Chinese Herbal Medicine on Cardiovascular Diseases and the Mechanisms of Action

Abstract

Cardiovascular diseases are the principal cause of death worldwide. The potentially serious adverse effects of therapeutic drugs lead to growing awareness of the role of Chinese herbal medicine in the treatment of cardiovascular diseases. Chinese herbal medicine has been widely used in many countries especially in China from antiquity; however, the mechanisms by which herbal medicine acts in the prevention and treatment of cardiovascular diseases are far from clear. In this review, we briefly describe the characteristics of Chinese herbal medicine by comparing with western medicine. Then we summarize the formulae and herbs/natural products applied in the clinic and animal studies being sorted according to the specific cardiovascular diseases. Most importantly, we elaborate the existing investigations into mechanisms by which herbal compounds act at the cellular levels, including vascular smooth muscle cells, endothelial cells, cardiomyocytes and immune cells. Future research should focus on well-designed clinic trial, in-depth mechanic study, investigations on side effects of herbs and drug interactions. Studies on developing new agents with effectiveness and safety from traditional Chinese medicine is a promising way for prevention and treatment of patients with cardiovascular diseases.

Keywords: Chinese herbal medicine; atherosclerosis; cardiovascular diseases; dyslipidemia; heart disease; hypertension.

FIGURE 1

A schematic diagraph indicating the targets on which plant products/herbs act during the pathogenesis of CVDs. Plant products/herbs demonstrate protective effect in CVDs by attenuating damage in cardiomyocytes, endothelial cells (ECs), vascular smooth muscle cells (VSMCs) and macrophages/monocytes (M&Ms). In VSMCs, plant products/herbs show the beneficial effect by inhibiting expression or activity of contractile and structural proteins, modulating expression of ECM proteins/glycoproteins, regulating calcium levels, attenuating proliferation and migrations, alleviating inflammation, and improving mitochondrial function. In ECs, plant products/herbs show the beneficial effect by inhibition of inflammation, oxidative stress and apoptosis, activation of endothelial nitric oxide synthase(NOS)-NO signaling pathway, induction of angiogenesis and suppression of endothelial permeability. In cardiomyocytes, plant products/herbs show the beneficial effect by inhibiting cardiac hypertrophy, oxidative stress and apoptosis, opening K_ATP channels and increasing atrial natriuretic peptide (ANP) secretion. In macrophages and monocytes, plant products/herbs show the beneficial effect by inhibition of inducible NOS-NO signaling pathway, activation of estrogen receptor and nuclear receptor peroxisome proliferator activated receptor alpha (PPARα). A myriad of molecular, and cellular pathways are favorably modulated by plant products/plants or their extracts.