Medicinal plants useful in people with arterial hypertension: A review
Introduction:
Hypertension is one of the most relevant and high-risk diseases in the world’s population, thus increasing the cases of mortality derived from cardiovascular problems in people. the risk factors within this problem have been studied in such a way that more accessible solutions can be found for those who suffer from it. Derived from that there are different alternatives for treatment in which not only conventional medical methods are used, but also a new approach in traditional herbal medicine [1].
According to the Pan American Health Organization (PAHO) in Mexico there have been 1.6 million deaths due to cardiovascular problems, where hypertension has figures of 250 million people suffering from hypertension, therefore, it has developed a series of preventive proposals where PAHO includes the following: physical activities, salt reduction, food rich in fruits, vegetables and obesity prevention [2].
The WHO states that the limit for detecting hypertensive candidates, where the main value is 140/90, 140 mmHg systolic, and 90 mmHg in diastolic [3].
In the article “Physical activity as a measure of control of arterial hypertension ”it is described that an investigation was carried out where the physical activity sought by older adults in a range of 30 years or more is that, by practicing physical exercises, it helps them to procure a better control in their blood pressure, and thereby decrease suffering some symptom derived from this disease [3].
Physiopathology
The mechanism of arterial hypertension is due to abnormal sodium transport across the cell wall. This is because the sodium-potassium pump (called Na, K-ATPase) functions inadequately. After all, there is an increase in the permeability of sodium ions. As a consequence, an elevation in the intracellular sodium concentration occurs. As Na+, K+ -ATPase can generate noradrenaline downstream to sympathetic neurons, inhibition of the process can increase the effect of noradrenaline, and thus lead to an abnormal elevation in blood pressure. Increased pulse rate when at rest may result in increased activity of the sympathetic nervous system and thus lead to the development of hypertension [4].
Herbalism and its usefulness in people with arterial hypertension
The popularity of the therapeutic use of plants has taken a wide path for the beginning of new alternatives for diseases that deteriorate the patient’s health, such as obesity, diabetes, hypertension, thyroid, asthma etc. Recent discoveries with plants used in the Mexican territory have provided a significant effect for cancer, such as the S. marginatum plant, which has shown a therapeutic effect when processed as a hot beverage (tea), making this of public interest [5].
The authors of the article “Effect of an infusion of Hibiscus sabdariffa L in hypertensive patients in an urban population: an important comorbidity before COVID-19”, Jamaica is traditionally one of the plants with the greatest impact in Mexico. In which they point out that this plant has a great therapeutic value derived from the use of its flowers in the clinical setting since it has been shown to have an antipertensive effect with its main components of anthocyanin and proanthocyanidin, plus the inhibition of calcium flow in the uncontrolled population of BP (blood pressure) [6].
Herbal medicine or herbal remedy is defined as the preparation that involves the use of parts of a plant in combination or specific individual, derived from empirical or scientific knowledge of plants to which therapeutic effects are attributed, to heal or relieve symptoms of a condition or disease [7].
Derived from that, there are different alternatives for treatment in which not only conventional medical methods are used, but a new approach in traditional herbal medicine.
Epidemiology
The Secretary of Agriculture and Rural Development of the Government of Mexico has pointed out that Mexico is the second place in the number of medicinal plants registered in the world. Since 90% of the population has been involved in the use of medicinal plants for the relief of ailments or discomforts, however, the percentage of safety and study of some plant species is only 5% [8].
In Mexico, from 1989 to 1994, the Ministry of Health stipulated a section that classifies traditional medicine with normative orientation, thus helping to fulfill the systematic, regulatory criteria of health law, which triggered the need to regulate the use of herbal medicine, thus giving rise to the project of the official Mexican standard PROY-NOM-248-SSA1-2006, good manufacturing practices for establishments dedicated to the elaboration of herbal remedies [9].
Objective. Describe the therapeutic effect of traditional medicine “plants” useful in hypertensive people from the perspective of science.
Research question:
Which plants have therapeutic effects in people with arterial hypertension?
General characteristics
Garlic
Commonly known more as a spice for cooking, garlic has proven to have therapeutic and culinary effects in different countries and regions of the world, it is easy to find it in temperate regions or tropical areas in different parts of the world, initially the first civilization to use it for therapeutic effects was in ancient Egypt, as it was used to prevent or treat heart problems, information that was collected from the oldest document in the world codex Ebers or better known as “Ebers papyrus”, which was written in the years 1550 BC [10].
Celery
Celery is one of the most popular vegetables to maintain an excellent diet in different nutritional processes, it is distributed in almost all parts of the world since its habitat is within the temperate, tropical and subtropical places, the parts that are most used for therapeutic effects are the seeds and leaves, this plant was traditionally used in Mexico as part of complementary treatment of hypertension, as well as the Philippines and Trinidad and Tobago [10].
Hibiscus
One of the countries that has resorted more to the use of Jamaica is Africa, since it is one of the traditional alternatives of choice to treat hypertension, as well as in Mexico, Egypt, and Sudan. Its habitat is found more in places with warm, tropical, and temperate temperatures. Its active principle is extracted in a preparation of infusion or decoction [10].
For the infusion of this plant, pilot clinical trials have been evaluated, which selected patients with hypertension, who took the infusion with a content of (10g/240Ml) in a control period of 4 weeks to 33 patients of an urban population in Mexico [6].
Piper Aduncum
It is a plant native to Brazil. it is considered an important kind of medicinal plant because it has pharmacological effects derived from its essential oils and chemical compounds (ethanol and methanol) and is commonly found in Amazonian, tropical, and subtropical áreas [11].
Dragon Fruit
It is a cetaceae plant native to Mexico produced mostly in the region of Tamaulipas, this is harvested wild, and has a great nutritional impact as the whole plant itself can be edible, but the part of the plant that is most investigated is the fruit, we can find it in the following areas of Tamaulipas, Ciudad Victoria, San Carlos, Jaumave, and Tula [13].The extract of this fruit is the most important since it has its therapeutic effect by blocking calcium channels [12].
Purple corn
Purple corn is a seed from Mexico and Peru. for some indigenous people, purple corn was one of the most sacred foods since it was cultivated in ancient times in wild lands. It has some health benefits which treat cardiovascular problems, mostly high blood pressure, and its potential antioxidant activities [14].
Methodology
A strategic search of information was carried out in different internet databases such as: Crossref, Scielo, Pudmed, Elsevier, Redalic, compiling a long list of information from articles, books, etc. With the following terms or keywords as “herbal medicine”, “herbal medicines”, “Medicinal plants with effect on hypertension”, ‘Phytomedicines’, “Antihypertensive effects”, “Natural products”, “Healing plants”, “Therapeutic use of plants”. More than 500 articles were found, and 90 were reviewed, of which 19 presented information related to medicinal plants or similar and only 16 were selected to gather selected information on the subject.
Results
As a result of the review of the cited articles, it was found that the different plants mentioned share different components in common which are flavonoids, alkaloids, saponins, phenolic compounds, anthocyanins, etc., which through their review and research help to inhibit the enzyme angiotensin converter known as (ACE), since they have vaso relaxing effects on vascular smooth muscles, thus producing the antihypertensive effect.
The responses found by acquiring certain plant component extracts were first tested in animals, mostly hypertensive rodents, which were observed as experimental models in vivo and in vitro to identify whether the active components exert effects that can halt the progression of hypertension in the rodent’s body.
Jamaica was one of the plants that was most closely observed through human consumption, as mentioned by Montes, Y, et al (2024) authors of the article “effect of an infusion of Hibiscus sabdariffa L in hypertensive patients in an urban population: an important comorbidity before COVID-19”.
Different types of plants proposed by researchers from different countries have been compiled and have been shown to contribute to the reduction of hypertension, as shown in the following (Table 1)
Canary Seed
The canaryseed is one of the seeds popularly known for being consumed by birds, since when mixed with other seeds, a rich composition of proteins can be obtained, making it a potential element for a healthy diet. The production of this seed is more significant in southwestern provinces, highlighting countries such as Canada, Argentina, and Thailand. It is considered in Mexico as one of the foods that can contribute to traditional herbal medicine as it is commonly used to treat some kidney conditions, hypertension, and especially hypercholesterolemia (Table 2 and 3) [16].
Discussion
This article detected information regarding the use of traditional medicine of useful plants in people with arterial hypertension, as stated in the text, the impact of arterial hypertension has reflected high rates of morbidity and mortality, as well as has impacted the economic and social condition of public health, particularly in developing countries such as Mexico, where lifestyles are unhealthy and access to preventive medical services is limited. Knowledge of the disease, from its pathophysiology to its evolution, allows us to understand the biological approach to the disease, which allows us to propose more specific and safer treatments.
Currently, the growing use of herbal medicine as a therapeutic complement in the control of arterial hypertension is relevant to the tradition of the use of medicinal plants, such as Jamaica, which has been used in the treatment of hypertension. (Hibiscus sabdariffa) [6], Garlic (Allium satiyum), Celery (Apium graveolens), Mexican sage bush (Piper aduncum), Dragon fruit (Selenicereus undatus), Canary seed (Phalaris canariensis), the use of medicinal plants is mainly in Mexico, thus highlighting the potential of therapies in conjunction with medicinal plants, as well as the need to seek more clinical studies in Mexico of plants that support the safety and efficacy of the validation of their therapeutic effects [6,10,14,16].
The treatment based on medicinal plants is used in families whose availability to medical treatment resources is limited, so the impact of the socioeconomic situation in Mexico does not cover the cost of medicines to which they are entitled, that is, “Right to health” to be acquired by the same vulnerable population to have mini-health systems in our country-devastated and in their poverty, herbal medicine represents one of the main options to seek to restore their health.
Conclusions
Herbal medicine represents an option for the vulnerable population, especially in the face of the devastating shortage of medicines and health supplies at the health institutions. The lack of a response to the “Right to Health” seems to have been forgotten. These resources must be purchased by the vulnerable population themselves, given the devastated mini-health systems in our country. Amid poverty, herbal medicine represents one of the main options for restoring their health.
The results of this review show that medicinal plants are used as support or even treatment by socioeconomically vulnerable populations, primarily those living in poverty and extreme poverty.
Conflict of interest. The authors declare that there is no conflict of interest in the publication of this article.
Financial support. No funding; the authors contributed the expenses.
Artificial Intelligence. No AI tools were used for the completion of this article.
References
[1]. Arroyo,J., Hañari, R., Tinco, A., Baca, D., Domínguez, L., Buendía, J., Efecto antihipertensivo del extracto de Piper aduncum matico sobre la hipertensión inducida por L-NAME en ratones. An. Fac. med. [Internet]. 2012 Oct [citado 2025 Feb 14] ; 73( 4 ): 275-280. Disponible en: http://www.scielo.org.pe/scielo.php?script=sci_arttext&pid=S1025-55832012000400002&lng=es.
[2]. Hipertensión [Internet]. Paho.org. [citado el 14 de febrero de 2025]. Disponible en: https://www.paho.org/es/temas/hipertension
[3]. López, M., Vázquez, R., Estrada, R., Cortez, K., Tlazola, Rut., Ruvalcaba, J.C,. Actividad Física como medida de control de la hipertensión arterial, Journal of negative & no positive resultados [internet]. 28 de agosto del 2017[citado 17/02/2025]:8.disponible en: https://www.jonnpr.com/pdf/1531.pdf
[4]. Bakris GL. Hipertensión [internet]. Manual MSD versión para profesionales. [citado el 11 de marzo de 2025]. Disponible en: https://www.msdmanuals.com/es/professional/trastornos-cardiovasculares/hipertensi%C3%B3n/hipertensi%C3%B3n
[5]. Ruvalcaba-Ledezma., J.C, Chávez-González., N, Ruvalcaba-Cobián., J.C, Ramírez-Hernández., B.C, Cuevas-Figueroa.,X.M, Imbert-Palafox., J.L, Therapeutic proposal of Solanum marginatum L.: A comparative analysis with Solanum torvum. International Journal of Botany Studies,[internet]. Julio 2019 [citado 17/02/2025];4(4):6. Disponible en: https://www.botanyjournals.com/assets/archives/2019/vol4issue4/4-4-42-556.pdf
[6]. MONTES RPY, FABELA IHE, ISLAS- MAG, REYNOSO -VJ, GARNICA -GB, RUVALCABA- LJC. THE EFFECT OF AN INFUSION OF HIBISCUS SABDARIFFA L. IN HYPERTENSIVE PATIENTS FROM AN URBAN POPULATION: AN IMPORTANT COMORBIDITY BEFORE COVID-19.: Effect of an infusion of Hibiscus sabdariffa L. in hypertensive patients. Afr J Tradit Complement Altern Med [Internet]. 2024 Dec. 20 [cited 2025 Mar. 7];20(1):1-7. Available from: https://journals.athmsi.org/index.php/ajtcam/article/view/6147
[7]. NORMA Oficial Mexicana NOM-248-SSA1-2011, Buenas prácticas de fabricación para establecimientos dedicados a la fabricación de remedios herbolarios [Internet]. Gob.mx. [citado el 19 de febrero de 2025]. Disponible en: https://www.dof.gob.mx/normasOficiales/4676/salud/salud.htm
[8]. Secretaría de Agricultura y Desarrollo Rural S. México, segundo lugar mundial en registro de plantas medicinales [Internet]. gob.mx. [citado el 19 de febrero de 2025]. Disponible en: https://www.gob.mx/agricultura/prensa/mexico-segundo-lugar-mundial-en-registro-de-plantas-medicinales
[9]. Esper RC, Caldera BL, Morales J. Hierbas, medicina herbolaria y su impacto en la práctica clínica. Rev Invest Med Sur Mex, Julio-Septiembre [Internet]. 2010 [citado el 19 de febrero de 2025];17(3):124–30. Disponible en: https://www.medigraphic.com/pdfs/medsur/ms-2010/ms103a.pdf
[10]. ANALISIS COMPARATIVO DEL EFECTO DE 3 PLANTAS ECUATORIANAS CON ACTIVIDAD ANTIHIPERTENSIVAS. [Internet] 2024 [citado el 25 de febrero de 2025]; Disponible en: https://editorialceo.ceocapacitacionestrategias.com/index.php/editorial/catalog/view/95/146/403
[11]. Morais VP, Cabral FV, Fernandes CC, Miranda MLD. Brief Review on Piper aduncum L., its Bioactive Metabolites and its Potential to Develop Bioproducts. Braz Arch Biol Technol [Internet]. 2023 [citado el 26 de febrero de 2025];66:e23220314. Disponible en: https://www.scielo.br/j/babt/a/tNwrsjjrQFNCJHC9RSWWBXx/
[12]. Ramírez-Rodríguez, Y., Espinosa-Tanguma, R., Valle-Aguilera, JR, Rodríguez-Menchaca, AA, Saderi, N., Salgado-Delgado, R., Bautista, E., Garcés, L., Ramírez, V., Robledo-Márquez, K., Riego-Ruiz, L., & Trujillo, J. (2024). Efecto vasorelajante y potencial de reducción de la presión arterial del concentrado de jugo de pitaya (Stenocereus huastecorum) asociado con el bloqueo de los canales de calcio. Alimentos, 13(16), 2631. https://doi.org/10.3390/foods13162631
[13]. Espinosa-Villanueva, T., Bolívar-Cimé, B., Horta-Vega, J.V., Martínez-Ávalos, J., Guadalupe. Glosophagine bats (Chiroptera: Phyllostomidae) as floral visitors of Stenocereus huastecorum (Plantae: Cactaceae) in the Jaumave Valley, Tamaulipas, Mexico. Acta Zool. Mex [revista en la Internet]. 2023 [citado 2025 Feb 28] ; 39: e2622. Disponible en: http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0065-17372023000100130&lng=es. Epub 06-Mayo-2024. https://doi.org/10.21829/azm.2023.3912622.
[14]. Guillén-Sánchez J, Mori-Arismendi S, Paucar-Menacho LM. Características y propiedades funcionales del maíz morado (Zea mays L.) var. subnigroviolaceo. Sci Agropecu [Internet]. 2010 [citado el 7 de marzo de 2025];5(4):211–7. Disponible en: http://www.scielo.org.pe/scielo.php?script=sci_arttext&pid=S2077-99172014000400005
[15]. Arroyo J, Raez E, Rodríguez M, Chumpitaz V, Burga J, Cruz W. D, , Valencia J. ACTIVIDAD ANTIHIPERTENSIVA Y ANTIOXIDANTE DEL EXTRACTO HIDROALCOHÓLICO ATOMIZADO DE MAÍZ MORADO (Zea mays L) EN RATAS. Revista Peruana de Medicina Experimental y Salud Pública [Internet]. 2008;25(2):195-199. Recuperado de: https://www.redalyc.org/articulo.oa?id=36311608007
[16]. Salas E, Aurora P. Identificación y caracterización de las propiedades biológicas de péptidos de alpiste: cereal empleado para el tratamiento de diabetes e hipertensión. [internet]. 2013 [citado el 14 de marzo de 2025]; Disponible en: https://repositorio.ipicyt.edu.mx/handle/11627/235
[17]. Verona-Ruiz A, Urcia-Cerna J, Paucar-Menacho L. Pitahaya (Hylocereus spp.): Culture, physicochemical characteristics, nutritional composition, and bioactive compounds. Sci Agropecu [Internet]. 2020 [citado el 11 de abril de 2025];11(3):439–53. Disponible en: http://www.scielo.org.pe/scielo.php?script=sci_arttext&pid=S2077-99172020000300439