**3.2 Echinacea in diabetes**

Not many studies have investigated the effects of echinacea in diabetes. In Wistar rats, 33 days of echinacea root extract showed hypoglycemic activity similar to glibenclamide. No safety parameters were investigated [29]. *Echinacea purpurea* flower extract and caffeic acid derivatives inhibited α-amylase, α-glucosidase, and ACE activities in a concentration-dependent manner [30].

### **3.3 Echinacea in heart disease**

Almost no studies have evaluated the effects of echinacea on heart conditions such as hypertension and hypercholesterolemia. In one study with 374 elderly, 349 reported to use over-the-counter drugs and 43 reported to use herbal medicine. Echinacea was the most common herbal therapy used while aspirin, acetaminophen, laxatives, antiacids, and vitamins were the most common over-the-counter drugs [31]. This single study suggests the potential for interaction of echinacea with drugs.
