Potential Impact of Sclerocarya birrea on Cardiovascular Health and Related Risk Factors: Review of Existing Evidence

Abstract

There is increasing use of modern medicine globally to manage cardiovascular diseases (CVDs). However, many people, especially in low-to-middle-income countries, still rely on traditional medicinal plants for their daily health needs. However, limited studies have explored the use of these remedies. Therefore, this narrative review aimed to evaluate the potential of Sclerocarya birrea (S. birrea) in managing diabetes, dyslipidemia, inflammation, and hypertension, including its effects on oxidative stress. This study reviewed evidence from PubMed, Web of Science, and ResearchGate, published in these databases up to 30 April 2025. The evidence showed that S. birrea had the potential to preserve cardiometabolic health and reduce CVD-associated risk factors. Notably, S. birrea improved glucose metabolism, inflammation, hypertension, and oxidative stress. This plant exhibits antihyperglycemic effects by activating adenosine monophosphate-activated protein kinase (AMPK) and inhibiting gluconeogenesis and the activities of carbohydrase. It also ameliorates dyslipidemia by modulating the activities of peroxisome proliferator-activated receptor alpha (PPARα) and increasing fatty acid oxidation. The anti-inflammatory potential of S. birrea is modulated by the activation of PPARα, which inhibits nuclear factor kappa beta (NF-κβ) and decreases the production of inflammatory cytokines. Its antioxidant property is attributed to its ability to increase antioxidant enzymes like catalase (CAT), superoxide dismutase (SOD), and glutathione (GSH), which are known to counteract oxidative damage. However, it is important to note that different parts of the plant had varying impacts on CVD risk factors, depending on whether the study was conducted preclinically or clinically. Therefore, its extract should be explored as a potential remedy for the management of CVD risk factors, especially in areas where access to healthcare is limited.

Keywords: Sclerocarya birrea; antidiabetic; antihypertensive; antioxidative; cardiovascular health; hypolipidemic.

Figure 1

Proposed mechanism by which S. birrea ameliorates hyperglycemia [32]. S. birrea reduces hyperglycemia by inhibiting alpha-amylase and glucosidases. This action prevents the breakdown of carbohydrates into simple sugar molecules, resulting in reduced blood glucose levels. It also stores glucose as glycogen in the liver and skeletal muscle. Akt: protein kinase beta; IRS-1: insulin resistant substrate-1; GSK3-β: glycogen synthase kinase 3 beta; PI3K: phosphatidylinositol 3-kinase; AMPK: AMP-activated protein kinase; GLUT-4: glucose transporter type 4; PPAR: peroxisome proliferator-activated receptor. Figure was created using Biorender.

Figure 2

The possible mechanism by which S. birrea lowers inflammation and dyslipidemia [32,37]. SREBP: sterol regulatory element-binding protein 1, AMPK: AMP-activated protein kinase, CPT1: carnitine palmitoyl transferase 1, TG: triglyceride, FAS: fatty acid synthase, IL-6: interleukin-6, TNF-α: tumor necrosis factor alpha, NF-κβ: nuclear factor kappa beta. Figure was created via Biorender.