Hypotensive and Antihypertensive Properties and Safety for Use of Annona muricata and Persea americana and Their Combination Products

Abstract

Introduction. In the management of hypertension (a cardiovascular disease and the leading metabolic risk factor in noncommunicable diseases) with herbal medicines, efficacy and safety are of uttermost concern. This study sought to establish hypotensive, antihypertensive, drug interaction, and safety for use of the aqueous leaf extracts of Annona muricata (AME), Persea americana (PAE), or their combination products (CAPE). Methodology. Systolic and diastolic blood pressure (SBP and DBP), mean arterial blood pressure (MAP), and heart rate (HR) were measured in normotensive Sprague-Dawley rats treated with 50–150 mg/kg of AME, PAE, or CAPE to establish a hypotensive effect. “Combination index” was calculated to establish interaction between AME and PAE. The antihypertensive effect of CAPE was established by measuring SBP, DBP, MAP, and HR in ethanol-sucrose- and epinephrine-induced hypertension. Full blood count, liver and kidney function tests, and urinalysis were determined in ethanol/sucrose-induced hypertension to establish safety for use. Results. AME, PAE, and CAPE significantly ( p ≤ 0.001 ) decreased BP in both normotensive and hypertensive animals. Effects of CAPE 1, CAPE 2, and CAPE 3 were synergistic (combination indices of 0.65 ± 0.07, 0.76 ± 0.09, and 0.87 ± 0.07, respectively). There was a significant decrease ( p ≤ 0.01 − 0.001 ) in SBP and MAP with 100 mg/kg CAPE 1 and 75 mg/kg CAPE 2 treatment in hypertension as well as with nifedipine ( p ≤ 0.001 ) treatment. Epinephrine-induced hypertension in anesthetized cats was significantly and dose-dependently inhibited ( p < 0.05 − 0.001 ) by 25–100 mg/ml CAPE 1 and 37.5–75 mg/ml CAPE 2. CAPE administration had no deleterious effect ( p > 0.05 ) on full blood count, liver and kidney function, and urine composition in hypertensive rats. Conclusion. The aqueous leaf extracts of Annona muricata, Persea americana, and their combination products possess antihypertensive properties, with combination products showing synergism and safety with use.

Preventive Potential of the Aqueous Extract of the Mixture of Bidens pilosa (Asteraceae) and Cymbopogon citratus (Poaceae) Aerial Parts on Hypertension Induced by a Chronic Salt and Alcohol Consumption on the Rats

“…pilosa and C . citratus , bioactive compounds present such as the phytochemicals mainly flavonoids and phenolic compounds act synergistically to cause a reduction in cardiac output and/or total peripheral resistance and consequently a decrease in blood pressure [ 39 ]. These effects would therefore be one of the mechanisms by which the aqueous extract of the mixture exerts its antihypertensive effect.…”

Pharmacological Activities of Soursop (Annona muricata Lin.)

“…The suggested hypotensive mechanism of action of A. muricata extract is via the blockage of calcium ion channels, which lowers blood pressure [35]. Another study showed that A. muricata aqueous extract had antihypertensive properties; combinations of A. muricata and other plants, such as Persea americana, also exhibited antihypertensive activity, providing a safe and effective solution for hypertension prevention and treatment [95].…”

Effect Of Complementary Therapy On Hypertension Patients: Systematic Review

“…Research shows that the aqueous extract of Annona muricata and its combination products have hypotensive and antihypertensive properties, with the product combination causing synergism in administration. The combination is safe for use in hypertension, so it has promising therapeutic advantages for the prevention and treatment of hypertension (Sokpe et al, 2020). The next therapy is the gotu kola therapy which can reduce hypertension blood pressure.…”