Arjuna (Terminalia arjuna) for Treating Cardiac Ailments

Terminalia arjuna belongs to the family Combertaceae. In Sankrit, it is known by various names like Arjuna, Dhavala, Indradru, Kakubha, Nadisraja and Veervruksha. It is known as Arjuna in Hindi as wells as English.

Arjuna is found in India. T. arjuna is an evergreen tree having stem bark; externally white and red internally. Flowers are white or yellow. Chemically it contains ß-sitosterol, ellagic acid, arjunic acid, glucosides (arjunetin and fridelin), and tannic acid. Coenzyme Q has been reported in the bark.

The rasa (taste), guna (physical property), virya (potency), and vipaka (post digestion effect) are katu (pungent), ruksha (ununctuous), shita (cold) and katu (pungent), respectively. Arjuna pacifies Pitta and Kapha. It has been defined as cardiac tonic.

Arjuna is used in the treatment of angina pectoris, hyperlipidemia, spermatorrhoea, bloody diarrhoea and pruritis. Locally the drug finds application in haemorrhage and fractures. Bark is utilised in medicine. Dose of the powdered preparation is 3-6 Gm and decoction is 50-100 ml. Formulations based on Arjuna are Arjunaristha, Arjuna Kshirapaka and Arjunaghrita.

Pre-clinical studies:

Antianginal and cardio protective, contraceptive, antimutagenic, hypocholesterolemic, antihepatotoxic, antifertility, antioxidant and platelet aggregation prevention, antihypertensive, antiproliferative, anti-genotoxic, nitric oxide inhibitor, and antiviral.

Clinical studies

  • Chronic stable angina: arjuna bark extract, 500 mg 8 hourly, given to 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 (40 mg/day) therapy and the extract was well tolerated.
  • Congestive cardiac failure: In a study the bark powder of arjuna was tested in treating congestive cardiac failure. It showed a marked improvement in over 40% of the cases. Also observed were congestive cardiac failure due to congenital anomaly of heart and valvular disease being brought under control as well as 4 out of 9 cases of CCF as a result of chronic bronchitis being relieved by the treatment. Symptomatic complaints of essential hypertension were relieved by Terminalia arjuna. Coagulation, bleeding and prothrombin time can be reduced by oral administration of an aqueous suspension of the bark powder. In a study studied the cardio protective activity of bark extract of T. arjuna was studied in twelve patients with refractory congestive cardiac failure. The extract demonstrated significant cardio protective activity as compared to placebo.
  • Coronary artery disease: A study investigated the effect arjuna bark powder on frequency of angina, serum-glucose, serum-lipids, body mass index and blood pressure, in 15 stable (labelled as Group A) and 5 unstable (labelled as Group B) angina patients. Results were analysed after 90 days of the treatment. Blood pressure and body mass index were reduced to a significant level (p < 0.05). Slight impact was observed in lipid levels. No unpleasant effect on liver or kidney functions was observed. The results suggest that T. arjuna was fairly effective in patients with symptoms of stable angina pectoris rather than in unstable angina.
  • Dyslipidemia: Effect of arjuna on serum lipids was investigated in ninety-six patients satisfying inclusion criteria. Signed informed was taken from the patients consent. Detailed medical history was undertaken. Arjuna powder was administered in a dose of 5 g, twice a day for 21 days. Arogyavardhini Vati was administered in a dose of 500 mg, twice a day for 28 days. A significant reduction in total cholesterol, low density lipids, serum-triglycerides, C-reactive protein, and blood sugar. On the other, raised high density lipids level was noticed.
  • Mitral regurgitation: 40 patients with fresh mitral regurgitation showing mitral regurgitation were randomly divided into 2 groups of 20 each. The patients were given placebo or 500 mg of arjuna along with treatment for ischemia. After 30 and 90 days of follow up, patients receiving T. arjuna as adjuvant therapy showed significant decrease in mitral regurgitation, improvement in the function of the left ventricle of the heart (E/A ratio). Above all, there was marked reduction in frequency of angina.

References

Anand V. Antianginal and cardio protective effects of Terminalia arjuna. J. Assoc. Physicians India, 1994; 42(9): 757.

Arora R.C. et al. Evaluation of CTI (cardio protective drug) in subjects of coronary artery disease, hypertension and diabetes mellitus. Flora & Fauna 1995; 2(2):203-205.

Bharani A, Ganguli A, Mathur LK, Jamra Y, Raman PG. Efficacy of Terminalia arjuna in chronic stable angina: a double-blind, placebo-controlled, crossover study comparing Terminalia arjuna with isosorbide mononitrate. Indian Heart J. 2002;54(2):170-5.

Bharani A, Ganguly A, Bhargava KD. Salutary effect of Terminalia arjuna in patients with severe refractory heart failure. Int J Cardiol 1995; 49(3):191-199.

Colabawala HM. An evaluation of the cardiotonic and other properties of Terminalia arjuna. Indian Heart J 1951; 3, 205-230.

Dwivedi S, Agarwal MP. Antianginal and cardio protective effects of Terminalia arjuna in coronary artery disease. J Assoc Physicians India 1994; 42(4): 287-289.

Dwivedi S, Agarwal MP. Antianginal and cardioprotective effects of Terminalia arjuna, an indigenous drug, in coronary artery disease. J Assoc Physicians India 1994;42(4):287-9.

Dwivedi S, Avasthi S, Mahajan S. Role of Terminalia arjuna in ventricular tachyarrythmias. Indian Pract 1994; 57(6): 523-525.

Dwivedi S, Jauhri R. Beneficial effects of Terminalia arjuna in coronary artery disease, Indian Heart J 1997; 49 (5): 507-510.

Dwivedi, S. et al. Role of Terminalia arjuna in ischemic mitral regurgitation. Ind J Cardiol 2005; 100(3):507-8.

Himmat S, Mishra SK, Pande M. Standardization of Arjunarishta formulation by TLC method. Int J Pharm Sci Rev Res 2010; 2:25-8.

Kumar G, Srivastava A, Sharma SK, Gupta YK. Safety and efficacy evaluation of Ayurvedic treatment (Arjuna powder and Arogyavardhini Vati) in dyslipidemia patients: A pilot prospective cohort clinical study. Ayu 2012; 33:197-201.

Lal UR, Tripathi SM, Jachak SM, Bhutani KK Singh IP. HPLC Analysis and Standardization of Arjunarishta – An Ayurvedic Cardioprotective Formulation. Sci Pharm 2009; 77: 605-16.

Ram A. et al. Hypocholesterolemic effects of Terminalia arjuna tree bark, J. Ethnopharmacol. 1997; 55(3):165-169. Shala HP, Udupa SL, Udupa AL. Hyperlipidemic effect of Terminalia arjuna in cholesterol fed rabbits. Fitoterapia 1997; 68(5): 405-409.

Sharma AK, Agarwal A, Bansal A. High performance thin layer chromatographic method for quantification of gallic acid in arjunarishta: an ayurvedic formulation. Asian J Pharm Med Sci 2011; 1.

Vasanthakumar KG, Pattanshetty JK, Bikshapathi T, Vijayalakshmi B. Standardization studies on arjunarishta. Bull Medico-Ethno-Botanical Res 2003; 24:97-102.

Additional Reading:

Beneficial effects of Terminalia arjuna in coronary artery disease

To get more information on Arjuna and to buy Arjuna products, please click on the links below:

Organic Arjuna Powder

Morpheme Terminalia Arjuna Cardiac Support Capsules

Healthvit Arjuna Capsules

 

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