**2.3. Molecular mechanisms involved in the pathogenesis of hypertension**

Previous studies have shown the involvement of excessive reactive oxygen species (ROS) in the pathophysiology of CVD [53-56]. At a molecular level, oxidative stress (Oxs) has been identified to have major implication in the development of clinical and experimental hyper‐ tension [57-59]. It was demonstrated that chronic glutathione depletion induced severe elevation of arterial BP [60]. The lack of endogenous antioxidant enzymes worsens oxidative stress and can indirectly promote the risk of hypertension. For example, a recent research supports the influence of genetic polymorphism of antioxidant enzymes in increasing the risk of hypertension [61]. Likewise, [62] in Taiwan demonstrated that manganese superoxide dismutase (MnSOD) polymorphism significantly increased the risk of hypertension.

Inflammation and lipid peroxidation are central to the development of multiple CVD and are mediated by a variety of cell types including macrophages, lymphocytes, endothelial cells and vascular smooth muscles cells [63-65]. The multiple cell types which participate in vascular inflammation produce various pro- and anti-inflammatory cytokines and specific membrane receptors allowing them to transmit their effects to the cells. Studies place a strong emphasis on the role of oxidative stress in the pathophysiology of hypertension through promotion of chronic inflammation [66]. In fact, the rise of Oxs in the vasculature decreased bioavailability of nitric oxide (NO). This leads to endothelial dysfunction due to the loss of vasodilation of blood vessels [58, 67-69]. In addition, oxidative stress coupled with hyperlipidaemia and hypercholesterolemia in the vasculature gives rise to atherosclerosis by oxidation of lipids in the vessels. Atherosclerosis is an inflammatory disease leading to increased arteriolar resist‐ ance and increased large artery stiffness and obstruction of blood vessels and subsequent ischemia [70].

#### **2.4. Consequences of hypertension**

The continuous high pressure exerted on the arteries wall causes long term damages to both blood vessels and organs. In fact, when hypertension is not timely acknowledged and controlled, damages to organs can become severe and fatal [15, 51-52]. Numerous complica‐ tions resulting from hypertension are illustrated in Table 3.

always affordable for the majority of the population, especially in developing countries, since managing hypertension represents a lifelong financial investment. Henceforth, research is now turning to alternative and complementary medicine. Many reports support the concept that natural or dietary supplementation can be used to develop effective, safe, simple and inexpensive antihypertensive treatment [6, 28]. As a result, many researches are currently directed towards a search for useful bioactive compounds in medicinal plants as

**End Organ CVD Damages Complications/**

Potential Role of *Parkia biglobosa* in the Management and Treatment of Cardiovascular Diseases

•Left ventricular hypertrophy leading to chronic heart failure

•Neurological damages (memory loss, dementia)

Eyes Hypertensive retinopathy Blindness

•Acute coronary syndrome, •Ischaemic heart diseases •Myocardial infarction, •Atrial fibrillation, •Arrhythmias,

•Coronary artery disease,

•Constant headaches

•Disability (paralysis)

•Atherosclerosis •Arterial resistance •Aneurysm

•All the above

**Table 3.** End organs damages related to hypertension

•Renovascular dysfunction, •Chronic kidney failure, •End stage renal diseases (ESDR)

•Embolus and thrombo-embolus

•Stroke

**Consequences**

http://dx.doi.org/10.5772/57229

355

Sudden death

Sudden death

Brain, heart, kidney, eyes damages Death

Death

Deeper exploration of phytochemicals found in medicinal plants is used as an approach to discover potential prophylactic and therapeutic agents in cardio protection [7-9]. Medicinal plants can be used to develop effective, safe, simple and inexpensive antihypertensive treatment since they are reputed for their excellent health-enhancing bioactive micronutrients, their cost-effectiveness and their widespread bioavailability [7, 77-78]. As a result, research is currently directed towards discovering useful bioactive compounds in medicinal plants that could be used as new strategies for treatment and management of hypertension [5, 8, 49, 76].

a new strategy for the treatment and management of hypertension [5, 8, 49, 76].

**2.6. Alternative therapeutic approach to hypertension**

Heart

Brain

Kidney

Vascular system

#### **2.5. Orthodox therapeutic approaches to managing/treating hypertension**

Although, no definite cure has been found to treat essential hypertension, many ap‐ proaches have been used to manage and control its incidence; in particular lifestyle changes and the use of medications. Lowering salt and alcohol intake, lowering consumption of saturated fats and cholesterol rich food and practising regular exercise are important steps taken towards control of BP [17]. However, these steps are often associated with prescrip‐ tion of anti-hypertensive medication. Many types of anti-hypertensive drugs have been developed over the years such as diuretics, ACE inhibitors, angiotensin II receptorblocker, calcium channel blockers, alpha and beta blockers [71-73]. Even though a wide variety of anti-hypertensive drugs are effective to control and manage hypertension, they are not without considerable side effects [74-75]. Additionally, the cost of medication is not


**Table 3.** End organs damages related to hypertension

**2.3. Molecular mechanisms involved in the pathogenesis of hypertension**

Previous studies have shown the involvement of excessive reactive oxygen species (ROS) in the pathophysiology of CVD [53-56]. At a molecular level, oxidative stress (Oxs) has been identified to have major implication in the development of clinical and experimental hyper‐ tension [57-59]. It was demonstrated that chronic glutathione depletion induced severe elevation of arterial BP [60]. The lack of endogenous antioxidant enzymes worsens oxidative stress and can indirectly promote the risk of hypertension. For example, a recent research supports the influence of genetic polymorphism of antioxidant enzymes in increasing the risk of hypertension [61]. Likewise, [62] in Taiwan demonstrated that manganese superoxide

dismutase (MnSOD) polymorphism significantly increased the risk of hypertension.

ischemia [70].

**2.4. Consequences of hypertension**

354 Antioxidant-Antidiabetic Agents and Human Health

tions resulting from hypertension are illustrated in Table 3.

**2.5. Orthodox therapeutic approaches to managing/treating hypertension**

Inflammation and lipid peroxidation are central to the development of multiple CVD and are mediated by a variety of cell types including macrophages, lymphocytes, endothelial cells and vascular smooth muscles cells [63-65]. The multiple cell types which participate in vascular inflammation produce various pro- and anti-inflammatory cytokines and specific membrane receptors allowing them to transmit their effects to the cells. Studies place a strong emphasis on the role of oxidative stress in the pathophysiology of hypertension through promotion of chronic inflammation [66]. In fact, the rise of Oxs in the vasculature decreased bioavailability of nitric oxide (NO). This leads to endothelial dysfunction due to the loss of vasodilation of blood vessels [58, 67-69]. In addition, oxidative stress coupled with hyperlipidaemia and hypercholesterolemia in the vasculature gives rise to atherosclerosis by oxidation of lipids in the vessels. Atherosclerosis is an inflammatory disease leading to increased arteriolar resist‐ ance and increased large artery stiffness and obstruction of blood vessels and subsequent

The continuous high pressure exerted on the arteries wall causes long term damages to both blood vessels and organs. In fact, when hypertension is not timely acknowledged and controlled, damages to organs can become severe and fatal [15, 51-52]. Numerous complica‐

Although, no definite cure has been found to treat essential hypertension, many ap‐ proaches have been used to manage and control its incidence; in particular lifestyle changes and the use of medications. Lowering salt and alcohol intake, lowering consumption of saturated fats and cholesterol rich food and practising regular exercise are important steps taken towards control of BP [17]. However, these steps are often associated with prescrip‐ tion of anti-hypertensive medication. Many types of anti-hypertensive drugs have been developed over the years such as diuretics, ACE inhibitors, angiotensin II receptorblocker, calcium channel blockers, alpha and beta blockers [71-73]. Even though a wide variety of anti-hypertensive drugs are effective to control and manage hypertension, they are not without considerable side effects [74-75]. Additionally, the cost of medication is not always affordable for the majority of the population, especially in developing countries, since managing hypertension represents a lifelong financial investment. Henceforth, research is now turning to alternative and complementary medicine. Many reports support the concept that natural or dietary supplementation can be used to develop effective, safe, simple and inexpensive antihypertensive treatment [6, 28]. As a result, many researches are currently directed towards a search for useful bioactive compounds in medicinal plants as a new strategy for the treatment and management of hypertension [5, 8, 49, 76].

#### **2.6. Alternative therapeutic approach to hypertension**

Deeper exploration of phytochemicals found in medicinal plants is used as an approach to discover potential prophylactic and therapeutic agents in cardio protection [7-9]. Medicinal plants can be used to develop effective, safe, simple and inexpensive antihypertensive treatment since they are reputed for their excellent health-enhancing bioactive micronutrients, their cost-effectiveness and their widespread bioavailability [7, 77-78]. As a result, research is currently directed towards discovering useful bioactive compounds in medicinal plants that could be used as new strategies for treatment and management of hypertension [5, 8, 49, 76].
