Abstract
Historically, traditional herbal medicines (THMs) have been the conventional treatment strategy in the Korean medical system for treating many diseases. However, THMs have rarely been used to treat hypertension, and moreover few studies have investigated the interaction of blood pressure with the coadministration of synthetic antihypertensives. We aimed to evaluate the vasorelaxant and hypotensive effects of the traditional herbal prescription Cheonwangbosimdan (CWBSD; “Tianwangbuxindan” in Chinese) and the combination of CWBSD with amlodipine. CWBSD was extracted with distilled water at 100°C for 2 h. To investigate vasorelaxant activities, CWBSD with amlodipine (10 μg/ml) was added cumulatively (10–1,000 μg/ml) to isolated rat aortic rings precontracted using phenylephrine or potassium chloride in organ chambers. To investigate hypotensive effects, CWBSD (2,476 mg/kg) was orally administered with or without amlodipine (5 mg/kg) to spontaneously hypertensive rats (SHRs). CWBSD increased the relaxation of rat aortic rings induced by amlodipine (P < 0.01). In vivo, CWBSD coadministration with amlodipine also significantly decreased the blood pressure of SHRs compared to the amlodipine-treated group. These results suggested that CWBSD could be a useful herbal prescription to treat hypertension and we recommend establishing guidelines for the use of herbal medicines in conjunction with antihypertensive drugs, including amlodipine.
Highlights
Hypertension is a major risk factor for cardiovascular disease, chronic kidney disease, cerebrovascular disease, ischemic heart disease, stroke, and coronary heart disease
Coadministration of amlodipine and CWBSD significantly lowered the systolic blood pressure (SBP) of spontaneously hypertensive rats (SHRs) compared to amlodipine alone. These findings suggest that CWBSD does not interfere with the blood-pressure-lowering effect of amlodipine, and it could aid the hypotensive effect of amlodipine through a vasorelaxant effect
These results suggested that CWBSD could be a useful herbal prescription to treat or prevent hypertension and the hypotensive and vasorelaxant effects of CWBSD were related to attenuation of the influx of extracellular Ca2+ through Receptor-Operative Ca2+ Channels (ROCCs) or Voltage-Dependent Ca2+ Channels (VDCCs)
Summary
Hypertension is a major risk factor for cardiovascular disease, chronic kidney disease, cerebrovascular disease, ischemic heart disease, stroke, and coronary heart disease. 30% of adults in the United States are not aware of their hypertension and in two-thirds of patients, hypertension is not being controlled [1]. According to the Korean National Health and Nutrition Examination Survey, the prevalence of hypertension among adults aged over 30 years was approximately 30% in Korea. The prevalence of hypertension has not been constant over time; the prevalence was 29% in 1998, decreased slightly to 24% in 2007, and increased again to 28% in 2011 [2]. Despite the improvement in the treatment rate of hypertension, some older patients still have untreated and uncontrolled hypertension. The prevalence of hypertension has remained relatively stable over the last several decades, the number of older people with hypertension has been steadily increasing due to a rapidly aging society. Isolated systolic hypertension, one of four subtypes of hypertension, is becoming more prevalent [3]
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