–14

    Article  PubMed  CAS  Google Scholar 

  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: 131–4

    Article  PubMed  CAS  Google Scholar 

  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: 234–8

    Article  PubMed  CAS  Google Scholar 

  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: 78–85

    PubMed  CAS  Google Scholar 

  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: 1967–72

    Google Scholar 

  146. Torbey E, Abi Rafeh N, Khoueiry G, et al. Ginseng: a potential cause of long QT. J Electrocardio 2011; 44: 357–8

    Article  Google Scholar 

  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.e5-6

    PubMed  Google Scholar 

  148. Williamson EM. Drug interactions between herbal and prescription medicines. Drug Saf 2003; 26: 1075–92

    Article  PubMed  CAS  Google Scholar 

  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: 1–14

    Article  PubMed  Google Scholar 

  150. Hu Z, Yang X, Ho PC, et al. Herb-drug interactions: a literature review. Drugs 2005; 65(9): 1239–82

    Article  PubMed  CAS  Google Scholar 

  151. Izzo AA, Ernst E. Interactions between herbal medicines and prescribed drugs: an updated systematic review. Drugs 2009; 69(13): 1777–98

    Article  PubMed  CAS  Google Scholar 

  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: 549–57

    Article  PubMed  Google Scholar 

  153. Greenblatt DJ, von Molkte LL. Interaction of warfarin with drugs, natural substances and foods. J Clin Pharmacol 2005; 45: 127–32

    Article  PubMed  CAS  Google Scholar 

  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: 23–7

    PubMed  CAS  Google Scholar 

  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: 1370–8

    Article  PubMed  CAS  Google Scholar 

  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: 715–21

    Article  PubMed  Google Scholar 

  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: 275–6

    Article  PubMed  Google Scholar 

  158. McRae S. Elevated serum digoxin levels in a patient taking digoxin and Siberian ginseng. CMAJ 1996; 155: 293–5

    PubMed  CAS  Google Scholar 

  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: 198–303

    Google Scholar 

  160. Buettner C, Yeh GY, Phillips RS, et al. Systematic review of the effects of ginseng on cardiovascular risk factors. Ann Pharmacother 2006; 40: 83–95

    PubMed  CAS  Google Scholar 

Download references

Acknowledgements

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.

Author information

Authors and Affiliations

  1. Department of Physiology and Pharmacology, Schulich School of Medicine and Dentistry, University of Western Ontario, Medical Sciences Building, 1151 Richmond Street, London, ON, N6A 5C1, Canada

    Morris Karmazyn, Melissa Moey & Xiaohong Tracey Gan

Authors
  1. Morris Karmazyn
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Melissa Moey
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Xiaohong Tracey Gan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Morris Karmazyn.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Karmazyn, M., Moey, M. & Gan, X.T. Therapeutic Potential of Ginseng in the Management of Cardiovascular Disorders. Drugs 71, 1989–2008 (2011). https://doi.org/10.2165/11594300-000000000-00000

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/11594300-000000000-00000

Keywords

Search

Navigation