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Therapeutic Potential of Terminalia Arjuna in Cardiovascular Disorders

Abstract

The bark of the tree Terminalia arjuna (Roxb.) is widely used in Indian medicine (Ayurveda) for various cardiovascular ailments. The bark has been reported to contain several bioactive compounds. Many experimental studies have reported its antioxidant, anti-ischemic, antihypertensive, and antihypertrophic effects, which have relevance to its therapeutic potential in cardiovascular diseases in humans. Several clinical studies have reported its efficacy mostly in patients with ischemic heart disease, hypertension, and heart failure. However, a major shortcoming in all these experimental and clinical studies is the absence of phytochemical standardization of the extracts. In addition, many clinical studies are poor in terms of design and methods used for generating safety data. This review discusses how to address all these issues for a scientific validation of this medicinal plant.

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References

  1. Reddy KS, Satija A. The Framingham Heart Study: impact on the prevention and control of cardiovascular diseases in India. Prog Cardiovasc Dis 2010; 53(1): 21–7

    PubMed  Article  Google Scholar 

  2. Daviglus ML, Lloyd-Jones DM, Pirzada A. Preventing cardiovascular disease in the 21st century: therapeutic and preventive implications of current evidence. Am J Cardiovasc Drugs 2006; 6(2): 87–101

    PubMed  Article  CAS  Google Scholar 

  3. Kirtikar KR, Basu BD. Terminalia arjuna. In: Kirtikar KR, Basu BD, editors. Indian medicinal plants. Volume II. 2nd ed. Allahabad: Lalit Mohan Basu Publications, 1935: 1023–8

    Google Scholar 

  4. Singh B, Singh VP, Pandey VB, et al. A new triterpene glycoside from Terminalia arjuna. Planta Medica 1995; 61: 576–7

    PubMed  Article  CAS  Google Scholar 

  5. Kandil FE, Nassar MI. A tannin anticancer promoter from Terminalia arjuna. Phytochemistry 1998; 47: 1567–8

    PubMed  Article  CAS  Google Scholar 

  6. Ali A, Abdullah ST, Hamid H, et al. Two new pentacyclic triterpenoid glycosides from the bark of Terminalia arjuna. Ind J Chem 2003; 42B: 2905–8

    CAS  Google Scholar 

  7. King FE, King TJ, Ross JM. The constituent of arjunoilc acid, a triterpene from Terminalia arjuna. J Chem Soc 1954; 3995–4003

  8. Singh DV, Verma RK, Singh SC, et al. RP-LC determination of oleane derivatives in Terminalia arjuna. J Pharm Biomed Anal 2002; 28: 447–52

    PubMed  Article  CAS  Google Scholar 

  9. Row LR, Murty PS, Rao GSRS, et al. Chemical examination of Terminalia species: Part XIII-Isolationa& structure determination of Arjunetin, from Terminalia arjuna. Ind J. Chem 1970; 8: 772–5

    CAS  Google Scholar 

  10. Chopra RN, Chopra IC, Handa KL, et al. (editors). Indigenous drugs of India. Kolkata: U.N. Dhur and Sons, 1958; pp. 51–595

    Google Scholar 

  11. Singh N, Kapur KK, Singh SP, et al. Mechanism of cardiovascular action of Terminalia arjuna. Planta Med 1982; 45(2): 102–4

    PubMed  Article  CAS  Google Scholar 

  12. Takahashi S, Tanaka H, Hano Y, et al. Hypotensive effects in rats of hydrophilic extract from Terminalia arjuna containing tannin-related compounds. Phytother Res 1997; 1: 424–7

    Article  Google Scholar 

  13. Gauthaman K, Banerjee SK, Dinda AK, et al. Terminalia arjuna (Roxb.) protects rabbit heart against ischemic-reperfusion injury: role of antioxidant enzymes and heat shock protein. J Ethnopharmacol 2005; 96(3): 403–9

    PubMed  Article  CAS  Google Scholar 

  14. Dwivedi S, Somani PN, Chansouria JPN, et al. Cardioprotective effects of certain indigenous drugs in myocardial ischemia in rabbits. Indian J Exp Biol 1988; 26(12): 969–75

    PubMed  CAS  Google Scholar 

  15. Pawar RS, Bhutani KK. Effect of oleanane triterpenoids from Terminalia arjuna: a cardioprotective drug on the process of respiratory oxyburst. Phytomedicine 2005; 12(5): 391–3

    PubMed  Article  CAS  Google Scholar 

  16. Gauthaman K, Maulik M, Kumari R, et al. Effect of chronic treatment with bark of Terminalia arjuna: a study on the isolated ischemic-reperfused rat heart. J. Ethnopharmacol 2001; 75(2–3): 197–201

    PubMed  Article  CAS  Google Scholar 

  17. Sumitra M, Manikandan P, Kumar DA, et al. Experimental myocardial necrosis in rats: role of arjunolic acid on platelet aggregation, coagulation and antioxidant status. Mol Cell Biochem 2001; 224(1–2): 135–42

    PubMed  Article  CAS  Google Scholar 

  18. Khanna AK, Chander C, Kapoor NK. Terminalia arjuna: an Ayurvedic cardiotonic regulates lipid metabolism in hyperlipidemic rats. Phytother Res 1996; 10(8): 663–6

    Article  Google Scholar 

  19. Subramaniam S, Ramachandran S, Uthrapathi S, et al. Anti-hyperlipidemic and antioxidant potential of different fractions of Terminalia arjuna Roxb. bark against PX- 407 induced hyperlipidemia. Indian J Exp Biol 2011; 49(4): 282–8

    Google Scholar 

  20. Subramaniam S, Subramaniam R, Rajapandian S, et al. Anti-atherogenic activity of ethanolic fraction of Terminalia arjuna bark on hypercholesterolemic rabbits. Evid Based Complement Alternat Med 2011; 487–916

  21. Kumar S, Enjamoori R, Jaiswal A, et al. Catecholamine-induced myocardial fibrosis and oxidative stress is attenuated by Terminalia arjuna (Roxb.). J Pharm Pharmacol 2009; 61(11): 1529–36

    PubMed  CAS  Google Scholar 

  22. Oberoi L, Akiyama T, Lee KH, et al. The aqueous extract, not organic extracts, of Terminalia arjuna bark exerts cardiotonic effect on adult ventricular myocytes. Phytomedicine 2011 Feb 15; 18(4): 259–6

    PubMed  Article  Google Scholar 

  23. Dwivedi S, Agarwal MP. Antianginal and cardioprotective effects of Terminalia arjuna, an indigenous drug, in coronary artery disease. J Assoc Phys India 1994; 42(4): 287–9

    CAS  Google Scholar 

  24. Dwivedi S, Jauhari R. Beneficial effects of Terminalia arjuna in coronary artery disease. Indian Heart J 1997; 49: 507–10

    PubMed  CAS  Google Scholar 

  25. The SOLVD Investigators. Effect of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure. N Engl J Med 1991; 325: 293–302

    Article  Google Scholar 

  26. Bharani A, Ganguli A, Mathur LK, et al. Efficacy of Terminalia arjuna in chronic stable angina: a double blind, placebo-controlled, crossover study comparing Terminalia arjuna with isosorbide mononitrate. Indian Heart J 2002; 54(2): 170–5

    PubMed  Google Scholar 

  27. Alexander KP, Shaw LJ, Shaw LK, et al. Value of exercise treadmill testing in women. J Am Coll Cardiol 1998; 32(6): 1657–64

    PubMed  Article  CAS  Google Scholar 

  28. Dwivedi S, Aggarwal A, Agarwal MP, et al. Role of Terminalia arjuna in ischaemic mitral regurgitation. Int J Cardiol 2005 Apr 28; 100(3): 507–8

    PubMed  Article  CAS  Google Scholar 

  29. Bharani A, Ahirwar LK, Jain N. Terminalia arjuna reverses impaired endothelial function in chronic smokers. Indian Heart J 2004; 6(2): 123–8

    Google Scholar 

  30. Raitakari OT, Adams MR, McCredie RJ, et al. Oral vitamin C and endothelial function in smokers: short-term improvement, but no sustained beneficial effect. J Am Coll Cardiol 2000; 35(6): 1616–21

    PubMed  Article  CAS  Google Scholar 

  31. Neunteufl T, Priglinger U, Heher S, et al. Effects of vitamin E on chronic and acute endothelial dysfunction in smokers. J Am Coll Cardiol 2000; 35(2): 277–83

    PubMed  Article  CAS  Google Scholar 

  32. Rao BCS, Singh RH, Tripathi K. Effect of Terminalia arjuna (W&A) on regression of LVH in hypertensives: a clinical study. J Res Ayurveda Sidhha 2001; XXII(3–4): 216–27

    Google Scholar 

  33. Fagard RH, Celis H, Thijs L, et al. Regression of left ventricular mass by antihypertensive treatment: a meta-analysis of randomized comparative studies. Hypertension 2009; 54(5): 1084–91

    PubMed  Article  CAS  Google Scholar 

  34. Bharani A, Ganguly A, Bhargava KD. Salutary effect of Terminalia Arjuna in patients with severe refractory heart failure. Int J Cardiol 1995; 49: 191–9

    PubMed  Article  CAS  Google Scholar 

  35. Greenberg B, Borghi C, Perrone S. Pharmacotherapeutic approaches for decompensated heart failure: a role for the calcium sensitiser, levosimendan? Eur J Heart Fail 2003; 5(1): 13–21

    PubMed  Article  CAS  Google Scholar 

  36. Kontush A, Chapman MJ. Antiatherogenic small, dense HDL: guardian angel of the arterial wall? Nat Clin Pract Cardiovasc Med 2006; 3(3): 144–53

    PubMed  Article  CAS  Google Scholar 

  37. Gupta R, Singhal S, Goyle A, et al. Antioxidant and hypocholesterolaemic effects of Terminalia arjuna tree-bark powder: a randomised placebocontrolled trial. J Assoc Physicians India 2001; 49: 231–5

    PubMed  CAS  Google Scholar 

  38. Malik N, Dhawan V, Bahl A, et al. Inhibitory effects of Terminalia arjuna on platelet activation in vitro in healthy subjects and patients with coronary artery disease. Platelets 2009; 20(3): 183–90

    PubMed  Article  CAS  Google Scholar 

  39. Sandhu JS, Shah B, Shenoy S, et al. Effects of Withania somnifera (Ashwagandha) and Terminalia arjuna (Arjuna) on physical performance and cardiorespiratory endurance in healthy young adults. Int J Ayurveda Res 2010 Jul; 1(3): 144–9

    PubMed  Article  Google Scholar 

  40. Jayakumar K. Bottlenecks in standardisation of traditional system of medicine. Res J Medicinal Plants 2011; 5(4): 443–7

    Article  Google Scholar 

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The authors have no conflicts of interest that are directly related to the content of this article. No external sources of funding were used in the preparation of this article.

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Correspondence to Subir K. Maulik.

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Maulik, S.K., Talwar, K.K. Therapeutic Potential of Terminalia Arjuna in Cardiovascular Disorders. Am J Cardiovasc Drugs 12, 157–163 (2012). https://doi.org/10.2165/11598990-000000000-00000

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Keywords

  • Left Ventricular Mass
  • Left Ventricular Mass Index
  • Bark Extract
  • Isosorbide Dinitrate
  • Hydroalcoholic Extract