**3. Scientific rationale for using Surinamese plants against hypertension**

In this section, 15 plants that are commonly used against hypertension in Suriname, as well as preclinical and clinical indications for their blood pressure-lowering effect and their presumed bioactive constituent(s) and mechanism(s) of action are in detail addressed. The plants are most frequently mentioned as traditional treatments for hypertension in the above-mentioned publications [45–55]. The data are summarized in **Table 2**.



**3.1. Acanthaceaea –** *Ruellia tuberosa* **L.**

saponins, sterols, and flavonoids in the plant [59].

lipid-lowering actions of *Ruellia* preparations [57, 58].

**Figure 2.** Acanthaceaea – *Ruellia tuberosa* L. (from: https://goo.gl/images/vk862o).

**3.2. Anacardiaceae –** *Mangifera indica* **L.**

sorbets, fruit bars, and pies.

The minnie root *R. tuberosa* (**Figure 2**) is probably native to Central America but has spread to various other tropical regions in South America as well as South and South east Asia. Both the English vernacular name 'cracker plant' and the Surinamese vernacular name *watrakanu* ('water canon') are probably derived from the loud crack emitted when the ripe fruits in a pod with seven to eight seeds burst open on contact with water, hurdling the seeds away. The whole plant, the leaves, and/or the roots are used in various traditional medicinal systems including those in Suriname as an antidiabetic, antipyretic, analgesic, diuretic, antihypertensive, gastroprotective, anthelmintic, antigonorrheal, antioxidant, blood-purifying, and abortifacient agent [46, 48, 49, 55, 56]. Some of these activities were supported by the results from pharmacological studies [57, 58] and could be associated with certain alkaloids, triterpenoids,

Plant-Based Ethnopharmacological Remedies for Hypertension in Suriname

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So far, no formal experimental evaluations on the presumed antihypertensive activity of *R. tuberosa* have been reported. However, crude extracts from the leaves of the closely related species *R. patula* and *R. brittoniana* as well as n-butanolic extracts and the aqueous layers of both plant extracts displayed cardiotonic effects in isolated rabbit hearts [60]. More importantly, a preparation from *R. patula* elicited a clear blood pressure-lowering effect in pentothal sodium-anesthetized rats [61]. This effect may be attributed, at least partially, to the blood

The mango tree *M. indica* is indigenous to Bangladesh, India, and Pakistan where it is found in the wild. It has been domesticated in India around 2000 BC, and many cultivated varieties have been produced in other tropical countries including Suriname. Both sour, unripe, and sweet, ripe mangoes are widely used in cuisine, among others, in chutneys, curries, pickles, or side dishes, and to prepare juices, smoothies, nectars, jams, and as a flavoring in ice creams,

**Table 2.** Preclinical and clinical evidence for blood pressure-lowering activity of 15 commonly used plants in Suriname for treating hypertension, the presumed key active constituent(s) in these plants, and their presumed mechanism of action.
