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Terminalia arjuna reverses impaired endothelial function in chronic smokers.

Indian heart journal
May 5, 2004
Anil Bharani et al. (3 authors)
Clinical TrialComparative StudyJournal ArticleRandomized Controlled TrialHuman StudyClinical
Study Details

Study Goal

The researchers aimed to determine whether Terminalia arjuna improves endothelial dysfunction in smokers by assessing its effects on flow-mediated dilation.

Results Summary

Terminalia arjuna significantly improved flow-mediated dilation in smokers compared to placebo, restoring endothelial function without affecting nitroglycerine-mediated dilation. No significant changes in vessel diameter or flow velocities were observed between the two therapies.

Population

18 healthy male smokers (aged 28.16±9.45 years) and 18 age-matched non-smoker controls.

Effective Dosage

500 mg every 8 hours (q8h)

Duration

2 weeks per intervention (crossover design)

Interactions

None mentioned

Extracted Claims (9)
InterventionDirectionEndpointPopulationDosageImpactClaim #
smoking
increase
endothelial dysfunction
-
-
causes
#1
smoking
increase
oxidative stress
-
-
largely through increased
#2
smoking cessation
increase
altered endothelial physiology
-
-
beneficial role by restoring
#3
antioxidant vitamin therapy
increase
altered endothelial physiology
-
-
beneficial role by restoring
#4
-
decrease
flow-mediated dilation
smokers
4.71+/-2.22 v. 11.75+/-5.94%
was significantly impaired
#5
-
no change
nitroglycerine-mediated dilation
smokers
20.35+/-3.89 v. 19.68+/-3.74%
was similar
#6
Terminalia arjuna
increase
flow-mediated dilation
smokers
9.31+/-3.74 v. 5.17+/-2.42%
showed significant improvement from baseline values
#7
placebo
no change
flow-mediated dilation
smokers
-
not with
#8
Terminalia arjuna therapy for two weeks
decrease
this endothelial abnormality
smokers
-
leads to significant regression of
#9
Abstract

BACKGROUND: Smoking, largely through increased oxidative stress, causes endothelial dysfunction which is an early key event in atherosclerosis. Smoking cessation and antioxidant vitamin therapy are shown to have beneficial role by restoring altered endothelial physiology. The present study was aimed to determine whether Terminalia arjuna, an Indian medicinal plant with potent antioxidant constituents, would improve endothelial dysfunction in smokers. METHODS AND RESULTS: Eighteen healthy male smokers (age 28.16+/-9.45 years) and equal number of age-matched non-smoker controls participated in the study. The baseline brachial artery reactivity studies were performed using high frequency ultrasound according to standard protocol under identical conditions to determine endothelium-dependent, flow-mediated dilation and endothelium-independent nitroglycerine-mediated dilation. The two groups were matched regarding age, body mass index, blood pressure, serum cholesterol, mean resting vessel diameters and post-occlusion flow velocities (all p=NS). While flow-mediated dilation was significantly impaired amongst smokers compared to controls (4.71+/-2.22 v. 11.75+/-5.94%, p <0.005), the nitroglycerine-mediated dilation was similar in the two groups (20.35+/-3.89 v. 19.68+/-3.74%, p=NS). Subsequently the smokers were given Terminalia arjuna (500 mg q8h) or matching placebo randomly in a double blind cross-over design for two weeks each, followed by repetition of brachial artery reactivity studies to determine various parameters including flow-mediated dilation after each period. There was no significant difference as regards vessel diameter and flow velocities between the two therapies. However, the flow-mediated dilation showed significant improvement from baseline values after Terrminalia arjuna therapy but not with placebo (9.31+/-3.74 v. 5.17+/-2.42%, p <0.005). CONCLUSIONS: Smokers have impaired endothelium-dependent but normal endothelium-independent vasodilation as determined by brachial artery reactivity studies. Further, Terrminalia arjuna therapy for two weeks leads to significant regression of this endothelial abnormality amongst smokers.

Medical Subject Headings (MeSH)
AdolescentAdultAnalysis of VarianceBlood Pressure DeterminationBrachial ArteryCardiovascular DiseasesCross-Over StudiesDouble-Blind MethodEndothelium, VascularFollow-Up StudiesHemodynamicsHumansIndiaMalePhytotherapyProbabilityReference ValuesRisk AssessmentSampling StudiesSmokingTerminaliaTobacco Use DisorderTreatment Outcome
Study Links
PubMed ID15377133
Quality Scores
SafetyNot Assessed
Efficacy85/10
Quality80/10
Citation Metrics
Total Citations6
Citations/Year0.3
Relative Citation Ratio0.21
NIH Percentile10.7%
Research Impact Scores
APT Score0.05
Weight Score0.77
Normalized Score0.70
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