Potential benefits of Terminalia arjuna in cardiovascular disease

The bark of the tree of Terminalia arjuna has been used in cardiac disorders in Ayurveda. In the Rigveda, the word Arjuna is used for the first time. The preclinical studies in modern medicine suggest that there are strong antioxidant properties of Terminalia arjuna and reduction of ischemic perfusion injury. It also causes attenuation of oxidative stress and antifibrotic activity has been shown. Clinical trials suggest that the benefit of arjuna could be in patients with ischemic heart disease and heart failure. The mechanisms of action are not very clear, but some evidence of antioxidant action, inotropic action and hypolipidemic action has been seen. The preclinical and clinical studies published so far are small and from limited centres. Large clinical studies and more mechanistic preclinical studies are needed to establish a firm role for arjuna in current cardiovascular practice. n n n J. Preventive Cardiology Vol. 3 No. 1 Aug 2013 n n n J. Preventive Cardiology Vol. 3 No. 1 Aug 2013 429 428 different formulations of the bark powder of arjuna. Phytochemistry of Terminalia arjuna Phytochemical analysis reveals that it contains triterpenes 5 6 7 (like arjunic acid ) , arjunolic acid , arjunolitin , and 8 arjungenin , tannins like arjunin, catechin, gallocatechin, 9 epicatechin, epigallocatechin , glycosides like 10 arjunglucoside-I, arjunetoside , terminolitin (2311 12 deoxyarjunolitin oleane Derivatives ) , arjunetoside , 13 arjunaphthanoloside-1 and very high amounts of flavonoids (quercetin, kaempferol, luteolin, and 14 pellargonidin), ellagic acids and phytosterols as well as minerals such as calcium, magnesium, zinc, and copper. Some other compounds in Terminalia arjuna are terminic 15 16 17 acid , arjunin , Casuarinin , sapogenins, serine, valine, 18 proline, methionine, histidine, lysine, etc. Preclinical studies done on Terminalia arjuna Although descriptions of cardiac ailments in the ancient medical texts did not match well with the modern classification of cardiovascular diseases, Ayurvedic physicians nevertheless widely prescribed the ‘drug’ for a wide range of cardiac conditions, from angina pectoris to heart failure. Evidence-based preclinical and clinical studies with Terminalia arjuna have only been reported during the last few decades. The preclinical studies suggest that there are strong 19 antioxidant properties of Terminalia arjuna and wound 20 healing and reduction of ischemic perfusion injury 21 (Gauthaman et al., 2005) , effect of this drug on the process 22 of respiratory oxyburst (Pawar et al., 2005) , and anti23 fibrotic activity (Kumar et al., 2009) have been shown. Kumar et al. have studied the effects of Terminalia arjuna bark extract on myocardial fibrosis and oxidative stress induced by chronic beta-adrenoceptor stimulation. nBotanical details Arjuna tree is a large, evergreen tree. The tree is about 60–80 feet in height. Arjuna tree is native to Indian soil. It is seen all around the sub-Himalayan tracts, the Deccan regions, Myanmar and Sri Lanka. It grows predominantly beside water channels or marshy belts. It has a buttressed trunk. Bark of tree is grey brown in color and slight rough in touch from outside and is thick, soft and of red color from inside. Leaves are sub-opposite, oblong or elliptical in shape and their shape resembles to the shape of guava leaves. Flowers are arranged in panicled spikes. Fruits are ovoid or ovoid-oblong, 2.5–5.0 cm and glabrous with five