Mini Review

Cardioprotective effect of herbs on HTN induced LVH: A Mini Review

Iram Iqbal^1,2*, Waniya Shahid³ and Ahmar Iqbal³

¹Primary & Secondary Healthcare Department, Govt. Of Punjab, 1 Birdwood Road, Lahore, 54000, Pakistan

²Department of Pharmacology, Bahauddin Zakariya University Multan, Punjab, Pakistan

³Department of General Surgery No. 1 Hospital affiliated to Shanxi Medical University, Yingze District, China

Submission:July 18, 2023; Published:August 02, 2023

*Corresponding author:Iram Iqbal , Primary & Secondary Healthcare department, Govt. Of Punjab, 1 Birdwood Road, Department of Pharmacology, Bahauddin Zakariya University Multan, Punjab, Pakistan

How to cite this article:Iram I, Waniya S, Ahmar I. Cardioprotective effect of herbs on HTN induced LVH: A Mini Review. Curr Trends Biomedical Eng & Biosci. 2023; 21(4): 556068 DOI:10.19080/CTBEB.2023.21.556068

Abstract

The significant risk factor for cardiovascular disease (CVD) related mortality and morbidity is hypertension. And long-term damage caused by primary HTN is LVH. Up-till now there are a lot of antihypertensive therapies available to lower the risk of HTN and LVH but none of them completely eliminate the likelihood of cardiac damage. So, it is need of time to find new drug therapies having cardioprotective effects. Recently herbal traditional medicines have gained popularity and a number of researches have been conducted to evaluate cardioprotective potential of herbs and isolated metabolites. This mini review summarizes some recent researches in this field.

Keywords: Hypertension; Left Ventricular hypertrophy; Cardioprotective, Herbal traditional medicines; Frank-Starling; Flavonoids; Phytoestrogens; Anti-inflammatory; Hemodynamic; Antihypertensive therapies

Introduction

A significant, controllable risk factor for the morbidity and mortality of cardiovascular disease (CVD) is hypertension (HTN) and the primary end-organ affected by HTN is the left ventricle (LV) [1]. Direct hemodynamic stress from a sustained rise in blood pressure (hypertension) results in ventricular hypertrophy [2]. More than 35% of hypertensive people develop left ventricular hypertrophy (LVH) [3]. Due to its increased impact on mortality and disability rates across many nations, hypertension is poised to become a crucial component of global health [4]. The major treatment for people with hypertension is the using of drugs such ACE inhibitors, angiotensin II receptor blockers, and -blockers to effectively regulate blood pressure; nonetheless, the total mortality rate from this condition is still very high [5]. Presently antihypertensive medications lower the likelihood of disease and LVH, although they do not completely eliminate them [6]. In order to create new pharmacological therapy for HTN it is crucial to find drugs that are more successful than currently available medications. Recently, herbal traditional medicine has gained popularity and is expanding quickly in many nations. Natural medicine has been endorsed by WHO as a potential course of therapy [7].

Discussion

When heart is facing some hemodynamic changes, the following actions can be taken by the heart to make up for a hemodynamic burden: (1) enhance crossbridge production by using the Frank-Starling method; (2) build up your muscle to handle the total load; and (3) deploy neurohormonal systems to enhance muscle contraction. The first mechanism’s application is constrained, while the third’s negative effects come from a chronic adjustment. As a result, mass gain plays a significant part in compensating for hemodynamic overload. Owing to the quick terminal differentiation of cardiomyocytes after birth, this mass gain is not the result of hyperplasia but rather the hypertrophy of preexisting myocytes. The simultaneous acquisition of sarcomeres generates a widening of the myocyte, which then causes a rise in wall thickness in diseases like aortic stenosis or hypertension, which are characterized by pressure overload. Concentric hypertrophy (a higher wall thickness to ratio/chamber diameter) is the result of this remodeling [8,9]. The increase in left ventricular mass known as left ventricular hypertrophy (LVH) is brought on by larger cardiomyocytes. LVH can be a pathological condition that is either hereditary or subseAbstract quent to LV overload or it can be a physiological adaptation to vigorous exercise, as in athletics [10]. Commonly benign, physiological LVH goes away when physical activity is reduced or stopped. Pathological LVH is a compensating condition that could ultimately develop into a dysfunctional state and lead to increasing LV dysfunction and sudden cardiac death (HF) [10]. Increased myocardial oxygen demand during left ventricular hypertrophy leads to diminished coronary blood flow reserve, which in turn increases the risk of angina, heart attack, and even death Figure 1 [11]. Myocyte growth must be followed by synchronised expansions of the capillary and nerve networks, as well as the connective tissue and ground material, in order for it to support an increased biomechanical load. Collagen makes up the majority of the connective tissue, with minor levels of elastin, laminin, and fibronectin also present. The myocardium contains collagen types I, III, and V, although type I makes up the majority - about 85%-of the tissue’s collagen. The intricate collagen web prevents interstitial edoema from developing and accounts for a large portion of the passive diastolic stiffness of the ventricle. It also gives a method for translating force produced by individual myocytes into ventricular contraction [8].

The prevailing consensus is that a mechanical signal sets off a series of biological processes that cause synchronized heart development. If this is the case, the indications for volume overload and pressure overload are either quite distinct, or they produce patterns and mechanisms of development that are notably different. Myosin heavy chains production rises by around 35% within hours of a pressure overload occurring in the ventricle in vivo; this increase is first mediated by an increase in translational efficiency [12]. Distinct geometric patterns are frequently used to classify HTN-induced remodeling of the LV: concentric LV hypertrophy (LVH; cLVH), and eccentric LVH (eLVH) (Figure 2) [13].

Herbs and HTN induced LVH

Around the world, more than 80% of people use herbal treatments for a variety of illnesses, including arterial hypertension [14]. In animal studies of cardiovascular illnesses, a number of prior research found positive results from employing medicinal herbs as natural remedies. Many of these plants have antihypertensive qualities that enhance vascular and cardiac health [15]. Flavonoids, natural phenolic compounds, and phytoestrogens, which are potent antioxidants, are just a few of the bioactive substances that have been found in plants [16]. Consuming fruits and vegetables with increased flavonoid content helps to avoid the onset of cardiovascular disease [17]. The effectiveness of these plants against cardiovascular illnesses may be attributed to active substances such coumarins and/or polyphenols with antioxidant and anti-inflammatory characteristics, according to bio-guided fractionation of these plant extracts [18]. Table 1 summarizes the antihypertensive potential of some plants and plant based bioactive substances.

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