**3.8. Fabaceae –** *Desmodium adscendens* **(Sw.) DC.**

hypertension [51, 101, 105]. Some of these claims may be explained, at least partially, by the presence of carotenoids and polyphenols, benzyl isothiocyanates and benzyl glucosinolates,

Support for the alleged antihypertensive effect of *C. papaya* was provided by the decrease in blood pressure in renal and salt-induced hypertensive Wistar rats treated with a crude ethanol extract from the unripened fruit [106]. This preparation, as well as a pentane extract from papaya seeds and an aqueous extract from papaya leaves relaxed vascular muscle tone of isolated rabbit arterial strips [106], strips of dog carotid artery precontracted with phenylephrine [107], and rat aortic ring preparations [108]. The relaxing effect of the fruit preparation was counteracted by phentolamine, suggesting that *C. papaya* contains (an) antihypertensive substance(s) that mainly exhibits α-adrenoceptor activity [108]. *C. papaya* preparations may also exert a blood pressure-lowering effect by stimulating diuresis, as suggested by the diuretic action of an aqueous root extract in laboratory rats, accomplishing similar effects on

The cucumber plant *C. sativus* is originally from South Asia, most probably India, where it has been cultivated for more than 3000 years. Nowadays, hundreds of cultivars are grown throughout the world and traded on the global market. The mature fruit contains about 90% water and is relatively low in nutrients, and many enjoy its appetizing flavor and texture, making it a popular ingredient of fresh salads as well as pickles and relishes. Cucumber extracts are also widely used in facial tonics and moisturizers, presumably because their high

Preparations from *C. sativus* leaves, seeds, flowers, and fruits are also used in various traditional medicines for treating, among others, bacterial and parasitic infections, kidney and gall stones, as well as thrombosis and hypertension [45, 50, 52, 56, 110]. Preclinical evaluation of the plant parts showed various pharmacological activities including blood pressure-lowering effects [111, 112]. Some of these effects may be associated with the presence in the plant of bioactive compounds such as cucurbitacins, cucumegastigmanes I and II, cucumerin A and B,

Importantly, a Chinese study found a significant reduction in blood pressure and a marked increase in coronary blood flow of patients receiving *C. sativus* vine compound tablets, as well as improved myocardial contraction in laboratory animals while no toxic effects were noted [113]. Furthermore, a relatively recent study conducted in Indonesia reported a reduction in mean blood pressure in elderly patients receiving 100 g of cucumber in juice form for

The antihypertensive effects of these preparations may be associated with the stimulation of diuresis. Indeed, an ethanolic extract from the leaves of *C. sativus*, either alone or as part of a polyherbal formulation, had a moderately stimulatory effect on diuresis in laboratory rats when compared to furosemide [115]. Also, an ether extract from the seeds of *C. melo* increased diuresis in anesthetized dogs [116], and an aqueous extract from the leaves of *C. trigonus*

water and antioxidant content would protect the skin from aging [93].

and/or the cyanogenic substance prunasin in papaya skin, pulp, and seeds [101].

electrolyte excretion as hydrochlorothiazide [109].

**3.7. Cucurbitaceae –** *Cucumis sativus* **L.**

vitexin, and orientin [111, 112].

7 days [114].

168 Herbal Medicine

The glue sticks *D. adscendens* is commonly encountered in forests, grasslands, secondary/disturbed vegetation, old cultivated fields, and roadsidesin tropical areas. The leaves and stems have probably been used for thousands of years by native peoples for a variety of health issues, including liver ailments, respiratory diseases, backache, rheumatism, gonorrhea, ovarian inflammation, and epilepsy [118, 119].

Main compounds in *D. adscendens* are flavonoids, triterpenes, saponins, amines, and alkaloids [120]. Pharmacological studies with *D. adscendens* leaf extracts showed, among others, spasmolytic effects in isolated guineas pig trachea and ilei precontracted with histamine [121, 122].

In Suriname, *D. adscendens* is generally known as '*konkruman*' ('informer') or '*toriman*' ('story teller') because the sticky pods stay clinging to clothing, betraying the unapproved presence of the bearer 'in the field', that is, away from home. Indigenous folklore believes that preparations from the plant attract and hold fortune and prosperity while at the same capturing and removing bad luck and disease [45]. A tea prepared from the macerated roots is also used as an antihypertensive [46]. This effect may be attributable to the above-mentioned relaxing effect of certain constituents of the plant on smooth muscle cells [121, 122] – possibly including those in blood vessel walls – but there are no scientific indications to support this presumption.

#### **3.9. Fabaceae –** *Hymenaea courbaril* **L.**

The courbaril, West Indian locust, or jatoba *H. courbaril* (**Figure 5**) is a common tree in the Caribbean, Central America, and South America. The hardwood is very durable and is used for manufacturing furniture, flooring, window frames, staircases, as well as canoes. The seeds are situated in a hard pod and are surrounded by an edible dry pulp that has an unpleasant scent reminiscent of foot odor. For this reason, the tree is also known as 'stinking toe' and 'old man's toe'. However, the pulp has a high content of starches and proteins and a sweet taste. It is often eaten raw; may be dried and powdered for making snacks; and may also be mixed with water to prepare a drink called 'atole'.

The stembark of the tree produces an orange, soft, sticky resin called 'animé', French for 'animated', referring to the large numbers of insects that are entrapped in it [123]. Animé has a pleasant fragrance and is used for the production of incense, perfume, and varnish [123]. Interestingly, the indigenous peoples of the Amazon have used *H. courbaril* resin for centuries to preserve the colors on their pottery [45]. Preparations from this substance, along with those from several other parts of the plant, have traditionally also been used in various South American and African countries for treating a variety of conditions such as anemia, kidney problems, dysfunctions of the respiratory system, and abdominal ailments [45, 123, 124].

been suggested to occur through direct sympatho-inhibition [131], protection of the body against oxidative assault that could initiate the development of hypertension [131, 133], and/

Plant-Based Ethnopharmacological Remedies for Hypertension in Suriname

http://dx.doi.org/10.5772/intechopen.72106

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The avocado tree *P. americana* probably originates from Central America and the western parts of South America and was presumably domesticated as early as 5000 BC. Today, avocados are a successful cash crop with a high commercial value. Avocado is mostly eaten raw; (prolonged) cooking makes it inedible, causing a chemical reaction that confers a bitter taste to it. It is an ingredient of many servings and dishes and is often used in vegetarian cuisine as a substitute for meats because of its relatively high content of monounsaturated fats [135]. The rather expensive oil extracted from avocados is mostly used for salads or dips and in

The stem bark, fruits, seeds, and leaves of *P. americana* are used in traditional medicine in Africa, the West Indies, as well as South and Central America including Suriname for treating, among others, menstrual problems, gastrointestinal ailments, bronchitis, diabetes mellitus, hypercholesterolemia, and hypertension [45, 46, 49, 52, 55, 137, 138]. Pharmacological evaluations with animal models provided some support for these ethnopharmacological claims [139]. These effects may partially be associated with the aliphatic acetogenins, terpenoid glycosides, furan ring-containing derivatives, flavonoids, and coumarins in various parts of the

Evidence for an antihypertensive effect of *P. americana* leaf and seed preparations came from the relaxing effects they produced in isolated guinea pig atrial muscle strips, rat portal veins, and rat thoracic aortic rings precontracted with noradrenaline [141] and the blood pressure-

The mechanisms responsible for these effects may involve vasorelaxation by substances that inhibit Ca2+ influx and stimulate the synthesis and release of endothelium-derived relaxing factors and vasoactive mediators [144], modulation of ACE activity [145], and/or lowering of total cholesterol, triglycerides, VLDL, and/or LDL [143, 145, 146]. However, a clinical study found no benefit with respect to body weight, BMI, and percentage body fat, and no difference in serum lipids, fibrinogen, blood flow, or blood pressure when avocados were substi-

The sea island cotton or Egyptian cotton *G. barbadense* (**Figure 6**) is believed to have emerged in Peru as a cross between *G. herbaceum* L. and *G. raimondii* Ulbrich or *G. gossypioides* (Ulbrich) Standley. It is now widely cultivated in the warmer parts of the world, and is an important

Cotton is the soft white fibrous substance that surrounds the seeds of the plant and helps in the dispersal of the seeds [148]. It consists of 88–96% α-cellulose, 3–6% hemicellulose, and 1–2%

industrial and export product of Egypt, the West Indies, Sudan, Peru, and the USA.

lowering effects they produced in laboratory animals [141–143].

tuted for mixed fats in an energy-restricted diet [147].

**3.12. Malvaceae –** *Gossypium barbadense* **L.**

or lowering of blood lipid levels [133, 134].

**3.11. Lauraceae –** *Persea americana* **Mill.**

cosmetics and toiletries [136].

plant [140].

**Figure 5.** Fabaceae – *Hymenaea courbaril* L. (from: https://goo.gl/images/ePJjyr).

Many bioactive compounds have been identified in leaves, seeds, and trunk resin of *H. courbaril*, including flavonoids, terpenoids, phenolic acids, steroids, and coumarins [124, 125]. Some of these compounds have been related to the myorelaxant, anti-inflammatory, and antimicrobial effects including activity against dengue virus type-2 observed in pharmacological studies with *H. courbaril* preparations [124, 126, 127]. In Suriname, the stembark is used to prepare a tea that would treat a similar variety of ailments as well as hypertension [45]. Whether the latter activity may be associated with vasodilation following relaxation of the smooth muscles [126] including those in the blood vessel walls remains to be determined.

#### **3.10. Fabaceae –** *Tamarindus indica* **L.**

The tamarind *T. indica* is probably indigenous to tropical Africa where it grows in the wild. It has been cultivated for centuries on the Indian subcontinent, and has been introduced in South America including Suriname by Spanish and Portuguese colonists in the sixteenth century. The fruit is a pod with a hard, brown shell that contains up to 12 seeds surrounded by a sweet and sour pulp that is used in cooking, to flavor foods, in refreshing drinks, and as a key ingredient of Worcestershire sauce.

Preparations from *T. indica* leaves, seeds, fruits, and roots are extensively used in folk medicine, among others, for treating abdominal discomfort, microbial and parasitic infestations, as an aphrodisiac, and against hypertension [48, 128, 129]. These parts of the plant contain various phenolic compounds, terpenes, sugars, as well as mucilage and pectin [128, 129]. Some of these constituents have been associated with, among others, antioxidant, anti-hyperlipidemic, and cardioprotective effects of the plant in laboratory models [130].

Furthermore, an aqueous tamarind seed extract produced a decrease in blood pressure, heart rate, as well as serum LDL, cholesterol, and HDL levels in streptozotocin-induced diabetic and hypertensive rats [131]. As well, administration of the dried and pulverized fruit pulp led to a decrease in diastolic blood pressure as well as total cholesterol and LDL-cholesterol levels in human subjects [132]. The blood pressure-lowering effects of the *T. indica* preparations have been suggested to occur through direct sympatho-inhibition [131], protection of the body against oxidative assault that could initiate the development of hypertension [131, 133], and/ or lowering of blood lipid levels [133, 134].
