Arjuna : Terminalia arjuna

Ayurvedic Properties and Action:
Bhagnasandhanakara, Hrdya, Kaphahara, Pittahara, Vrananasana, Vyanga Hara

The bark extract contains acids (arjunolic acid, terminic acid), glycosides (arjunetin, arjunosides I–IV), and strong antioxidants—flavones, tannins, oligomeric proanthocyanidins2. It also contains alicyclic, amino acids and polyols, Triterpenoid saponins (arjunic acid, arjunolic acid, arjungenin, arjunglycosides), Flavonoids (arjunone, arjunolone, luteolin), Gallic acid, ellagic acid, Oligomeric proanthocyanidins (OPCs), Phytosterols (b-sitosterol), calcium, magnesium, zinc, and copper.

Pharmacological Actions:
It is cardio protective, anti-anginal, spasmogenic, antifungal, antibacterial, hepatoprotective, astringent, tonic, deobstruent, and cardiotonic.

Medicinal Use:
It is useful in cardiac disorder, excessive perspiration, fatigue, inflammation, cirrhosis of liver and hypertension.

It is used as a cardioprotective and cardiotonic in angina and poor coronary circulation; as a diuretic in cirrhosis of liver and for symptomatic relief in hypertension.

The Ayurvedic Pharmacopoeia of India recommends the powder of the stembark in emaciation, chest diseases, cardiac disorders, lipid imbalances and polyuria.

Clinical / experimental study:
Several studies have been made to assess the efficacy of Terminalia Arjuna bark in cardiac disorders. Decoction of bark powered was found more useful in hypertensive heart disease as compared to congestive heart failure. Alcoholic decoction of bark was found to be beneficial in stable cases of ischemic heart disease. Prolonged use of this drug brought sense of well being in patients and increased euglobulin lysis time and prothrombin time. The drug also showed electrocardiographic improvement.A particular patient, an adult male who developed Stokes-Adams attacks following acute chest pain, became well after three months use of crude powder of Terminalia Arjuna. In another study 500 mg crude drug powder of Terminalia Arjuna was administered in 30 stable angina pectoris patients. The drug was found to be effective in alleviating angina pain. It was also noted to be useful in cases of ischemic heart diseases associated with rhythm disturbances, particularly premature beats. The drug was found to be beneficial in modifying various known coronary risk factors like obesity, hypertension, hyperglycemia and circulating catecholamine in these patients. No significant side effects were observed in these patients.A clinical trial was taken on 51 patient of coronary heart disease to assess the effect of Terminalia Arjuna. The studies revealed statistically significant positive results. Reduction in systolic and diastolic blood pressure, pulse rate, erum cholesterol and HDL and LDL cholesterol was noticed.The bark given to (58 male) patients with stable angina with provocable ischemia on treadmill exercise, led to improvement in clinical and treadmill exercise parameters as compared to placebo therapy. These benefits were similar to those observed with isosorbide mononitrate.Arjunolic acid exhibited significant cardiac protection in isoproterenol induced myocardial necrosis in rats.
A study demonstrated that the alcoholic extract of Terminalia arjuna bark augmented endogenous antioxidant compounds of the rat heart and prevented from isoproterenol-induced myocardial ischemic reperfusion injury.

Cardiac lipid peroxidation in male Wistar rats was reduced by 38.8% in a study based on aqueous freeze-dried extract of the bark.

Oral administration of bark powder for 10 days produced significant increase in circulating histamine, a little increase in 5-HT, catecholamines and HDL cholesterol, and decrease in total lipid, triglycerides and total cholesterol in normal rats.

Experiments in rats with T. arjuna and extracted arjunolic acid have demonstrated an antiplatelet and anticoagulant action similar to that of acetylsalicylic acid.
In dogs, T. arjuna bark extract caused dose-dependent hypotension, suggesting adrenergic beta-2 receptor agonist activity.

Clinical studies have been conducted in coronary heart disease using T. arjuna bark extract at doses of 500 mg every 8 hours. Statistically significant reduction in angina and improved diastolic function was shown in patients with ischemic mitral regurgitation at 1 and 3 months with T. arjuna11. Effects similar to treatment with isosorbide mononitrate 40 mg daily were demonstrated in patients with chronic stable angina given T. arjuna bark extract. Reduction in the frequency of angina and improved treadmill exercise test parameters were shown.

Brachial artery endothelial dysfunction was improved after 2 weeks of T. arjuna bark extract versus placebo in young male smokers.
A reduction in cholesterol in humans has also been reported with T. arjuna bark extract at a dosage of 500 mg daily.

In clinical trials and animal experiments, T. arjuna exhibited hepatoprotective effects.

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