The Therapeutic Potentials of Malaysian Medicinal Plants for Cardiovascular Diseases: A Review
Keywords:
antihyperlipidaemia, anticoagulant,, cardioprotective, cardiovascular diseases, Malaysian plants, vasorelaxantAbstract
Cardiovascular diseases are among the most common diseases around the world with a considerably high rate of mortality. In view of this, multiple approaches have been proposed, especially in exploiting the potential of herbal plants due to their availability, accessibility and medicinal values. This review was conducted based on 16 medicinal herbs available in Malaysia as listed in the Malaysian Herbal Monograph. The aim was to study their effects on the alleviation of cardiovascular diseases, to analyse the relationship between the phytochemical compounds of herbal plants in relation to cardiovascular diseases and to review their underlying mechanism of action. The medicinal plants are organised based on their effects on alleviating cardiovascular diseases either directly or indirectly through reduction of cardiovascular disease risk factors, such as antihyperlipidemic, vasodilatory effects, cardioprotective and anticoagulant effects. Both in vivo and in vitro studies are included in this review to demonstrate the scientific value of related plants in cardiovascular diseases. In conclusion, many studies have identified a diversity of herbal plants in Malaysia to possess cardiovascular-relieving activities. Further studies can be conducted to develop these plants for cardiovascular disease treatment or prevention.
Downloads
Metrics
References
Abdul Azis, N.A., Agarwal, R., Ismail, N.M., Ismail, N.H., Kamal, M.S.A., Radjeni, Z., et al. 2019. Blood pressure lowering effect of Ficus deltoidea var kunstleri in spontaneously hypertensive rats: Possible involvement of renin-angiotensin-aldosterone system, endothelial function and antioxidant system. Molecular Biology Report, 46(3): 2841-2849. DOI: https://doi.org/10.1007/s11033-019-04730-w
Abdullah, N., Hosseinpour Chermahini, D.S., Chua, L.S. & Sarmidi, M.R. 2013. Labisia pumila: A review on its traditional, phytochemical and biological uses. World Applied Sciences Journal, 27(10): 1297-1306.
Abdullah, Z., Hussain, K., Ismail, Z. & Mat Ali, R. 2009. Anti-inflammatory activity of standardised extracts of leaves of three varieties of Ficus deltoidea. International Journal of Pharmaceutical and Clinical Research, 1(3): 100-105.
Abeywardena, M., Runnie, I., Nizar, M., Suhaila, M., Head, R. & Momamed, S. 2002. Polyphenol-enriched extract of oil palm fronds (Elaeis guineensis) promotes vascular relaxation via endothelium-dependent mechanisms. Asia Pacific Journal of Clinical Nutrition, 11(7): S467-72. DOI: https://doi.org/10.1046/j.1440-6047.11.s.7.10.x
Agatemor, U.M.M., Nwodo, O.F.C. & Anosike, C.A. 2015. Anti-inflammatory activity of Cucumis sativus L. British Journal of Pharmaceutical Research, 8(2): 1-8. DOI: https://doi.org/10.9734/BJPR/2015/19700
Agila, A. & Barringer, S.A. 2011 Volatile profile of cashews (Anacardium occidentale L.) from different geographical origins during roasting. Journal of Food Science, 76(5): 768-774. DOI: https://doi.org/10.1111/j.1750-3841.2011.02180.x
Ahmad Kamal, M.S., Ismail, N.H., Satar, N.A., Azis, N.A., Radjeni, Z., Mohammad Noor, H.S., et al. 2019. Standardized ethanol-water extract of Ficus deltoidea Angustifolia reduces blood pressure in spontaneously hypertensive rats. Clinical and Experimental Hypertension, 41(5): 444-451. DOI: https://doi.org/10.1080/10641963.2018.1506467
Ahmad Nazri, K.A., Haji Mohd Saad, Q., Mohd Fauzi, N., Buang, F., Jantan, I. & Jubri, Z. 2021. Gynura procumbensethanol extract improves vascular dysfunction by suppressing inflammation in postmenopausal rats fed a high-fat diet. Pharmaceutical Biology, 59(1): 1203-1215. DOI: https://doi.org/10.1080/13880209.2021.1970199
Ali, N.S. & Khuwaja, A.K. 2011. Betel nut (Areca catechu) usage and its effects on health. In: Nuts and seeds in health and disease prevention. Preedy, V.R., Watson, R.R. & Patel, V.B. Academic Press, San Diego. 197-204 pp. DOI: https://doi.org/10.1016/B978-0-12-375688-6.10023-4
American Heart Association (AHA). 2020. Prevention and treatment of high cholesterol (hyperlipidemia) [WWW Document]. URL https://www.heart.org/en/health-topics/cholesterol/prevention-and-treatment-of-high-cholesterol-hyperlipidemia (accessed 10.05.22).
Anyanji, V., Mohamed, S., Zokti, J. & Ado, M.A. 2013. Anti-inflammatory properties of oil palm leaf (Elaeis guineensis Jacq.) extract in aged rats. International Journal of Pharmacy and Pharmaceutical Sciences, 5(4): 134-136.
Azadmehr, A., Ziaee, A., Ghanei, L., Fallah Huseini, H., Hajiaghaee, R., Tavakoli-Far, B. et al. 2014. A randomized clinical trial study: Antioxidant, anti-hyperglycemic and anti-hyperlipidemic effects of olibanum gum in type 2 diabetic patients. Iranian Journal of Pharmaceutical Research, 13(3): 1003-9.
Aziz, Z. & Tey, N.P. 2009. Herbal medicines: Prevalence and predictors of use among DOI: https://doi.org/10.1016/j.ctim.2008.04.008
Malaysian adults. Complementary Therapies in Medicine, 17(1): 44-50.
Baptista, A., Gonçalves, R.V., Bressan, J., Pelúzio, M.D.C.G. 2018. Antioxidant and antimicrobial activities of crude extracts and fractions of cashew (Anacardium occidentale L.), cajui (Anacardium microcarpum), and pequi (Caryocar brasiliense C.): A systematic review. Oxidative Medicine and Cellular Longevity, 2018: 3753562. DOI: https://doi.org/10.1155/2018/3753562
Basar, S., Uhlenhut, K., Högger, P., Schöne, F. & Westendorf, J. 2010. Analgesic and antiinflammatory activity of Morinda citrifolia L. (Noni) fruit. Phytotherapy Research, 24(1): 38-42. DOI: https://doi.org/10.1002/ptr.2863
Bastos, J.F., Moreira, I.J., Ribeiro, T.P., Medeiros, I.A., Antoniolli, A.R., De Sousa, D.P. et al. 2010. Hypotensive and vasorelaxant effects of citronellol, a monoterpene alcohol, in rats. Basic & Clinical Pharmacology & Toxicology, 106(4): 331-7. DOI: https://doi.org/10.1111/j.1742-7843.2009.00492.x
Bekkouch, O., Gökhan Zengin, G., Harnafi, M., Touiss, I., Khoulati, A., Saalaoui, E. et al. 2023. Anti-inflammatory study and phytochemical characterization of Zingiber officinale Roscoe and Citrus limon L. juices and their formulation. ACS Omega, 8(30): 26715–26724. DOI: https://doi.org/10.1021/acsomega.2c04263
Bhaskaran, S., Unnikrishnan, A., Ranjit, R., Qaisar, R., Pharaoh, G., Matyi, S. et al. 2017. A fish oil diet induces mitochondrial uncoupling and mitochondrial unfolded protein response in epididymal white adipose tissue of mice. Free Radical Biology & Medicine, 108: 704-714. DOI: https://doi.org/10.1016/j.freeradbiomed.2017.04.028
Bian, D., Liu, M., Li, Y., Xia, Y., Gong, Z. & Dai, Y. 2012. Madecassoside, a triterpenoid saponin isolated from Centella asiatica herbs, protects endothelial cells against oxidative stress. Journal of Biochemical and Molecular Toxicology, 26(10): 399-406. DOI: https://doi.org/10.1002/jbt.21434
Bian, G.X., Li, G.G., Yang, Y., Liu, R.T., Ren, J.P., Wen, L.Q. et al. 2008. Madecassoside reduces ischemia-reperfusion injury on regional ischemia induced heart infarction in rat. Biological & Pharmaceutical Bulletin, 31(3): 458-63. DOI: https://doi.org/10.1248/bpb.31.458
Brasil, G.A., Ronchi, S.N., do Nascimento, A.M., de Lima, E.M., Romão, W., da Costa, H.B. et al. 2014. Antihypertensive effect of Carica papaya via a reduction in ACE activity and improved baroreflex. Planta Medica, 80(17): 1580-7. DOI: https://doi.org/10.1055/s-0034-1383122
Bunaim, M.K., Kamisah, Y., Mohd Mustazil, M.N., Fadhlullah Zuhair, J.S., Juliana, A.H. & Muhammad, N. 2021. Centella asiatica (L.) Urb. prevents hypertension and protects the heart in chronic nitric oxide deficiency rat model. Frontiers in Pharmacology, 12: 742562. DOI: https://doi.org/10.3389/fphar.2021.742562
Chong, K., Zakaria, Z., Sasidharan, S., Kalnisha Devi, P.V., Yoga Latha, L. & Ramanathan, S. 2007. Antimicrobial activity of Elaeis guineensis leaf. Pharmacologyonline, 3: 379-386.
Dai, Y., Wang, Z., Quan, M., Lv, Y., Li, Y., Xin, H.B. et al. 2018. Asiatic acid protests against myocardial ischemia/reperfusion injury via modulation of glycometabolism in rat cardiomyocyte. Drug Design, Development and Therapy, 12: 3573-3582. DOI: https://doi.org/10.2147/DDDT.S175116
Department of Statistic Malaysia (DOSM). 2024. Statistics on causes of death, Malaysia, 2024. [WWW Document]. URL https://www.dosm.gov.my/portal-main/release-content/statistics-on-causes-of-death-malaysia-2024 (accessed 01.11.24).
Devi, R.C., Sim, S.M. & Ismail, R. 2012. Effect of Cymbopogon Citratus and citral on vascular smooth muscle of the isolated thoracic rat aorta. Evid-Based Complementary and Alternative Medicine, 2012: 1-8. DOI: https://doi.org/10.1155/2012/539475
Dianita, R., Jantan, I., Amran, A.Z. & Jalil, J. 2015. Protective effects of Labisia pumila var. alata on biochemical and histopathological alterations of cardiac muscle cells in isoproterenol-induced myocardial infarction rats. Molecules, 20(3): 4746-63. DOI: https://doi.org/10.3390/molecules20034746
Dianita, R., Jantan, I., Jalil, J. & Amran, A.Z. 2016. Effects of Labisia pumila Var Alata extracts on the lipid profile, serum antioxidant status and abdominal aorta of high-cholesterol diet rats. Phytomedicine, 23(8): 810-817. DOI: https://doi.org/10.1016/j.phymed.2016.04.004
Dias, C.C.Q., Madruga, M.S., Pintado, M.M.E., Almeida, G.H.O., Alves, A.P.V., Dantas, F.A. et al. 2019. Cashew nuts (Anacardium occidentale L.) decrease visceral fat, yet augment glucose in dyslipidemic rats. PLoS One, 14(12): e0225736. DOI: https://doi.org/10.1371/journal.pone.0225736
Duan, D.P., Li, H.J., Chai, S.Y., Zhang, L.L., Fan, T.F., Hu, Z.F. et al. 2024. The relationship between cardiac oxidative stress, inflammatory cytokine response, cardiac pump function, and prognosis post‐myocardial infarction. Scientific Reports, 14: 8985. DOI: https://doi.org/10.1038/s41598-024-59344-5
Eno, A.E., Owo, O.I., Itam, E.H. & Konya, R.S. 2000. Blood pressure depression by the fruit juice of Carica papaya (L.) in renal and doca-induced hypertension in the rat. Phytotherapy Research, 14(4): 235-239. DOI: https://doi.org/10.1002/1099-1573(200006)14:4<235::AID-PTR574>3.0.CO;2-G
Farsi, E., Ahmad, M., Hor, S.Y., Ahamed, M.B., Yam, M.F., Asmawi, M.Z. et al. 2014. Standardized extract of Ficus deltoidea stimulates insulin secretion and blocks hepatic glucose production by regulating the expression of glucose-metabolic genes in streptozitocin-induced diabetic rats. BMC Complementary and Alternative Medicine, 14:220. DOI: https://doi.org/10.1186/1472-6882-14-220
Feingold, K.R. 2021. Introduction to lipids and lipoproteins. Endotext, South Darthmouth. [WWW Document]. URL https://www.ncbi.nlm.nih.gov/books/NBK305896/ (accessed 01.11.24).
Figueirinha, A., Cruz, M.T., Francisco, V., Lopes, M.C., Batista, M.T. 2010. Anti-inflammatory activity of Cymbopogon citratus leaf infusion in lipopolysaccharide-stimulated dendritic cells: Contribution of the polyphenols. Journal of Medicinal Food, 13(3): 681-90. DOI: https://doi.org/10.1089/jmf.2009.0115
Fu, J., Zhang, X.W., Liu, K., Li, Q.S., Zhang, L.R., Yang, X.H., et al. 2012. Hypolipidemic activity in Sprague-Dawley rats and constituents of a novel natural vegetable oil from Cornus wilsoniana fruits. Journal of Food Science, 77(8): H160-9. DOI: https://doi.org/10.1111/j.1750-3841.2012.02786.x
Frangogiannis, N.G. 2015. Pathophysiology of myocardial infarction. Comprehensive Physiology, 5(4): 1841-1875. DOI: https://doi.org/10.1002/j.2040-4603.2015.tb00664.x
Gayathri, K., Jayachandran, K.S., Vasanthi, H.R. & Victor Rajamanickam, G. 2011. Cardioprotective effect of lemon grass as evidenced by biochemical and histopathological changes in experimentally induced cardiotoxicity. Human & Experimental Toxicology, 30(8): 1073-1082. DOI: https://doi.org/10.1177/0960327110386391
Gidding, S.S. & Allen, N.B. 2019. Cholesterol and atherosclerotic cardiovascular disease: A lifelong problem. Journal of American Heart Association, 8(11): 1-3. DOI: https://doi.org/10.1161/JAHA.119.012924
Gilani, A.H., Mandukhail, S.U., Iqbal, J., Yasinzai, M., Aziz, N., Khan, A., et al. 2010. Antispasmodic and vasodilator activities of Morinda citrifolia root extract are mediated through blockade of voltage dependent calcium channels. BMC Complementary Alternative Medicine and Therapy, 10: 2. DOI: https://doi.org/10.1186/1472-6882-10-2
Gui, J.S., Jalil, J., Jubri, Z. & Kamisah, Y. 2019. Parkia speciosa empty pod extract exerts anti-inflammatory properties by modulating Nfκb and Mapk pathways in cardiomyocytes exposed to tumor necrosis factor-Α. Cytotechnology, 71(1): 79-89. DOI: https://doi.org/10.1007/s10616-018-0267-8
Hackam, D.G. & Spence, J.D. 2019. Antiplatelet therapy in ischemic stroke and transient ischemic attack. Stroke, 50(3): 773-778. DOI: https://doi.org/10.1161/STROKEAHA.118.023954
Harrison, D.G., Coffman, T.M. & Wilcox, C.S. 2021. Pathophysiology of hypertension: The Mosaic Theory and beyond. Circulation Research, 128(7): 847-863. DOI: https://doi.org/10.1161/CIRCRESAHA.121.318082
Harwoko, H., Pramono, S. & Nugroho, A.E. 2014. Triterpenoid-rich fraction of Centella asiatica leaves and in vivo antihypertensive activity. International Food Research Journal, 21(1): 149-154.
Hoe, S.Z., Kamaruddin, M.Y. & Lam, S.K. 2007. Inhibition of angiotensin-converting enzyme activity by a partially purified fraction of Gynura procumbens in spontaneously hypertensive rats. Medical Principles and Practice, 16(3): 203-208. DOI: https://doi.org/10.1159/000100391
Hoe, S.Z., Lee, C.N., Mok, S.L., Kamaruddin, M.Y. & Lam, S.K. 2011. Gynura procumbens Merr. decreases blood pressure in rats by vasodilatation via inhibition of calcium channels. Clinics (Sao Paulo), 66(1): 143-50. DOI: https://doi.org/10.1590/S1807-59322011000100025
Hou, Q., Li, M., Lu, Y.H., Liu, D.H. & Li, C.C. 2016. Burn wound healing properties of asiaticoside and madecassoside. Experimental and Therapeutic Medicine, 12(3): 1269-1274. DOI: https://doi.org/10.3892/etm.2016.3459
Huang, W.Y., Fu, L., Li, C.Y., Xu, L.P., Zhang, L.X. & Zhang, W.M. 2017. Quercetin, hyperin, and chlorogenic acid improve endothelial function by antioxidant, antiinflammatory, and ACE inhibitory effects. Journal of Food Science, 82(5): 1239-1246. DOI: https://doi.org/10.1111/1750-3841.13706
Huang, X., Zuo, L., Lv, Y., Chen, C., Yang, Y., Xin, H., Li, Y. & Qian, Y. 2016. Asiatic acid attenuates myocardial ischemia/reperfusion injury via Akt/GSK-3β/HIF-1α signaling in rat H9c2 cardiomyocytes. Molecules, 21(9): 1248. DOI: https://doi.org/10.3390/molecules21091248
Iqbal, Z., Bello, I., Asmawi, M.Z., Al-Mansoub, M.A., Ahmad, A., Jabeen, Q., et al. 2017. Vasorelaxant activities and underlying pharmacological mechanisms of Gynura procumbens Merr. leaf extracts on rat thoracic aorta. Inflammopharmacology, 27(2): 421-431. DOI: https://doi.org/10.1007/s10787-017-0422-4
Issac, P., Jayaseelan, A., Chandrakumar, S. & Jaiganesh, S. 2018. Tannins of Jatropha gossypifolia exert anti-hyperlipidemic effect in streptozotocin-nicotinamide induced diabetic rats. European Journal of Biomedical and Pharmaceutical Sciences, 5(1): 607-614.
Iyer, D., Sharma, B.K. & Patil, U.K. 2011. Effect of ether- and water-soluble fractions of Carica papaya ethanol extract in experimentally induced hyperlipidemia in rats. Pharmaceutical Biology, 49(12): 1306-1310. DOI: https://doi.org/10.3109/13880209.2011.596210
Jaffri, J.M., Mohamed, S., Rohimi, N., Ahmad, I.N., Noordin, M.M. & Manap, Y.A. 2011. Antihypertensive and cardiovascular effects of catechin-rich oil palm (Elaeis guineensis) leaf extract in nitric oxide-deficient rats. Journal of Medicinal Food, 14(7-8): 775-83. DOI: https://doi.org/10.1089/jmf.2010.1170
Jiang, S., Xu, L., Xu, Y., Guo, Y., Wei, L., Li, X. et al. 2020. Antidiabetic effect of Momordica charantia saponins in rats induced by high-fat diet combined with STZ. Electronic Journal of Biotechnology, 43: 41-47. DOI: https://doi.org/10.1016/j.ejbt.2019.12.001
Joachimdass, R.J., Subramaniam, K., Sit, N.W., Lim, Y.M., Teo, C.H., Ng, C.J., et al. 2021. Self-management using crude herbs and the health-related quality of life among adult patients with hypertension living in a suburban setting of Malaysia. PLoS One, 16(9): e0257336. DOI: https://doi.org/10.1371/journal.pone.0257336
Kamisah, Y., Zuhair, J., Juliana, A. & Jaarin, K. 2017. Parkia speciosa empty pod prevents hypertension and cardiac damage in rats given N(G)-nitro-L-arginine methyl ester. Biomedicine & Pharmacotherapy, 96: 291-298. DOI: https://doi.org/10.1016/j.biopha.2017.09.095
Kant, R., Srivastav, P.P. & Datta, A.K. 2019. The medicinal role of Centella asiatica and its applications in the Dahi: A research review. Journal of Pharmaceutical Research International, 28(6): 1-9. DOI: https://doi.org/10.9734/jpri/2019/v28i630220
Kaski, J.C. 2024. Pathogenesis of atherosclerosis. [WWW Document]. URL https://www.uptodate.com/contents/pathogenesis-of-atherosclerosis (accessed 01.11.24).
Kelishadi, R., Mansourian, M., Ghanadian, M., Ataei, E. & Mirmoghtadaee, P. 2016. Nutraceuticals in hyperlipidemic children: A systematic review and meta-analysis. International Journal of Pediatric Perspectives, 4: 1569-1578.
Khare, C.P. 2007. Kaempferia galanga Linn. In. Khare, C. P. Indian medicinal plants: An illustrated dictionary. Springer, New York. DOI: https://doi.org/10.1007/978-0-387-70638-2_848
Khoo, L.T., Abas, F., Abdullah, J.O., Mohd Tohit, E.R. & Abdullah, J.A. 2014. Anticoagulant activity of polyphenolic-polysaccharide isolated from Melastoma malabathricum L. Evidence-Based Complementary and Alternative Medicine, 2014: 1-8. DOI: https://doi.org/10.1155/2014/614273
Khoo, L.T., Abdullah, J.O., Abas, F., Tohit, E.R. & Hamid, M. 2015. Bioassay-guided fractionation of Melastoma malabathricum Linn. leaf solid phase extraction fraction and its anticoagulant activity. Molecules, 20(3): 3697-715. DOI: https://doi.org/10.3390/molecules20033697
Kim, M.J., Lee, H.J., Wiryowidagdo, S. & Kim, H.K. 2006. Antihypertensive effects of Gynura procumbens extract in spontaneously hypertensive rats. Journal of Medicinal Food, 9(4): 587-90. DOI: https://doi.org/10.1089/jmf.2006.9.587
Kumari, S., Deori, M., Elancheran, R., Kotoky, J. & Devi, R. 2016. In vitro and in vivo antioxidant, anti-hyperlipidemic properties and chemical characterization of Centella asiatica (L.) extract. Frontiers in Pharmacology, 7: 400. DOI: https://doi.org/10.3389/fphar.2016.00400
Kuriakose, D. & Xiao, Z. 2020. Pathophysiology and treatment of stroke: Present status and future perspectives. International Journal of Molecular Science, 21(20): 7609. DOI: https://doi.org/10.3390/ijms21207609
Leisegang, K., Finelli, R., Sikka, S.C. & Panner Selvam, M.K. 2022. Eurycoma longifolia(Jack) improves serum total testosterone in men: A systematic review and meta-analysis of clinical trials. Medicina (Kaunas), 58(8): 1047. DOI: https://doi.org/10.3390/medicina58081047
Lim, T. 2012. Parkia speciosa edible medicinal and non-medicinal plants. Springer, New York. 798-803 pp. DOI: https://doi.org/10.1007/978-94-007-1764-0_90
Liu, J., Liu, Y., Sun, J., Guo, Y., Lei, Y., Guo, M. & Wang, L. 2023. Protective effects and mechanisms of Momordica charantia polysaccharide on early-stage diabetic retinopathy in type 1 diabetes. Biomedicine & Pharmacotherapy, 168: 115726. DOI: https://doi.org/10.1016/j.biopha.2023.115726
Liu, X., Li, G., Wang, H., Qin, N., Guo, L., Wang, X. & Shen, S. 2021. Identification, characterization and antihypertensive effect in vivo of a novel ACE-inhibitory heptapeptide from defatted areca nut kernel globulin hydrolysates. Molecules, 26(11): 3308. DOI: https://doi.org/10.3390/molecules26113308
Liu, Y.T., Chuang, Y.C., Lo, Y.S., Lin, C.C., His, Y.T., Hsieh, M.J., et al. 2020. Asiatic acid, extracted from Centella asiatica and induces apoptosis pathway through the phosphorylation p38 mitogen-activated protein kinase in cisplatin-resistant nasopharyngeal carcinoma cells. Biomolecules, 10(2): 184. DOI: https://doi.org/10.3390/biom10020184
Mahadeva Rao, U.S. & Shanmuga Sundaram, C. 2017. Antihypercholesterolemic, antioxidant and renal protective effects of mengkudu (Rubiaceae) fruit in nephropathy-induced albino rats. Chinese Journal of Integrative Medicine, 15 Sept 2017. DOI: https://doi.org/10.1007/s11655-017-2785-1
Mahwish, Saeed, F., Arshad, M.S., Nisa, M.U., Nadeem, M.T. & Arshad, M.U. 2017. Hypoglycemic and hypolipidemic effects of different parts and formulations of bitter gourd (Momordica Charantia). Lipids in Health and Disease, 16(1): 211. DOI: https://doi.org/10.1186/s12944-017-0602-7
Mandalaneni, K., Rayi, A. & Jillella, D.V. 2024. Stroke reperfusion injury. [WWW Document]. URL https://www.ncbi.nlm.nih.gov/books/NBK564350/ (accessed 01.11.24).
Mandukhail, S.U.R., Aziz, N. & Gilani, A.H. 2010. Studies on antidyslipidemic effects of Morinda citrifolia (noni) fruit, leaves and root extracts. Lipids in Health and Disease, 9: 88. DOI: https://doi.org/10.1186/1476-511X-9-88
Manicam, C., Abdullah, J.O., Rahayu, E., Mohd Tohit, E.R., Seman, Z., Sieo, C.C., et al. 2010. In vitro anticoagulant activities of Melastoma malabathricum Linn. aqueous leaf extract: a preliminary novel finding. Journal of Medicinal Plants Research, 4(14): 1464-1472.
Manshor, N.M., Razali, N., Jusoh, R.R., Asmawi, M.Z., Mohamed, N., Zainol, S., et al. 2020. Vasorelaxant effect of water fraction of Labisa pumila and its mechanisms in spontaneously hypertensive rats aortic ring preparation. International Journal of Cardiology Hypertension, 4: 1-7. DOI: https://doi.org/10.1016/j.ijchy.2020.100024
Matsui, S., Yamane, T., Takita, T., Oishi, Y. & Kobayashi-Hatori, K. 2013. The hypocholesterolemic activity of Momordica charantia fruit is mediated by the altered cholesterol- and bile acid-regulating gene expression in rat liver. Nutrition Research, 33(7): 580-585. DOI: https://doi.org/10.1016/j.nutres.2013.05.002
Mechanic, O.J., Gavin, M. & Grosman, S.A. 2022. Acute myocardial infarction. [WWW
Document]. URL https://www.ncbi.nlm.nih.gov/books/NBK459269/ (accessed
11.1.24).
Meenapriya, M. & Priya, J. 2017. Effect of lemongrass oil on rheumatoid arthritis. Journal of Pharmaceutical Sciences and Research, 9(2): 237-239.
Michel, J., Abd Rani, N.Z. & Husain, K. 2020. A review on the potential use of medicinal plants from Asteraceae and Lamiaceae plant family in cardiovascular diseases. Frontiers in Pharmacology, 11: 852. DOI: https://doi.org/10.3389/fphar.2020.00852
Minaiyan, M, Zolfaghari, B. & Kamal, A. 2011. Effect of hydroalcoholic and buthanolic extract of Cucumis sativus seeds on blood glucose level of normal and streptozotocin-induced diabetic rats. Iranian Journal of Basic Medical Sciences, 14(5): 436 – 442. DOI: https://doi.org/10.5897/JMPR11.1369
Ministry of Health (MOH). 2024. National health and morbidity survey 2023. [WWW Document]. URL https://iku.nih.gov.my/images/nhms2023/key-findings-nhms-2023.pdf (accessed 01.11.24).
Ndiaye, M., Anselm, E., Séne, M., Diatta, W., Dièye, A.M., Faye, B., et al. 2009. Mechanisms underlying the endothelium-dependent vasodilatory effect of an aqueous extract of Elaeis Guineensis Jacq. (Arecaceae) in porcine coronary artery rings. African Journal of Traditional, Complementary and Alternative Medicine, 7(2):118-24. DOI: https://doi.org/10.4314/ajtcam.v7i2.50869
Od-Ek, P., Deenin, W., Malakul, W., Phoungpetchara, I. & Tunsophon, S. 2020. Antiobesity effect of Carica papaya in high-fat diet fed rats. Biomedical Reports, 13(4): 30. DOI: https://doi.org/10.3892/br.2020.1337
Othman, R., Ibrahim, H., Mohd, M.A., Awang, K., Gilani, A.U. & Mustafa, M.R. 2002. Vasorelaxant effects of ethyl cinnamate isolated from Kaempferia galanga on smooth muscles of the rat aorta. Planta Medica, 68(7): 655-657. DOI: https://doi.org/10.1055/s-2002-32900
Parab, R.S. & Mengi, S.A. 2002. Hypolipidemic activity of Acorus calamus L. in rats. Fitoterapia, 73(6): 451-455. DOI: https://doi.org/10.1016/S0367-326X(02)00174-0
Pawlaczyk, I., Czerchawski, L., Kańska, J., Bijak, J., Capek, P., Pliszczak-Król, A., et al. 2010. An acidic glycoconjugate from Lythrum salicaria L. with controversial effects on haemostasis. Journal of Ethnopharmacology, 131(1): 63-9. DOI: https://doi.org/10.1016/j.jep.2010.06.001
Pazos, D.C., Jiménez, F.E., Garduño, L., Lopez, V.E. & Cruz, M.C. 2011. Hypolipidemic effect of seed oil of noni (Morinda citrifolia). Natural Product Communications, 6(7): 1005-1008. DOI: https://doi.org/10.1177/1934578X1100600722
Poh, T.F., Ng, H.K., Hoe, S.Z. & Lam, S.K. 2013. Gynura procumbens causes vasodilation by inhibiting angiotensin ii and enhancing bradykinin actions. Journal of Cardiovascular Pharmacology, 61(5): 378-384. DOI: https://doi.org/10.1097/FJC.0b013e31828685b3
Raish, M. 2017. Momordica charantia polysaccharides ameliorate oxidative stress, hyperlipidemia, inflammation, and apoptosis during myocardial infarction by inhibiting the Nf-Κb signaling pathway. International Journal of Biological Macromolecules, 97: 544-551. DOI: https://doi.org/10.1016/j.ijbiomac.2017.01.074
Rajput, S.B., Tonge, M.B. & Karuppayil, S.M. 2014. An overview on traditional uses and pharmacological profile of Acorus calamus Linn. (sweet flag) and other Acorus species. Phytomedicine, 21(3): 268-276. DOI: https://doi.org/10.1016/j.phymed.2013.09.020
Ravikant, T., Nishant, G., Shashipal, S., Samriti, T., Thakur, R., Kumar, et al. 2012. Antihypertensive effect of ethanolic extract of indian Carica papaya l. root bark (caricaeae) in renal artery occluded hypertensive rats. International Journal Pharmaceutical and Clinical Research, 4(3): 20-23.
Reddy, M.D., Kalpana, M., Sivaraj, N., Kamala, V., Pandravada, S.R. & Sunil, N. 2019. Indigenous traditional knowledge on health and equitable benefits of oil palm (Elaies Spp.) Open Access Library Journal, 6(1): 1-25. DOI: https://doi.org/10.4236/oalib.1105103
Rishavy, M.A., Hallgren, K.W., Wilson, L., Singh, S., Runge, K.W. & Berkner, K.L. 2018. Warfarin alters vitamin K metabolism: a surprising mechanism of VKORC1 uncoupling necessitates an additional reductase. Blood, 131(25): 2826-2835. DOI: https://doi.org/10.1182/blood-2017-09-804666
Saad, D.Y., Soliman, M.M., Baiomy, A.A., Yassin, M.H. & El-Sawy, H.B. 2017. Effects of Karela (bitter melon; Momordica charantia) on genes of lipids and carbohydrates metabolism in experimental hypercholesterolemia: Biochemical, molecular and histopathological study. BMC Complementary and Alternative Medicine, 17(1): 319. DOI: https://doi.org/10.1186/s12906-017-1833-x
Savarese, G., Becher, P.M., Lund, L.H., Seferovic, P., Rosano, G.M.C. & Coats, A.J.S.
Global burden of heart failure: a comprehensive and updated review of
epidemiology. Cardiovascular Research, 118(17): 3272-3287.
Schwinger, R.H.G. 2021. Pathophysiology of heart failure. Cardiovascular Diagnosis and Therapy, 11(1): 263-276. DOI: https://doi.org/10.21037/cdt-20-302
Senanayake, G.V., Maruyama, M., Shibuya, K., Sakono, M., Fukuda, N., Morishita, T., et al. 2004. The effects of bitter melon (Momordica charantia) on serum and liver triglyceride levels in rats. Journal of Ethnopharmacology, 91(2-3): 257-62. DOI: https://doi.org/10.1016/j.jep.2003.12.026
Shah, A.J. & Gilani, A.H. 2012. Aqueous-methanolic extract of sweet flag (Acorus calamus) possesses cardiac depressant and endothelial-derived hyperpolarizing factor-mediated coronary vasodilator effects. Journal of Natural Medicines, 66(1): 119-126. DOI: https://doi.org/10.1007/s11418-011-0561-7
Shahlehi, S. & Petalcorin, M.I.R. 2021. Activation of cholinergic pathway induced vasodilation in rat aorta using aqueous and methanolic leaf extracts of Gynura procumbens. Biomedicine & Pharmacotherapy, 143: 1-8. DOI: https://doi.org/10.1016/j.biopha.2021.112066
Sharif, F., Hamid, M. & Adam, Z. 2015. Antihyperglycemic activity of oil palm Elaeis guineensis fruit extract on streptozotocin-induced diabetic rats. Jurnal Sains Kesihatan Malaysia, 13(2): 37-43. DOI: https://doi.org/10.17576/jskm-2015-13(2)4
Shimoda, H., Seki, E. & Aitani, M. 2006. Inhibitory effect of green coffee bean extract on fat accumulation and body weight gain in mice. BMC Complementary and Alternative Medicine, 6: 9. DOI: https://doi.org/10.1186/1472-6882-6-9
Shoeb, A., Alwar, M.C., Shenoy, P.J. & Gokul, P. 2016. Effect of Morinda citrifolia (noni) fruit juice on high fat diet induced dyslipidemia in rats. Journal of Clinical & Diagnostic Research, 10(4): 6-10. DOI: https://doi.org/10.7860/JCDR/2016/17900.7650
Simões, D.M., Malheiros, J., Antunes, P.E., Figueirinha, A., Cotrim, M.D. & Fonseca, D.A. 2020. Vascular activity of infusion and fractions of Cymbopogon citratus (DC) Stapf. in human arteries. Journal of Ethnopharmacology, 258: 112947. DOI: https://doi.org/10.1016/j.jep.2020.112947
Singh, B.K., Pillai, K.K., Kohli, K. & Haque, S.E. 2011. Isoproterenol-induced cardiomyopathy in rats: Influence of Acorus calamus Linn.: A. calamus attenuates cardiomyopathy. Cardiovascular Toxicology, 11(3): 263-271. DOI: https://doi.org/10.1007/s12012-011-9121-3
Siow, H.L. & Gan, C.Y. 2013. Extraction of antioxidative and antihypertensive bioactive peptides from Parkia speciosa seeds. Food Chemistry, 141(4): 3435-3442. DOI: https://doi.org/10.1016/j.foodchem.2013.06.030
Siti, H.N., Jalil, J., Asmadi, A.Y. Kamisah, Y. 2021. Parkia speciosa Hassk. empty pod extract alleviates angiotensin ii-induced cardiomyocyte hypertrophy in H9c2 cells by modulating the Ang II /ROS/NO axis and MAPK pathway. Frontiers in Pharmacology, 12: 1-17. DOI: https://doi.org/10.3389/fphar.2021.741623
Soltani, R., Hashemi, M., Farazmand, A., Asghari, G., Heshmat-Ghahdarijani, K., Kharazmkia, A., et al. 2017. Evaluation of the effects of cucumis sativus seed extract on serum lipids in adult hyperlipidemic patients: A randomized double-blind placebo-controlled clinical trial. Journal of Food Science, 82(1): 214-218. DOI: https://doi.org/10.1111/1750-3841.13569
Srivastava, N., Mishra, S., Iqbal, H., Chanda, D. & Shanker, K. 2021. Standardization of Kaempferia galanga L. rhizome and vasorelaxation effect of its key metabolite ethyl p-methoxycinnamate. Journal of Ethnopharmacology, 271: 1-10. DOI: https://doi.org/10.1016/j.jep.2021.113911
Trammel, J.E. & Sapra, A. 2023. Physiology, systemic vascular resistance. [WWW Document]. URL https://www.ncbi.nlm.nih.gov/books/NBK556075/ (accessed 01.11.24).
Varatharajan, R., Sattar, M.Z., Chung, I., Abdulla, M.A., Kassim, N.M. & Abdullah, N.A. 2013. Antioxidant and pro-oxidant effects of oil palm (Elaeis guineensis) leaves extract in experimental diabetic nephropathy: A duration-dependent outcome. BMC Complementary and Alternative Medicine, 13: 242. DOI: https://doi.org/10.1186/1472-6882-13-242
Vijayarathna, S. & Sasidharan, S. 2012. Cytotoxicity of methanol extracts of Elaeis guineensis on MCF-7 and vero cell lines. Asian Pacific Journal of Tropical Biomedicine, 2(10): 826-829. DOI: https://doi.org/10.1016/S2221-1691(12)60237-8
Wahid, M., Saqib, F., Chicea, L., Ahmedah, H.T., Sajer, B.H., Marc Vlaic, R.A., et al. 2022. Metabolomics analysis delineates the therapeutic effects of hydroethanolic extract of Cucumis sativus L. seeds on hypertension and isoproterenol-induced myocardial infarction. Biomedicine and Pharmacotherapy, 148: 112704. DOI: https://doi.org/10.1016/j.biopha.2022.112704
Wang, S.Y., Zhao, H., Xu, H.T., Han, X.D., Wu, Y.S., Xu, F.F., et al. 2021. Kaempferia galanga L.: Progresses in phytochemistry, pharmacology, toxicology and ethnomedicinal uses. Frontiers in Pharmacology, 12: 675350. DOI: https://doi.org/10.3389/fphar.2021.675350
Wigati, D., Anwar, K. & Sudarsono. 2017. Hypotensive activity of ethanolic extracts of Morinda citrifolia L. leaves and fruit in dexamethasone-induced hypertensive rat. Journal of Evidence-Based Complementary and Alternative Medicine, 22(1): 107-113. DOI: https://doi.org/10.1177/2156587216653660
World Health Organisation (WHO). 2025. Cardiovascular diseases (CVDs). [WWW
Document]. URL https://www.who.int/news-room/fact-
sheets/detail/cardiovascular-diseases-(cvds) (accessed 18.10.25).
Yamaguchi, S., Ohnishi, J., Sogawa, M., Maru, I., Ohta, Y. & Tsukada, Y. 2002. Inhibition of angiotensin I converting enzyme by noni (Morinda citrifolia) juice. Journal of Japan Society Food Science and Technology, 49(9): 624-627. DOI: https://doi.org/10.3136/nskkk.49.624
Yoshitomi, H., Zhou, J., Nishigaki, T., Li, W., Liu, T., Wu, L., et al. 2020. Morinda citrifolia (Noni) fruit juice promotes vascular endothelium function in hypertension via glucagon-like peptide-1 receptor-CaMKKβ-AMPK-eNOS pathway. Phytotherapy Research, 34(9): 2341-2350. DOI: https://doi.org/10.1002/ptr.6685
Yusuf, S., Joseph, P., Rangarajan, S., Islam, S., Mente, A., Hystad, P., et al. 2020. Modifiable risk factors, cardiovascular disease, and mortality in 155 722 individuals from 21 high-income, middle-income, and low-income countries (PURE): A prospective cohort study. Lancet, 395(10226): 795-808. DOI: https://doi.org/10.1016/S0140-6736(19)32008-2
Zahra, M.A., Abdulla, M., Mohd Ali, H., Noor, S. & Ismail S. 2009. Anti-ulcerogenic activity of aqueous extract of Ficus deltoidea against ethanol-induced gastric mucosal injury in rats. Research Journal of Medical Sciences, 3(2): 42-46.
Zetina-Esquivel, A., Tovilla-Zarate, C.A., Guzmán-Garcia, C., Rodriguez-Hernandez, A., Castell-Rodriguez, A.E., Ble-Castillo, J.L., et al. 2015. Effect of Carica papaya leaf extract on serum lipids and liver metabolic parameters of rats fed a high cholesterol diet. Health, 7: 1196-1205. DOI: https://doi.org/10.4236/health.2015.79134
Published
How to Cite
Issue
Section
Any reproduction of figures, tables and illustrations must obtain written permission from the Chief Editor (wicki@ukm.edu.my). No part of the journal may be reproduced without the editor’s permission











