Abstract
Cardiovascular diseases (CVDs) are the main cause of mortality in type 2 diabetes mellitus (T2DM); however, not all patients are fully satisfied with the current available treatments. Medicinal plants have been globally investigated regarding their effect in CVD, yet the field is far from getting exhausted. The current paper aims to provide an evidence-based review on the clinically evaluated medicinal plants and their main therapeutic targets for the management of CVD in T2DM. Electronic databases including PubMed, Cochrane, Embase, Scopus, and Web of Science were searched from 2000 until November 2019, and related clinical studies were included. Lipid metabolism, glycemic status, systemic inflammation, blood pressure, endothelial function, oxidative stress, and anthropometric parameters are the key points regulated by medicinal plants in T2DM. Anti-inflammatory and antioxidant properties are the two most important mechanisms since inflammation and oxidative stress are the first steps triggering a domino of molecular pathological pathways leading to T2DM and, subsequently, CVD. Polyphenols with potent antioxidant and anti-inflammatory effects, essential oil-derived compounds with vasorelaxant properties, and fibers with demonstrated effects on obesity are the main categories of phytochemicals beneficial for CVD of T2DM. Some medicinal plants such as garlic (Allium sativum) and milk thistle (Silybum marianum) have strong evidences regarding their beneficial effects; however, others have low level of evidence which reveals the need for further clinical studies with larger sample sizes and longer follow-up periods to confirm the safety and efficacy of medicinal plants for the management of CVD in T2DM.
Highlights
Type 2 diabetes mellitus (T2DM) is a metabolic disorder accompanied with reduced glucose uptake, abnormal glucose metabolism, and insulin resistance which affects 1 in 11 adults [1]
In diabetes-associated cardiovascular diseases (CVDs), plant-derived natural supplements could play a positive role in preventing oxidative damage and inflammation [19] which are two basic mechanisms involved in the pathophysiology of T2DMassociated CVD. us, plants can be future candidates for the management of CVD in T2DM. e aim of the present study is to review controlled clinical trials on the cardiovascular effects of plants in T2DM patients
Exclusion criteria were animal and cellular studies, human studies other than clinical trials, comparing the results of the herbal intervention with a standard drug, choosing healthy individuals as control subjects, including type 1 diabetic patients or patients with obesity or metabolic syndrome without a diagnosis of T2DM, and administration of a mixture of herbal and nonherbal materials
Summary
Type 2 diabetes mellitus (T2DM) is a metabolic disorder accompanied with reduced glucose uptake, abnormal glucose metabolism, and insulin resistance which affects 1 in 11 adults [1]. T2DM is a principal risk factor for a broad spectrum of severe conditions amongst which the most important ones are cardiovascular diseases (CVDs) [4]. More than 80% of deaths in T2DM patients occur due to cardiovascular events which caused CVD to be the leading cause of mortality in these patients [5]. A recent meta-analysis demonstrated higher risk of atrial fibrillation in diabetic patients [7]. Another meta-analysis revealed that diabetes significantly increases the risk of sudden cardiac death [8]. Diabetes is an important risk factor for chronic heart failure [10]. Some cardiovascular drugs, such as statins, can increase the risk of diabetes[11]. us, there is a close relationship between T2DM and CVD
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