Abstract
Introduction: The Emblica officinalis (EO) fruit has traditionally been considered as a cardioactive medication and has demonstrated remarkable cardiovascular effects in the pharmacological literature. The present study systematically reviews EO’s potential for prevention and therapy of cardiovascular diseases (CVD). Methods: PubMed, ScienceDirect, Scopus, Proquest, Ebsco, Google, Google Scholar, Ovid, and Cochrane databases were searched from 1966 to 2017 for the English and non-English literature using the terms including the cognates of EO including amla, Emblic myrobalan, Emblica officinalis, Emblica pectinata , Indian gooseberry, and Phyllanthus emblica together with antioxidant, arrhythmia, cardioprotective, cardiotoxicity, heart disease, heart failure, hyperlipidemia, hypertension, myocardial dysfunction, and oxidative stress. The inclusion criteria were in vitro, animal, and clinical cardiovascular pharmacological studies conducted on EO and full-text accessibility. The exclusion criterion was studies in which a combination of EO and at least one other plant was investigated. The reference lists of the retrieved articles were also searched manually for additional eligible articles. The methodological quality of clinical trials was assessed by the Jadad scale, and animal studies were evaluated by the ARRIVE checklist. Results: Nineteen articles concerning the cardiovascular pharmacological effects of EO were included in this review. The plant has shown antiatherogenic, anticoagulant, hypolipidemic, antihypertensive, antioxidant, antiplatelet, and vasodilatory effects as well as lipid deposition inhibitory properties. Moreover, it prevents from doxorubicin and isoproterenol cardiotoxicity and myocardial ischemia/reperfusion injury, and improves vascular endothelial function in animal studies. Some high-quality clinical studies report the vasodilatory and myocardial antioxidant properties as well as anti-platelet aggregation effects of this plant. Conclusion: EO influences various cardiovascular risk-factors. However, there is not sufficient evidence to confirm the plant efficacy in preventing and treating CVD.
Highlights
The Emblica officinalis (EO) fruit has traditionally been considered as a cardioactive medication and has demonstrated remarkable cardiovascular effects in the pharmacological literature
Google Scholar, Ovid, and Cochrane databases were For clinical studies, PICO was considered as patients with searched for the English and non-English literature from a type of cardiovascular disease who took the EO with or 1966 to 2017 using the terms amla, Emblic myrobalan, without a control group with the aim to identify changes
This review collected and presented the evidences concerning the effects of EO on hyperlipidemia, hypertension, myocardial and endothelial function, cardiac specific antioxidants, and coagulation factors
Summary
Cardiovascular diseases (CVD) are the leading cause of death worldwide, resulting in 17.9 million deaths in 20151 and expectedly exceeding 23.6 million by 2030.2 Some medicinal plants and food components (as monotherapy or adjunct to standard pharmacotherapy) have traditionally been used to treat CVD and have demonstrated various cardiovascular pharmacological effects.[3,4,5,6] Emblica officinalis is one of the medicinal plants whose cardiovascular effects have been considered both in the traditional medicine and in the modern scientific literature. Emblica pectinata Ridl.) (family Euphorbiaceae), known as Emblic myrobalan, Indian gooseberry, or amla, hereafter referred to as EO This medium-sized deciduous tree is native to India and cultivated in Pakistan, Uzbekistan, Sri Lanka, South East Asia, China, and Malaysia.[7] The EO fruits are used more than the other parts of the plant for treatment of various diseases in the Ayurveda and Unani medicines.[7] The dried fruit is a common imported herbal product in the herbal markets of Iran. Google Scholar, Ovid, and Cochrane databases were For clinical studies, PICO was considered as patients with searched for the English and non-English literature from a type of cardiovascular disease who took the EO with or 1966 to 2017 using the terms amla, Emblic myrobalan, without a control group with the aim to identify changes. Serum TC, TG and LDL-C; cholesterol contents of the liver and aorta; fecal excretion of cholesterol
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