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Current Traditional Medicine

Editor-in-Chief

ISSN (Print): 2215-0838
ISSN (Online): 2215-0846

Review Article

The Role of the most Important Fruits in the Prevention and Treatment of Cardiovascular Diseases in Persian Traditional Medicine

Author(s): Mohammad Abazari, Arash Gholoobi, Ali Reza Derakhshan, Shahin Saeedinejat and Mahdi Yousefi*

Volume 10, Issue 5, 2024

Published on: 19 July, 2023

Article ID: e020623217641 Pages: 12

DOI: 10.2174/2215083810666230602163727

Price: $65

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Abstract

Cardiovascular diseases (CVD) are the leading cause of health problems worldwide. CVD are defined as conditions affecting the heart and blood vessels. Mortality due to cardiovascular diseases has increased in recent years. However, they can be easily controlled by reducing risk factors, including lipid profile, blood pressure, tobacco, alcohol, and low physical activity. Fruits have an important role in improving the risk factors of CVD. Ancient medical sources can play an important role in generating ideas for new research. In this study, the most common fruits that have been recommended by Persian traditional physicians in patients with CVD were reviewed. New documents supporting these effects were also extracted through a search on electronic databases. The findings showed that some fruits have a therapeutic role in CVD, according to Persian traditional medicine. Old Persian traditional physicians, such as Avicenna, advised fruits, including apples, lemon, pomegranate, pineapple, quince, cucumber, plums, and citron, for the treatment of CVDs. Several studies have been carried out on the effects of the above fruits, including apple (Malus pumila), pomegranate (Punica granatum), pineapple (Ananas comosus), Quince (Cydonia oblonga Mill.), fig (Ficus carica L.), and olive (Olea europaea). Modulation of signaling pathways and molecular properties that leads to reducing lipid metabolism disorders, correcting endothelial dysfunction, reducing blood pressure, reducing oxidative stress, and suppressing inflammation responses are the major mechanisms conducted by these fruits in preventing CVD. These pieces of evidence show that the opinion of Iranian medicine physicians regarding choosing fruits for treating CVD is worthy of consideration and an entry for deriving hypotheses for future studies.

[1]
Wang H, Naghavi M, Allen C, et al. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: A systematic analysis for the Global Burden of Disease Study 2015. Lancet 2016; 388(10053): 1459-544.
[http://dx.doi.org/10.1016/S0140-6736(16)31012-1] [PMID: 27733281]
[2]
Joseph P, Leong D, McKee M, et al. Reducing the global burden of cardiovascular disease, Part 1. Circ Res 2017; 121(6): 677-94.
[http://dx.doi.org/10.1161/CIRCRESAHA.117.308903] [PMID: 28860318]
[3]
Leong DP, Joseph PG, McKee M, et al. Reducing the global burden of cardiovascular disease, Part 2. Circ Res 2017; 121(6): 695-710.
[http://dx.doi.org/10.1161/CIRCRESAHA.117.311849] [PMID: 28860319]
[4]
Grosso G, Marventano S, Yang J, et al. A comprehensive meta-analysis on evidence of Mediterranean diet and cardiovascular disease: Are individual components equal? Crit Rev Food Sci Nutr 2017; 57(15): 3218-32.
[http://dx.doi.org/10.1080/10408398.2015.1107021] [PMID: 26528631]
[5]
Shah MH. The general principles of Avicenna's Canon of Medicine: Naveed Clinic. 1966.
[6]
Kordafshari G, Kenari HM, Esfahani MM, et al. Nutritional aspects to prevent heart diseases in traditional Persian medicine. J Evid Based Complementary Altern Med 2015; 20(1): 57-64.
[http://dx.doi.org/10.1177/2156587214553939] [PMID: 25331095]
[7]
National Center for Biotechnology Information. Available from: https://pubchem.ncbi.nlm.nih.gov/compound/44093
[8]
Patel H, Chandra S, Alexander S, Soble J, Williams KA Sr. Plant-based nutrition: An essential component of cardiovascular disease prevention and management. Curr Cardiol Rep 2017; 19(10): 104.
[http://dx.doi.org/10.1007/s11886-017-0909-z] [PMID: 28887684]
[9]
Rouhi-Boroujeni H, Heidarian E, Rouhi-Boroujeni H, Deris F, Rafieian-Kopaei M. Medicinal plants with multiple effects on cardiovascular diseases: A systematic review. Curr Pharm Des 2017; 23(7): 999-1015.
[http://dx.doi.org/10.2174/1381612822666161021160524] [PMID: 27774898]
[10]
Aqili Khorasani MH. Kholasat al-Hikma (Summary of Wisdom). Qom: Ismaili Publications. 2006; Vol. 1: pp. 7-537-538.
[11]
Arzani MA. Mufarrah al-Qulub. Tehran: Al-Maei Publications. 2012; 1: pp. 7-22.
[12]
Hindu I. Miftah al-Tibb (Key to Medicine). Publication Number: 70Tehran: Institute of Medical History Studies, Islamic and Complementary Medicine of Iran University of Medical Sciences 2008; 2: p. 179-80.
[13]
Dadvar A, Yousefi M, Bagher Fazljou SM, Taheraghdam AA. Investigating the destructive effects of cold humors on brain in traditional medicine. Int J Ecosyst Ecol Sci 2019; 9(1): 99-102.
[http://dx.doi.org/10.31407/ijees9113]
[14]
Delshad E, Yousefi M, Javan R. Stroke from the perspective of persian medicine. Mediev Hist J 2018; 9(33): 107-16.
[15]
Delshad E, Hassan D, Gilles G, et al. Are herbal medicines effective in the treatment of ischemic stroke? a systematic review of human-controlled clinical trials. Herbal Med J 2019; 4(1): 44-54.
[16]
Li G, Zhu Y, Zhang Y, Lang J, Chen Y, Ling W. Estimated daily flavonoid and stilbene intake from fruits, vegetables, and nuts and associations with lipid profiles in Chinese adults. J Acad Nutr Diet 2013; 113(6): 786-94.
[http://dx.doi.org/10.1016/j.jand.2013.01.018] [PMID: 23522824]
[17]
Ravn-Haren G, Dragsted LO, Buch-Andersen T, et al. Intake of whole apples or clear apple juice has contrasting effects on plasma lipids in healthy volunteers. Eur J Nutr 2013; 52(8): 1875-89.
[http://dx.doi.org/10.1007/s00394-012-0489-z] [PMID: 23271615]
[18]
Chai SC, Hooshmand S, Saadat RL, Payton ME, Brummel-Smith K, Arjmandi BH. Daily apple versus dried plum: Impact on cardiovascular disease risk factors in postmenopausal women. J Acad Nutr Diet 2012; 112(8): 1158-68.
[http://dx.doi.org/10.1016/j.jand.2012.05.005] [PMID: 22818725]
[19]
Auclair S, Chironi G, Milenkovic D, et al. The regular consumption of a polyphenol-rich apple does not influence endothelial function: A randomised double-blind trial in hypercholesterolemic adults. Eur J Clin Nutr 2010; 64(10): 1158-65.
[http://dx.doi.org/10.1038/ejcn.2010.135] [PMID: 20683465]
[20]
Tenore GC, Caruso D, Buonomo G, et al. Annurca (Malus pumila Miller cv. Annurca) apple as a functional food for the contribution to a healthy balance of plasma cholesterol levels: Results of a randomized clinical trial. J Sci Food Agric 2017; 97(7): 2107-15.
[http://dx.doi.org/10.1002/jsfa.8016] [PMID: 27571713]
[21]
Hodgson JM, Prince RL, Woodman RJ, et al. Apple intake is inversely associated with all-cause and disease-specific mortality in elderly women. Br J Nutr 2016; 115(5): 860-7.
[http://dx.doi.org/10.1017/S0007114515005231] [PMID: 26787402]
[22]
Lim SH, Lee J. Xyloglucan intake attenuates myocardial injury by inhibiting apoptosis and improving energy metabolism in a rat model of myocardial infarction. Nutr Res 2017; 45: 19-29.
[http://dx.doi.org/10.1016/j.nutres.2017.07.003] [PMID: 29037328]
[23]
Bondonno N, Lewis J, Prince R, et al. Fruit intake and abdominal aortic calcification in elderly women: A prospective cohort study. Nutrients 2016; 8(3): 159.
[http://dx.doi.org/10.3390/nu8030159] [PMID: 26978394]
[24]
Wang L, Fumoto T, Masumoto S, et al. Regression of atherosclerosis with apple procyanidins by activating the ATP-binding cassette subfamily A member 1 in a rabbit model. Atherosclerosis 2017; 258: 56-64.
[http://dx.doi.org/10.1016/j.atherosclerosis.2017.01.032] [PMID: 28196336]
[25]
ABCA 1 gene. Available from: https://ghr.nlm.nih.gov/gene/ABCA1
[26]
Thilakarathna SH, Rupasinghe HPV, Needs PW. Apple peel bioactive rich extracts effectively inhibit in vitro human LDL cholesterol oxidation. Food Chem 2013; 138(1): 463-70.
[http://dx.doi.org/10.1016/j.foodchem.2012.09.121] [PMID: 23265512]
[27]
Martínez-Ladrón de Guevara E, Pérez-Hernández N, et al. The actions of lyophilized apple peel on the electrical activity and organization of the ventricular syncytium of the hearts of diabetic rats. J Diabetes Res 2016; 2016: 8178936.
[http://dx.doi.org/10.1155/2016/8178936] [PMID: 26839897]
[28]
Gonzalez J, Donoso W, Sandoval N, et al. Apple peel supplemented diet reduces parameters of metabolic syndrome and atherogenic progression in ApoE-/- mice. Evidence-based complementary and alternative medicine: eCAM 2015; 2015: p. 918384.
[29]
Oude Griep LM, Stamler J, Chan Q, et al. Association of raw fruit and fruit juice consumption with blood pressure: the INTERMAP Study. Am J Clin Nutr 2013; 97(5): 1083-91.
[http://dx.doi.org/10.3945/ajcn.112.046300] [PMID: 23553162]
[30]
Balasuriya N, Rupasinghe HPV. Antihypertensive properties of flavonoid-rich apple peel extract. Food Chem 2012; 135(4): 2320-5.
[http://dx.doi.org/10.1016/j.foodchem.2012.07.023] [PMID: 22980808]
[31]
Svendsen M, Tonstad S, Heggen E, et al. The effect of kiwifruit consumption on blood pressure in subjects with moderately elevated blood pressure: A randomized, controlled study. Blood Press 2015; 24(1): 48-54.
[http://dx.doi.org/10.3109/08037051.2014.976979] [PMID: 25483553]
[32]
Hansen L, Dragsted LO, Olsen A, et al. Fruit and vegetable intake and risk of acute coronary syndrome. Br J Nutr 2010; 104(2): 248-55.
[http://dx.doi.org/10.1017/S0007114510000462] [PMID: 20178672]
[33]
Stockton A, Farhat G, McDougall GJ, Al-Dujaili EAS. Effect of pomegranate extract on blood pressure and anthropometry in adults: A double-blind placebo-controlled randomised clinical trial. J Nutr Sci 2017; 6: e39.
[http://dx.doi.org/10.1017/jns.2017.36] [PMID: 29152243]
[34]
Asgary S, Sahebkar A, Afshani MR, Keshvari M, Haghjooyjavanmard S, Rafieian-Kopaei M. Clinical evaluation of blood pressure lowering, endothelial function improving, hypolipidemic and anti-inflammatory effects of pomegranate juice in hypertensive subjects. Phytother Res 2014; 28(2): 193-9.
[http://dx.doi.org/10.1002/ptr.4977] [PMID: 23519910]
[35]
Asgary S, Keshvari M, Sahebkar A, Hashemi M, Rafieian-Kopaei M. Clinical investigation of the acute effects of pomegranate juice on blood pressure and endothelial function in hypertensive individuals. ARYA Atheroscler 2013; 9(6): 326-31.
[PMID: 24575134]
[36]
Sahebkar A, Ferri C, Giorgini P, Bo S, Nachtigal P, Grassi D. Effects of pomegranate juice on blood pressure: A systematic review and meta-analysis of randomized controlled trials. Pharmacol Res 2017; 115: 149-61.
[http://dx.doi.org/10.1016/j.phrs.2016.11.018] [PMID: 27888156]
[37]
Wang Y, Huang M, Yang X, Yang Z, Li L, Mei J. Supplementing punicalagin reduces oxidative stress markers and restores angiogenic balance in a rat model of pregnancy-induced hypertension. Korean J Physiol Pharmacol 2018; 22(4): 409-17.
[http://dx.doi.org/10.4196/kjpp.2018.22.4.409] [PMID: 29962855]
[38]
Griendling KK, FitzGerald GAJC. Oxidative stress and cardiovascular injury: Part II: Animal and human studies. Circulation 2003; 108(17): 2034-40.
[39]
Razani Z, Dastani M, Kazerani HR. Cardioprotective effects of pomegranate (Punica granatum) juice in patients with ischemic heart disease. Phytother Res 2017; 31(11): 1731-8.
[http://dx.doi.org/10.1002/ptr.5901] [PMID: 28913846]
[40]
Gupta M, Sharma P, Mazumder AG, Patial V, Singh D. Dwindling of cardio damaging effect of isoproterenol by Punica granatum L. peel extract involve activation of nitric oxide-mediated Nrf2/ARE signaling pathway and apoptosis inhibition. Nitric Oxide 2015; 50: 105-13.
[41]
Jadeja RN, Thounaojam MC, Patel DK, Devkar RV, Ramachandran AV. Pomegranate (Punica granatum L.) juice supplementation attenuates isoproterenol-induced cardiac necrosis in rats. Cardiovasc Toxicol 2010; 10(3): 174-80.
[http://dx.doi.org/10.1007/s12012-010-9076-9] [PMID: 20509006]
[42]
Mohan M, Patankar P, Ghadi P, Kasture S. Cardioprotective potential of Punica granatum extract in isoproterenol-induced myocardial infarction in Wistar rats. J Pharmacol Pharmacother 2010; 1(1): 32-7.
[http://dx.doi.org/10.4103/0976-500X.64533] [PMID: 21808588]
[43]
Ding M, Wang Y, Sun D, et al. Punicalagin pretreatment attenuates myocardial ischemia-reperfusion injury via activation of AMPK. Am J Chin Med 2017; 45(1): 53-66.
[http://dx.doi.org/10.1142/S0192415X17500057] [PMID: 28081629]
[44]
Moazzen H, Alizadeh M. Effects of pomegranate juice on cardiovascular risk factors in patients with metabolic syndrome: A double-blinded, randomized crossover controlled trial. Plant Foods Hum Nutr 2017; 72(2): 126-33.
[http://dx.doi.org/10.1007/s11130-017-0605-6] [PMID: 28303364]
[45]
Hamoud S, Hayek T, Volkova N, et al. Pomegranate extract (POMx) decreases the atherogenicity of serum and of human monocyte-derived macrophages (HMDM) in simvastatin-treated hypercholesterolemic patients: A double-blinded, placebo-controlled, randomized, prospective pilot study. Atherosclerosis 2014; 232(1): 204-10.
[http://dx.doi.org/10.1016/j.atherosclerosis.2013.11.037] [PMID: 24401239]
[46]
Sahebkar A, Simental-Mendía LE, Giorgini P, Ferri C, Grassi D. Lipid profile changes after pomegranate consumption: A systematic review and meta-analysis of randomized controlled trials. Phytomedicine 2016; 23(11): 1103-12.
[http://dx.doi.org/10.1016/j.phymed.2015.12.014] [PMID: 26857863]
[47]
Wu PT, Fitschen PJ, Kistler BM, et al. Effects of pomegranate extract supplementation on cardiovascular risk factors and physical function in hemodialysis patients. J Med Food 2015; 18(9): 941-9.
[http://dx.doi.org/10.1089/jmf.2014.0103] [PMID: 25826143]
[48]
Rivara MB, Mehrotra R, Linke L, Ruzinski J, Ikizler TA, Himmelfarb J. A pilot randomized crossover trial assessing the safety and short-term effects of pomegranate supplementation in hemodialysis patients. J Ren Nutr 2015; 25(1): 40-9.
[http://dx.doi.org/10.1053/j.jrn.2014.07.006]
[49]
Gbinigie OA, Onakpoya IJ, Spencer EA. Evidence for the effectiveness of pomegranate supplementation for blood pressure management is weak: A systematic review of randomized clinical trials. Nutr Res 2017; 46: 38-48.
[http://dx.doi.org/10.1016/j.nutres.2017.07.007] [PMID: 29173650]
[50]
Hassanpour Fard M, Ghule AE, Bodhankar SL, Dikshit M. Cardioprotective effect of whole fruit extract of pomegranate on doxorubicin-induced toxicity in rat. Pharm Biol 2011; 49(4): 377-82.
[http://dx.doi.org/10.3109/13880209.2010.517758] [PMID: 21391840]
[51]
Daher CF, Abou-Khalil J, Baroody GM. Effect of acute and chronic grapefruit, orange, and pineapple juice intake on blood lipid profile in normolipidemic rat. Med Sci Monit 2005; 11(12): BR465-72.
[PMID: 16319784]
[52]
Huang HY, Chang CK, Tso TK, Huang JJ, Chang WW, Tsai YC. Antioxidant activities of various fruits and vegetables produced in Taiwan. Int J Food Sci Nutr 2004; 55(5): 423-9.
[http://dx.doi.org/10.1080/09637480412331324695] [PMID: 15545051]
[53]
Gholami S, Hosseini MJ, Jafari L, et al. Mitochondria as a target for the cardioprotective effects of Cydonia oblonga Mill. and Ficus carica L. in doxorubicin-induced cardiotoxicity. Drug Res 2017; 67(6): 358-65.
[http://dx.doi.org/10.1055/s-0043-101824] [PMID: 28320040]
[54]
Zhou W, Abdusalam E, Abliz P, et al. Effect of Cydonia oblonga Mill. fruit and leaf extracts on blood pressure and blood rheology in renal hypertensive rats. J Ethnopharmacol 2014; 152(3): 464-9.
[http://dx.doi.org/10.1016/j.jep.2014.01.018] [PMID: 24472663]
[55]
Alamgeer IS, Iman S, Asif H, Saleem M. Evaluation of antihypertensive potential of Ficus carica fruit. Pharm Biol 2017; 55(1): 1047-53.
[http://dx.doi.org/10.1080/13880209.2017.1278611] [PMID: 28187689]
[56]
Belguith-Hadriche O, Ammar S, Contreras MM, et al. Antihyperlipidemic and antioxidant activities of edible Tunisian Ficus carica L. fruits in high fat diet-induced hyperlipidemic rats. Plant Foods Hum Nutr 2016; 71(2): 183-9.
[http://dx.doi.org/10.1007/s11130-016-0541-x] [PMID: 27086310]
[57]
Khaw KT, Sharp SJ, Finikarides L, et al. Randomised trial of coconut oil, olive oil or butter on blood lipids and other cardiovascular risk factors in healthy men and women. BMJ Open 2018; 8(3): e020167.
[http://dx.doi.org/10.1136/bmjopen-2017-020167] [PMID: 29511019]
[58]
Katsarou AI, Kaliora AC, Papalois A, et al. Serum lipid profile and inflammatory markers in the aorta of cholesterol-fed rats supplemented with extra virgin olive oil, sunflower oils and oil-products. Int J Food Sci Nutr 2015; 66(7): 766-73.
[http://dx.doi.org/10.3109/09637486.2015.1088936] [PMID: 26401576]
[59]
Farràs M, Fernández-Castillejo S, Rubió L, et al. Phenol-enriched olive oils improve HDL antioxidant content in hypercholesterolemic subjects. A randomized, double-blind, cross-over, controlled trial. J Nutr Biochem 2018; 51: 99-104.
[http://dx.doi.org/10.1016/j.jnutbio.2017.09.010] [PMID: 29125992]
[60]
Ghorbel I, Khemakhem M, Boudawara O, et al. Effects of dietary extra virgin olive oil and its fractions on antioxidant status and DNA damage in the heart of rats co-exposed to aluminum and acrylamide. Food Funct 2015; 6(9): 3098-108.
[http://dx.doi.org/10.1039/C5FO00342C] [PMID: 26215160]
[61]
Mnafgui K, Khlif I, Hajji R, et al. Preventive effects of oleuropein against cardiac remodeling after myocardial infarction in Wistar rat through inhibiting angiotensin-converting enzyme activity. Toxicol Mech Methods 2015; 25(7): 538-46.
[http://dx.doi.org/10.3109/15376516.2015.1053648] [PMID: 26056852]
[62]
Buckland G, Travier N, Barricarte A, et al. Olive oil intake and CHD in the European Prospective investigation into cancer and nutrition spanish cohort. Br J Nutr 2012; 108(11): 2075-82.
[http://dx.doi.org/10.1017/S000711451200298X] [PMID: 23006416]
[63]
Martínez-González MA, Dominguez LJ, Delgado-Rodríguez M. Olive oil consumption and risk of CHD and/or stroke: A meta-analysis of case–control, cohort and intervention studies. Br J Nutr 2014; 112(2): 248-59.
[http://dx.doi.org/10.1017/S0007114514000713] [PMID: 24775425]

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