Pharmaceutical care in the use of medicinal plants with anti-hypertensive action in the elderly
DOI:
https://doi.org/10.33448/rsd-v10i9.17793Keywords:
Pharmaceutical care; Hypertension; Elderly; Medicinal plants.Abstract
Hypertension is a highly prevalent cardiovascular disease among the elderly population, representing an expressive risk factor for morbidity and mortality. Based on empirical knowledge, a large part of this population uses medicinal plants to treat illnesses such as hypertension. The objective was to identify in the literature the main medicinal plants with anti-hypertensive potential used by the elderly in the treatment of hypertension, highlighting the importance of pharmaceutical care in therapy. The research was carried out in Scielo, BVS, PubMed and Google Academic in the period between 2011 and 2021, in Portuguese, English and Spanish. 45 articles were selected and 7 species of medicinal plants with antihypertensive potential were chosen. Allium sativum, Camellia sinensis, Cymbopogon citratus, Ginkgo biloba, Hibiscus sabdariffa, Panax ginseng and Zingiber officinale showed pharmacological actions in the control of hypertension. The indiscriminate use of these species can cause adverse effects such as intestinal gastric discomfort, hepatotoxicity and headache, hemorrhagic and cardiovascular events. In addition, the species, Ginkgo biloba, Hibiscus sabdariffa, Panax ginseng and Zingiber officinale showed drug interactions with antiplatelet and/or anticoagulant and antiepileptic drugs. In view of the risks presented, especially in the elderly, pharmaceutical care represents a potential therapeutic tool, evidenced in pharmacotherapeutic monitoring, guidance in the form of preparation, collection and storage of medicinal plants, facilitator of treatment adherence, educator and prescriber in the prevention of chronic diseases such as hypertension, promoting the rational use of medicinal plants with antihypertensive properties.
References
Abubakar, M. G., Ukwuani, A. N., & Mande, U. U. (2015). Antihypertensive activity of Hibiscus Sabdariffa aqueous calyx extract in Albino rats. SKY journal of biochemistry, 4, 13-15.
Ajay, M., Chai, H. J., Mustafa, A. M., Gilani, A. H., & Mustafa, M. R. (2007). Mechanisms of the anti-hypertensive effect of Hibiscus sabdariffa L. calyces. Journal of ethnopharmacology, 109(3), 388–393.
Al Disi, S. S., Anwar, M. A., & Eid, A. H. (2016). Anti-hypertensive Herbs and their Mechanisms of Action: Part I. Frontiers in pharmacology, 6, 323.
Akinyemi, A., Thomé, G., Morsch, V., Stefanello, N., Goularte, J., Belló-Klein, A., Oboh, G., Rosa, M., Schetinger, C. (2015). Effect of dietary supplementation of ginger and turmeric rhizomes on angiotensin-1 converting enzyme (ACE) and arginase activities in L-NAME induced hypertensive rats. Journal of Functional Foods, 17, 792-801.
Anwar, M. A., Al Disi, S. S., & Eid, A. H. (2016). Anti-Hypertensive Herbs and Their Mechanisms of Action: Part II. Frontiers in pharmacology, 7, 50.
Basati, G., Mehrabi Rad, F., Momeni Safarabadi, A., Shakib, P., Sedighi, M., & Cheraghi, M. (2021). An Overview of the Most Important Medicinal Plants that Affect Hypertension and their Antihypertensive Mechanism. Journal of Medicinal plants and By-product, 10(Special), 1-8.
BRASIL (2012). Ministério da saúde. Cadernos de atenção básica. Plantas medicinais e fitoterápico na atenção básica. http://bvsms.saude.gov.br/bvs/publicacoes/praticas_integrativas_complementares_plantas_medicinais_cab31.pdf
Chua, Y. T., Ang, X. L., Zhong, X. M., & Khoo, K. S. (2015). Interaction between warfarin and Chinese herbal medicines. Singapore medical journal, 56(1), 11–18.
Coon, J. T., & Ernst, E. (2002). Panax ginseng: a systematic review of adverse effects and drug interactions. Drug safety, 25(5), 323–344.
Deka, A., & Vita, J. A. (2011). Tea and cardiovascular disease. Pharmacological research, 64(2), 136–145.
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. Evidence-based complementary and alternative medicine, 2012(1), 8.
Ekpenyong, C. E., Akpan, E., & Nyoh, A. (2015). Ethnopharmacology, phytochemistry, and biological activities of Cymbopogon citratus (DC.) Stapf extracts. Chinese journal of natural medicines, 13(5), 321–337.
Fakeye, T. O., Pal, A., Bawankule, D. U., Yadav, N. P., & Khanuja, S. P. (2009). Toxic effects of oral administration of extracts of dried calyx of Hibiscus sabdariffa Linn. (Malvaceae). Phytotherapy research: PTR, 23(3), 412–416.
Figueredo, C. A., Gurgel, I. G. D., & Gurgel, G. D. (2014). A Política Nacional de Plantas Medicinais e Fitoterápicos: construção, perspectivas e desafios. Physis: Revista de Saúde Coletiva [online] 24(2). https://www.scielo.br/j/physis/a/fzMtXMF6QwLVHLk8nzxdFdM/abstract/?lang=pt
Gurley, B. J., Fifer, E. K., & Gardner, Z. (2012). Pharmacokinetic herb-drug interactions (part 2): drug interactions involving popular botanical dietary supplements and their clinical relevance. Planta médica, 78(13), 1490–1514.
Herrera, A. A., Miranda, S. J., Avila, C. P., Herrera, A. S., Jiménez, F. J. E., Zamilpa, A., Román, R. R., Ponce, M. H., & Tortoriello, J. (2007). Clinical effects produced by a standardized herbal medicinal product of Hibiscus sabdariffa on patients with hypertension. A randomized, double-blind, lisinopril-controlled clinical trial. Planta médica, 73(1), 6–12.
Hopkins, A. L., Lamm, M. G., Funk, J. L., & Ritenbaugh, C. (2013). Hibiscus sabdariffa L. in the treatment of hypertension and hyperlipidemia: a comprehensive review of animal and human studies. Fitoterapia, 85, 84–94.
Hu, J., Webster, D., Cao, J., & Shao, A. (2018). The safety of green tea and green tea extract consumption in adults - Results of a systematic review. Regulatory toxicology and pharmacology, 95, 412–433.
Isah T. (2015). Rethinking Ginkgo biloba L.: Medicinal uses and conservation. Pharmacognosy reviews, 9(18), 140–148.
Izzo, A. A., & Ernst, E. (2009). Interações entre medicamentos fitoterápicos e medicamentos prescritos: uma revisão sistemática atualizada. Drugs, 69(13), 1777–1798.
Jacobs, L. P., Shaikh, K. A., Thomas, B., & Nyakudya, T. T. (2020). An Overview of the Potential Use of Ethno-Medicinal Plants Targeting the Renin-Angiotensin System in the Treatment of Hypertension. Molecules, 25(9), 2114.
Jang, S. J., Lim, H. J., & Lim, D. Y. (2011). Inhibitory Effects of Total Ginseng Saponin on Catecholamine Secretion from the Perfused Adrenal Medulla of SHRs. Journal of ginseng research, 35(2), 176–190.
Jovanovski, E., Bateman, E. A., Bhardwaj, J., Fairgrieve, C., Mucalo, I., Jenkins, A. L., & Vuksan, V. (2014). Effect of Rg3-enriched Korean red ginseng (Panax ginseng) on arterial stiffness and blood pressure in healthy individuals: a randomized controlled trial. Journal of the American Society of Hypertension, 8(8), 537–541.
Kim, J. H. (2012). Cardiovascular Diseases and Panax ginseng: A Review on Molecular Mechanisms and Medical Applications. Journal of ginseng research, 36(1), 16–26.
Kim, J. H. (2018). Pharmacological and medical applications of Panax ginseng and ginsenosides: a review for use in cardiovascular diseases. Journal of ginseng research, 42(3), 264–269.
Kolawole, J. A., & Maduenyi, A. (2004). Effect of zobo drink (Hibiscus sabdariffa water extract) on the pharmacokinetics of acetaminophen in human volunteers. European journal of drug metabolism and pharmacokinetics, 29(1), 25–29.
Kouame, N.M., Kamagate, M., Koffi, C., Die-Kakou, H. M., Yao, N. A. R., Kakou, A. (2016). Cymbopogon citratus (DC.) Stapf : ethnopharmacologie, phytochimie, activités pharmacologiques et toxicologie. Phytothérapie, 14, 384–392.
Ku, D. D., Abdel, R. T. T., Dai, J., Kim-Park, S., Fallon, M. B., & Abrams, G. A. (2002). Garlic and its active metabolite allicin produce endothelium- and nitric oxide-dependent relaxation in rat pulmonary arteries. Clinical and experimental pharmacology & physiology, 29(1-2), 84–91.
Liu, L., Xu, F. R., & Wang, Y. Z. (2020). Traditional uses, chemical diversity and biological activities of Panax L. (Araliaceae): A review. Journal of ethnopharmacology, 263, 112792.
Li, W., Yang, J., Zhu, X. S., Li, S. C., & Ho, P. C. (2016). Correlation between tea consumption and prevalence of hypertension among Singaporean Chinese residents aged ⩾40 years. Journal of human hypertension, 30(1), 11–17.
Locatelli, M., Zengin, G., Uysal, A., Carradori, S., De Luca, E., Bellagamba, G., Aktumsek, A., & Lazarova, I. (2017). Multicomponent pattern and biological activities of seven Asphodeline taxa: potential sources of natural-functional ingredients for bioactive formulations. Journal of enzyme inhibition and medicinal chemistry, 32(1), 60–67.
Malati, C. Y., Robertson, S. M., Hunt, J. D., Chairez, C., Alfaro, R. M., Kovacs, J. A., & Penzak, S. R. (2012). Influence of Panax ginseng on cytochrome P450 (CYP)3A and P-glycoprotein (P-gp) activity in healthy participants. Journal of clinical pharmacology, 52(6), 932–939.
Mansour, S. M., Bahgat, A. K., El-Khatib, A. S., & Khayyal, M. T. (2011). Ginkgo biloba extract (EGb 761) normalizes hypertension in 2K, 1C hypertensive rats: role of antioxidant mechanisms, ACE inhibiting activity and improvement of endothelial dysfunction. Phytomedicine: international journal of phytotherapy and phytopharmacology, 18(8-9), 641–647.
Marques, L. A. M; Vale, F. V. V. R., Nogueira, V. A. S., Mialhe, F. L., & Silva, L. C. (2011). Atenção farmacêutica e práticas integrativas e complementares no SUS: conhecimento e aceitação por parte da população sãojoanense. Physis: Revista de Saúde Coletiva, 21(2). https://www.scielo.br/j/physis/a/GQwvbNSDKrky5hpQ3t395hs/abstract/?lang=pt
Mashayekh, A., Pham, D. L., Yousem, D. M., Dizon, M., Barker, P. B., & Lin, D. D. (2011). Effects of Ginkgo biloba on cerebral blood flow assessed by quantitative MR perfusion imaging: a pilot study. Neuroradiology, 53(3), 185–191.
Mesquita, T., de Jesus, I., Dos Santos, J. F., de Almeida, G., de Vasconcelos, C., Guatimosim, S., Macedo, F. N., Dos Santos, R. V., de Menezes-Filho, J., Miguel-Dos-Santos, R., Matos, P., Scalzo, S., Santana-Filho, V. J., Albuquerque-Júnior, R., Pereira-Filho, R. N., & Lauton-Santos, S. (2017). Cardioprotective Action of Ginkgo biloba Extract against Sustained β-Adrenergic Stimulation Occurs via Activation of M2/NO Pathway. Frontiers in pharmacology, 8, 220.
Mahmoudian-Sani, M. R., Hashemzadeh-Chaleshtori, M., Asadi-Samani, M., & Yang, Q. (2017). Ginkgo biloba in the treatment of tinnitus: An updated literature review. The International Tinnitus Journal, 21(1), 58–62.
Mucalo, I., Jovanovski, E., Rahelić, D., Božikov, V., Romić, Z., & Vuksan, V. (2013). Effect of American ginseng (Panax quinquefolius L.) on arterial stiffness in subjects with type-2 diabetes and concomitant hypertension. Journal of ethnopharmacology, 150(1), 148–153.
Nakasone, Y., Nakamura, Y., Yamamoto, T., & Yamaguchi, H. (2013). Effect of a traditional Japanese garlic preparation on blood pressure in prehypertensive and mildly hypertensive adults. Experimental and therapeutic medicine, 5(2), 399–405.
Oliveira, I., Freitas, E., Detoni, K., & Oliveira, D. (2017). Use of the patient's medication experience in pharmacists' decision making process. International Journal of Pharmacy, 7(1):1-8.
Oliveira, R. E. M., Filipin, M. D. V., & Giardini, M. H. (2015). Intervenções farmacêuticas destinadas à otimização da adesão ao tratamento medicamentoso de um paciente. Revista Eletrônica De Farmácia, 12(2), 39–51.
Park, S. H., Huh, T. L., Kim, S. Y., Oh, M. R., Tirupathi Pichiah, P. B., Chae, S. W., & Cha, Y. S. (2014). Antiobesity effect of Gynostemma pentaphyllum extract (actiponin): a randomized, double-blind, placebo-controlled trial. Obesity (Silver Spring, Md.), 22(1), 63–71.
Peng, X., Zhou, R., Wang, B., Yu, X., Yang, X., Liu, K., & Mi, M. (2014). Effect of green tea consumption on blood pressure: a meta-analysis of 13 randomized controlled trials. Scientific reports, 4, 6251.
Pelentir, M., Deuschle, V. C. K. N; Deuschle, R. A. N. (2015). Importância da assistência e atenção farmacêutica no ambiente hospitalar. Ciência & tecnologia, 1(1), 20-28. http://www.revistaeletronicaocs.unicruz.edu.br/index.php/CIENCIAETECNOLOGIA/article/view/487
Pereira, A. S., Shitsuka, D. M., Parreira, F. J., & Shitsuka, R. (2018). Metodologia da pesquisa científica. [free e-book]. Santa Maria/RS. Ed. UAB/NTE/UFSM.
Ramalho, O. (2011). Atenção Farmacêutica: da Filosofia ao Gerenciamento da Terapia Medicamentosa. 1a. São Paulo: RNC Editora. 344 p.
Ried, K. (2016). Garlic Lowers Blood Pressure in Hypertensive Individuals, Regulates Serum Cholesterol, and Stimulates Immunity: An Updated Meta-analysis and Review. The Journal of nutrition, 146(2), 389S–396S.
Ryan, J. L., & Morrow, G. R. (2010). Ginger. Oncology nurse edition, 24(2), 46–49.
Shaito, A., Thuan, D., Phu, H. T., Nguyen, T., Hasan, H., Halabi, S., Abdelhady, S., Nasrallah, G. K., Eid, A. H., & Pintus, G. (2020). Herbal Medicine for Cardiovascular Diseases: Efficacy, Mechanisms, and Safety. Frontiers in pharmacology, 11, 422.
Shehabi, T., Iratni, R., & Eid, A. H. (2016). Anti-atherosclerotic plants which modulate the phenotype of vascular smooth muscle cells. Phytomedicine, 23(11), 1068–1081.
Shin, W., Yoon, J., Oh, G.T., & Ryoo, S. (2013). Korean red ginseng inhibits arginase and contributes to endotheliumdependent vasorelaxation through endothelial nitric oxide synthase coupling. Journal of Ginseng Research, 37(1):64.
Soares, A. J. S., Alkmim, A. C., Oliveira, D. R., Mendonça, S. A. M., & Rodrigues, I. (2021). Potencialidades da prática da atenção farmacêutica no uso de fitoterápicos e plantas medicinais. Journal of Applied Pharmaceutical Sciences, (7), 10-21.
Stoner, G. D. (2013). Ginger: is it ready for prime time? Cancer prevention research (Philadelphia, Pa.), 6(4), 257–262.
Tajidin, E. (2012). Chemical composition and citral content in lemongrass (Cymbopogon citratus) essential oil at three maturity stages. African journal of biotechnology, 11(11), 2685-2693.
Tan, M.-S., Yu, J.-T., Tan, C.-C., Wang, H.-F., Meng, X.-F., Wang, C., Tan, L. (2015). Efficacy and adverse effects of ginkgo biloba for cognitive impairment and dementia: a systematic review and meta-analysis. Journal of Alzheimer’s Disease, 43(2), 589–603.
Tavares, B., Silva, F., Luiza, M., Moura, C., Rego, G., Aquino, D. S. (2018). O papel do farmacêutico no controle da automedicação em idosos. Boletim Informativo Geum, 8(3), 18.
Telesi, E. (2016). Práticas integrativas e complementares em saúde, uma nova eficácia para o SUS. Estudos Avançados, 30(86), 99-112.
Ude, C., Schubert-Zsilavecz, M., & Wurglics, M. (2013). Ginkgo biloba extracts: a review of the pharmacokinetics of the active ingredients. Clinical pharmacokinetics, 52(9), 727–749.
Varshney, R., & Budoff, M. J. (2016). Garlic and Heart Disease. The Journal of nutrition, 146(2), 416S–421S.
Verma, T., Sinha, M., Bansal, N., Yadav, S. R., Shah, K., & Chauhan, N. S. (2021). Plants Used as Antihypertensive. Natural products and bioprospecting, 11(2), 155–184.
Viana, S., Arantes, T., & Ribeiro, S. (2017). Interventions of the clinical pharmacist in an Intermediate Care Unit for elderly patients. Einstein (São Paulo, Brazil), 15(3), 283–288.
WORLD HEALTH ORGANIZATION – WHO (2014). Global status report on noncommunicable diseases 2014 [Internet]. Geneva: World Health Organization. https://www.who.int/nmh/publications/ncd-status-report-2014/en/
Won, H. J., Kim, H. I., Park, T., Kim, H., Jo, K., Jeon, H., Ha, S. J., Hyun, J. M., Jeong, A., Kim, J. S., Park, Y. J., Eo, Y. H., & Lee, J. (2019). Non-clinical pharmacokinetic behavior of ginsenosides. Journal of ginseng research, 43(3), 354–360.
Xiong, X. J., Liu, W., Yang, X. C., Feng, B., Zhang, Y. Q., Li, S. J., Li, X. K., & Wang, J. (2014). Ginkgo biloba extract for essential hypertension: a systemic review. Phytomedicine: international journal of phytotherapy and phytopharmacology, 21(10), 1131–1136.
Yeh H., Chuang C., Chen H., Wan C., Chen T., Lin L. (2014). Bioactive components analysis of two various gingers (Zingiber officinale Roscoe) and antioxidant effect of ginger extracts. LWT - Food Science and Technology, 55(1), 329–334.
Yin, J. Y., Duan, S. Y., Liu, F. C., Yao, Q. K., Tu, S., Xu, Y., & Pan, C. W. (2017). Blood Pressure Is Associated with Tea Consumption: A Cross-sectional Study in a Rural, Elderly Population of Jiangsu China. The journal of nutrition, health & aging, 21(10), 1151–1159.
Wang, Y., Yu, H., Zhang, X., Feng, Q., Guo, X., Li, S., Li, R., Chu, D., & Ma, Y. (2017). Evaluation of daily ginger consumption for the prevention of chronic diseases in adults: A cross-sectional study. Nutrition, 36, 79–84.
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