- ANTIHYPERLIPIDEMIC EFFECTSOFCRATAEGUSCURVISEPALALIND.

· S. Asgary, N. Sarrafzadegan~ N. Ghassemi,A. Ghanadi, E. Sajadi, F.Sajadi Gh. Naderi

CrataegusCurvisepalaUnd is found widely in north and central parts.of Iran. Due ta its vasodilator effect, its dried Rowers, fruits and leaves areusedin the treahnentof coronaryartery disease(CAnl and hyper1ensive patients. Previous studies claimed that its Ravonoids and procyanidinglycosides have cardiotonic properties. The purpose of this double bt.nd placebo control dinicol trial was ta determine whether using this leavesplant by hyperlipidemic patients i~ associated wi.th an improvement in their serum lipids levels (as some German reports confirm this effectJ. Eightyhyperlipidemic men and women ~ 3().M who were selected randomly from hypempidemia ct.nic in Isfahan card"lOvascular research centerreceived either the hydroolcohol"lC extract or a placebo as 15 drops daily for a period of up to ~)'n.OI1ths. Primary moderate hypercholesterolemia

ond/ or hyper1riglyceridemia,~~ts who have not ~n used any anh"hypert.pidemicdrugs ye" Cr010egusdecreased the lchollevel by 23% andTG by 13%.in the whole popuJO'ticjft'.i~ i!t_the 5Iudi but patients with secondary hypercholesterolemia and hypertriglycmfemia, hyperthyroidism,hyper1ension and CAD w~ excrugTOlOl ChOlesterol (T.cho), and serum triglycerides were measured at the beginning of the study and the endof the sixtJ\ months using enzymatic.method.Themean and stondard deviation of oltemolions in these variables after 6 months were comparedbetween two groups based on sex using t student test. Although, these changes were only meaningful statistically about the T.choof women andthe l chcu~nd TG in the whole population. We conclude that the antihyperttdic effects of this pIont is mainly effective in lowering T.cholevel mainlyin women' ~ men, larger stud"teSwith more samples may be needed to confirm its effect in men or other serum t.pids. OntercontinentolCardiology1998;7:7H5')

Key Words: Anlihyperlipidemic drug. Craloegus. serum lipids.

Introduction: Preparations of crata~us species (FemFor centuries, plants have been an Rosaceae) have been applied to humanimportant source of chemotherapeutic since many years(3).Several species ofagents. Evenin thisage of syntheticdrugs the genus Crataegus, commonly calledand. ~e mass produdion of antibiotics Hawthorn, have been studied for theirby microbial fermentation, the plant : pOtenti~1 medicinal value. Claims of"kingd<;Jo\"i.~:-still.re.sppnsible. for.:the:, . phorrrjocorc5gical adivityra.nge :FromprovisiQo of..some25 per cent of the. curotrve agents in hypertension to theworld's medicinal" I'equirements\ll. The treatment of certain cardiac disorder~.s,6).range of pharmacologically active Drie9Rowers,leaves,and twigsof thiscompound,synthesisedby plantsl1.21 plant havebeenusecJl3J.

Itads on cardiac or circulatory problemsby causing dilatation of blood vessels,especially the coronary arteries, and bycausing some reduction in bloodpressure, it is used prop~ylactically inI;]ngina.pe<:torisI7,8J; It contains IkIvpno!<:J ..'

.gly~osides, oligom~re prOcyonidineond'triterpenoid Y.1poninl81.' . '.Flavonoids are natural antioxidantspossesing a wide range of biologicalactivities(9, 10,11J

Corre5pOflCling auihor: S. Asgary.Ph.D Isfahan University of Medical Sciences, Carc/ioVOSCtJlar Research Cen/er. Tel. 98-31-220807-98-31'221826 P.O.80X: 81465-1148 Fox: 98-31-226103 ISFAHAN, IRAN. E-mail: carvasrc@clci.iron.S.

Intercontinental Cardiology Vol. 7. N° 2 /998 73

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Regardingthe fact that Aavonoids have

antioxidant properties and free radicalscavenging activity, in this studythe effectof hydroalcoholic extract of Crataeguscurvisepala on blood lipid is investigated.This plant is found widely in different partof the north and central part of Iran insuch a way that more than twenty kindsof crataegus is found in different regionsof Iran which are mainly medicalplantsl121.One of the important kindsfound in Iran is the Crataeguscurvisepala.

Material and method.

Plant gatheringThe Rowersand leaves, of the plant wasgathered in Hamgin ~Iig~ near city ofDehaghan in Isfahan province in May1994 at an altitude of 2300m.

The plant was identified in the Botanydepartment of the faculty of Science atthe University of Isfahan (Iran) and avoucher specimen was deposited in theHerbarium of the pharmacognosyDepartment, Faculty of Pharmacy andpharmaceutical Sciences at the Isfahan

University of Medical Sciences(lran).

Medical Drop preparationBy using perculation method and 7()o

alcohol for 48hr., the medical drop wasprepared and the ratio of the dried plantmaterial to the amount of alcohol wasused as 1 to 8113.161.And also theratio ofleaves to Rowerswas 2 to 1.

placebo Drop preparationRegarding the clinical testbeing carriedout (placebo control double blind) thedrop without considering the plant

, material was used as ploce.bo'drop,:

Physic~hemical ControlsFor investigatingthe element effecting the

drop and it's physical characteristic,several test weredone for example,theamount of flavonoids to the rate of

hyperosideandprocyanidine,thedry leftover, colour, smell and tasteilA. 15)(table I).

Patients and Method

The type of study was double blindplacebo control.Thisstudycontains80men and womenaged between30-60years randomly chosenamong those

No Type of test

The leftover of the dryFlavonoids measurement

Procyanidins measurement

Alcoholic degreeColourSmellTaste

Resulb

3-4 gms in 100 mg. 9-100 mg in 100 ml130-140 mg in 1OOml60-62 degreesDark greenAlmost brightBitter

A two sample independentt-testwasused for the analysisofthedata. Avalue<0.05 was considered statisticallysignificant for comparison of the datafrom the two groups.

Result and discussion:So for numerous studies have been

performed on the therapeutic effects ofdifferent species of the Crataegus whichare mainly on hypertension, ischemicheart disease and on the cardiacmechanical dysfunction{17.18.19).Only inone study on the Crataegus pentagyna,the effectof thisplant on blood lipid onin another study the effect of water-solublefractionofCrataegusseedswereinvestigated which showedon increasedlDl receptors in the cell surface of theliverl20I.In this study,we investigated theeffect of the Crataegus curvisepala onblood lipids.Resultsfrom this studyaHersix months j,the two groups (Placeboand medicineiwith the daily dosage of 15 drops in thewhole number of 80 people show thatonly the level of lowering tot91cholesterolwas lower in men who have used

medicine than th~ placebo group, but in

74 Intercontinental Cardiolog)' Vol. 7. Ng ~ /'JI)X

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coming to the hyperlipidemic clinic ofIsfahan Cardiovascular ResearchCenter

and the placebo or medical drop hasbeen given to them for six months.Those entering this study, have a totalcholesterol (lcho) rat~ equalled to orhigher than 240mg/ dl and a tryglyceride(TG) rate equalled or higher than200mg/ dl who hove not been usedanyantihyperlipidemic drugs yet.All the familial hyperlipidemic symptoms,hyperthyroidism, hypertension,coronaryartery disease and the secondaryhyperlipidemic symptoms beinginvestigated in these peaple and foiled,a certain kind of dietary regimen beinggiven out to the placebo and medicalgroup. The degree of blood lipids wasmeasured at the beginning of the study

and the end of the sixth months usingenzymatic method by Elan 2000autoanalyzer.

Statistical methods

The mean and standard deviation ofalternations in these variables aHer six

month were compared between twogroups based on sex using t-student test(tablell).

.

Drug PlaceboMeanfSD MeanfSD P

Male T.cho -23 :t: 21.2 -27.33 :t: 19.6 0.8TG -54.6 :t: 48.6 -12 :t: 69.8 0.3

Female T.cho -106.7 :t: 140.5 -24.33 :t: 26.6 0.02TG -27.7 :I: 36.4 -0.5 :t: 41.7 0.2

Total T.cho .71 :t: 113.3 -25.3 :t: 23.2 0.03TG -39.9 :t: 42.5 -4.33 :t: 48.34 0.04

T. cho- Totol cholesterol, T<3- Trigiyceride

P value less than 0.05 is signicant.

other ~roups the levelof lowering totalcholesterolandtriglyceridein thegroupusing medicine was higher than thegroupr~eiving placebo.Although,these

. changes were only meaningfulstatisticallyabout the lCho of womenand the lCho and TG in the wholepopulation(TableII).On the whole, it can be said that in thewhole populationthe level of loweringlcho 23% and .thelevel of loweringtriglyceride13%and in women~e levelof loweringlCho 12%and loweringTG9.7% and in men in order is 9% and16.2%, whereas the levels wereunchongedin theplacebogroup.

The meaningJessnessof the results canbe due to different factors:

1. N.:>tenough dosage of the medicinewhich can be replaced by usingmedicine in different daily dosages.

2. Not enough number of samples ofwhich has been shown. In eachgroup(placebo and medicine) a number of20 women or men have been used

and those people have been in sucha way that in some only triglycerideor just cholesterol was high and insome both was high, meaning thatone persan was used in both groups,whereas by chossinga correct samplein which either triglyceride orcholesterol were high, one can reachdesirable results. The reason of

chossing little sample is because ofthe tasteof the medicine since one of

patients had complained about it'sbitter tastewhich can be changed inlater studies.

Although, fortunately no side effectssuc.h as constipation, hiccups,headaches, vomiting or nausea wereseen.

3. By choosing the correct amont of thesample adjustments regarding BMI,and age, weight can be considered

... " fora:betterviewpoinfaboutrn«ii~in~.

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