**2.1. Geography, people, and economy**

The Republic of Suriname is located on the north-east coast of South America and borders the Atlantic Ocean to the north, French Guiana to the east, Brazil to the south, and Guyana to the west (**Figure 1**). The country's land area of roughly 165,000 km2 can be distinguished into a northern narrow low-land coastal area that harbors the capital city Paramaribo as well as other urbanized areas, a broad but sparsely inhabited savannah belt, and a southern forested area that comprises about three-quarters of its surface area and largely consists of dense, pristine, and highly biodiverse tropical rain forest. Roughly 80% of the population of about 570,000 lives in the urbanized northern coastal zone while the remaining 20% populates the rural and interior savannas and hinterlands [20].

Suriname is renowned for its ethnic, religious, and cultural diversity, harboring various Amerindian tribes, the original inhabitants of the country; descendants from runaway enslaved Africans brought in between the sixteenth and the nineteenth century (called Maroons); those from mixed Black and White origin (called Creoles); descendants from contract workers from China, India (called Hindustanis), and Java, Indonesia (called Javanese) who arrived between the second half of the nineteenth century and the first half of the twentieth century; descendants from a number of European countries; and more recently, immigrants from various

the average tobacco and alcohol consumption *per capita* in individuals of 15 years and older

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As a result, in 2008, 25.1% of Surinamese was obese [28, 29]; 7.4% had prediabetes and 13.0% diabetes mellitus [30]; the overall estimated prevalence of the metabolic syndrome was 39.2% [31]; and more than 25% of adults had a raised blood pressure [29, 32]. These observations indicate that Suriname, similarly to many other economically developing countries [19], is facing increasing public health threats of lifestyle-related non-communicable diseases includ-

Indeed, WHO assessments from 2014 attributed 68% of total deaths in Suriname to the four main non-communicable diseases (cardiovascular, neoplastic, diabetic, and chronic respiratory diseases) and estimated that the probability of dying between age 30 and 70 years from these conditions was 14% [29]. Notably, in all approximations and previsions, cardiovascular disease was the most important cause of morbidity and mortality in Suriname. For instance, in 2012, stroke (11%), ischemic heart disease (9.1%), diabetes mellitus (7.3%), and hypertensive heart disease (4.5%) were among the leading causes of mortality, together accounting for about 800 or almost one-third of the total number of deaths in that year [29]. Indeed, with 864 fatalities in 2013 (or more than one-quarter of the total number of 3260 deaths in that year), cardiovascular disease was by far the leading cause of mortality in Suriname, ahead of death due to malignant neoplasms, external causes, perinatal complications, diabetes mellitus, and

The comprehensive, nation-wide Suriname Health Study on non-communicable diseases found an overall prevalence of hypertension of 26.2% [32]. This was in the range of values reported for many other developing countries [34] as well as the relatively large Surinamese diaspora in The Netherlands [35]. Mean values for systolic and diastolic blood pressure were higher in males than in females; increased with older age; and were highest in Creoles Hindustanis, and Javanese, and lowest in Maroons and Amerindians [32]. The prevalence of hypertension in demographic risk factor subgroups differed between ethnic groups, as did the associations of ethnic groups with hypertension [32], implying the need of tailor-made

The findings from two other Surinamese studies suggest that an urban lifestyle may also contribute to the development of prehypertension and hypertension in Suriname, reporting higher prevalence rates in the urban areas of the country (39 and 41%, respectively [36]), and in an urban middle-income population (31 and 41%, respectively [37]). These studies found neither gender differences nor racial/ethnic differences in the prevalence of hypertension in their participants [36, 37], but prehypertension was more common in urban males than in urban females [36] and after adjusting for age, urban African-Surinamese had significantly

An apparent ethnic/racial predilection of hypertension was also observed in several Dutch epidemiological studies that included Surinamese migrants. These studies reported a higher incidence of prehypertension, hypertension, malignant hypertension, and related renal complications

intervention programs to control hypertension in Suriname [32].

higher odds of having hypertension than their Asian counterparts [36].

was unacceptably high [28].

ing cardiovascular disease.

acute respiratory infections [33].

**2.3. Hypertension**

**Figure 1.** Map of Suriname depicting the administrative districts (from: https://goo.gl/images/gqdxwn). The insert (from: https://goo.gl/images/rWXrAL) indicates the location of Suriname in South America.

Latin American and Caribbean counties including Brazil, Guyana, French Guiana, Haiti, etc. [20]. The largest ethnic groups in the country are the Hindustanis, Maroons, Creoles, and Javanese, accounting for 27.4, 21.7, 17.0, and 15.7%, respectively, of the total population [20]. All ethnic groups have largely preserved their own specific identity [21], making Suriname one of the culturally most diverse countries in the world [22].

Suriname is situated on the Guiana Shield, a Precambrian geological formation estimated to be 1.7 billion years old and one of the regions with the largest expanse of undisturbed tropical rain forest in the world with a very high animal and plant biodiversity [23]. The high mineral density of Suriname's soil contributes to its ranking as the 17th richest country in the world in terms of natural resources and development potential [24]. Suriname's most important economic means of support are crude oil drilling, bauxite and gold mining, agriculture, fisheries, forestry, and ecotourism [24]. These activities contributed substantially to the gross domestic income in 2014 of USD 5.21 billion and the average *per capita* income in that year of USD 9325 [24]. This positions Suriname on the World Bank's list of upper-middle income economies [25].

#### **2.2. Non-communicable diseases**

At the same time, as observed in many low- and middle-income countries [19], more and more Surinamese are adapting a Western lifestyle. For instance, only about half of the country's overall population met the levels for physical activity recommended by the World Health Organization (WHO) [26]; almost three-quarters of school children aged 13–15 years had less than 1 hour of physical activity per day and 81% had a high calorie intake [27]; and the average tobacco and alcohol consumption *per capita* in individuals of 15 years and older was unacceptably high [28].

As a result, in 2008, 25.1% of Surinamese was obese [28, 29]; 7.4% had prediabetes and 13.0% diabetes mellitus [30]; the overall estimated prevalence of the metabolic syndrome was 39.2% [31]; and more than 25% of adults had a raised blood pressure [29, 32]. These observations indicate that Suriname, similarly to many other economically developing countries [19], is facing increasing public health threats of lifestyle-related non-communicable diseases including cardiovascular disease.

Indeed, WHO assessments from 2014 attributed 68% of total deaths in Suriname to the four main non-communicable diseases (cardiovascular, neoplastic, diabetic, and chronic respiratory diseases) and estimated that the probability of dying between age 30 and 70 years from these conditions was 14% [29]. Notably, in all approximations and previsions, cardiovascular disease was the most important cause of morbidity and mortality in Suriname. For instance, in 2012, stroke (11%), ischemic heart disease (9.1%), diabetes mellitus (7.3%), and hypertensive heart disease (4.5%) were among the leading causes of mortality, together accounting for about 800 or almost one-third of the total number of deaths in that year [29]. Indeed, with 864 fatalities in 2013 (or more than one-quarter of the total number of 3260 deaths in that year), cardiovascular disease was by far the leading cause of mortality in Suriname, ahead of death due to malignant neoplasms, external causes, perinatal complications, diabetes mellitus, and acute respiratory infections [33].

#### **2.3. Hypertension**

Latin American and Caribbean counties including Brazil, Guyana, French Guiana, Haiti, etc. [20]. The largest ethnic groups in the country are the Hindustanis, Maroons, Creoles, and Javanese, accounting for 27.4, 21.7, 17.0, and 15.7%, respectively, of the total population [20]. All ethnic groups have largely preserved their own specific identity [21], making Suriname

**Figure 1.** Map of Suriname depicting the administrative districts (from: https://goo.gl/images/gqdxwn). The insert (from:

Suriname is situated on the Guiana Shield, a Precambrian geological formation estimated to be 1.7 billion years old and one of the regions with the largest expanse of undisturbed tropical rain forest in the world with a very high animal and plant biodiversity [23]. The high mineral density of Suriname's soil contributes to its ranking as the 17th richest country in the world in terms of natural resources and development potential [24]. Suriname's most important economic means of support are crude oil drilling, bauxite and gold mining, agriculture, fisheries, forestry, and ecotourism [24]. These activities contributed substantially to the gross domestic income in 2014 of USD 5.21 billion and the average *per capita* income in that year of USD 9325 [24]. This positions Suriname on the World Bank's list of upper-middle income

At the same time, as observed in many low- and middle-income countries [19], more and more Surinamese are adapting a Western lifestyle. For instance, only about half of the country's overall population met the levels for physical activity recommended by the World Health Organization (WHO) [26]; almost three-quarters of school children aged 13–15 years had less than 1 hour of physical activity per day and 81% had a high calorie intake [27]; and

one of the culturally most diverse countries in the world [22].

https://goo.gl/images/rWXrAL) indicates the location of Suriname in South America.

economies [25].

154 Herbal Medicine

**2.2. Non-communicable diseases**

The comprehensive, nation-wide Suriname Health Study on non-communicable diseases found an overall prevalence of hypertension of 26.2% [32]. This was in the range of values reported for many other developing countries [34] as well as the relatively large Surinamese diaspora in The Netherlands [35]. Mean values for systolic and diastolic blood pressure were higher in males than in females; increased with older age; and were highest in Creoles Hindustanis, and Javanese, and lowest in Maroons and Amerindians [32]. The prevalence of hypertension in demographic risk factor subgroups differed between ethnic groups, as did the associations of ethnic groups with hypertension [32], implying the need of tailor-made intervention programs to control hypertension in Suriname [32].

The findings from two other Surinamese studies suggest that an urban lifestyle may also contribute to the development of prehypertension and hypertension in Suriname, reporting higher prevalence rates in the urban areas of the country (39 and 41%, respectively [36]), and in an urban middle-income population (31 and 41%, respectively [37]). These studies found neither gender differences nor racial/ethnic differences in the prevalence of hypertension in their participants [36, 37], but prehypertension was more common in urban males than in urban females [36] and after adjusting for age, urban African-Surinamese had significantly higher odds of having hypertension than their Asian counterparts [36].

An apparent ethnic/racial predilection of hypertension was also observed in several Dutch epidemiological studies that included Surinamese migrants. These studies reported a higher incidence of prehypertension, hypertension, malignant hypertension, and related renal complications in participants from Afro-Surinamese and Hindustani descent compared to white individuals [35, 38–40]. These differences were tentatively explained by ethnic disparities in the perception of hypertension (supporting one of the findings of the Suriname Heath Study [32]), as well in drug adherence, blood pressure control, and/or insurance status [38, 40–42].

and cultural groups in the country have preserved much of their original cultural and ethnopharmacological practices as a means of strengthening the ethnic identity during the secluded lifestyle the former colonial authorities had forced them into [21, 22]. Furthermore, Suriname's large biodiversity provides ample and readily available raw material that can be processed into traditional medicines [23]. As a result, many disease conditions including hypertension are often treated with traditional plant-based medicines and may be used instead of, or in

The medicinal plants used throughout the country have extensively been discussed in the literature [45], and those used more commonly by Hindustanis, Maroons, and Javanese have also been reviewed [46–48]. Less comprehensive accounts of these plants have been presented as well [49–55]. Together, these publications have compiled 789 Surinamese medicinal plants, 65 of which (roughly 8%) are used for treating hypertension. The latter plants, plant parts, and methods of processing are given in **Table 1**. They belong to 38 different families, the most represented of which are the Fabaceae with 7 species, the Solanaceae with 5 species, the Malvaceae and the Piperaceae with 4 species each, and the Asteraceae and the Cucurbitaceae with 3 species each (**Table 1**). In 31 cases the leaves are used, in 9 cases the whole plant, in 6 cases the fruits, in 5 cases the bark, and in 1–3 cases other plant parts such as roots and flow-

**Part(s) used Mode of preparation**

Leaves Infusion

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Roots and leaves Infusion

Whole plant Infusion

Leaves Infusion

Fresh leaves Infusion

Fresh leaves Infusion

Whole plant Infusion

Fresh stem bark Decoction

Fresh fruits; fresh peels Pressed to obtain juice to

drink; infusion

conjunction with prescription drugs.

ers (**Table 1**).

**Family Species**

Acanthaceae *Justicia pectoralis* Jacq.

Acanthaceae *Ruellia tuberosa* L.

Anacardiaceae *Mangifera indica* L.

Anacardiaceae *Spondias dulcis* L.

Annonaceae *Annona muricata* L.

Apiaceae *Apium graveolens* L.

**(Vernacular names in English;** 

(Freshcut; tonkawiwiri)

(Minnieroot; watrakanu)

(Brazilian joyweed; weti ede)

(Ambarella; pomme cythère)

**Surinamese)**

Amaranthaceae *Alternanthera brasiliana* (L.) Kuntze

(Mango; manya)

(Soursop; zuurzak)

(Celery; soepgroenten)

(Rosy periwinkle; kotomisi)

(Pao-pereira bark; bergi bita)

Apocynaceae *Catharanthus roseus* (L.) G.Don, 1837

Apocynaceae *Geissospermum laeve* (Vell.).Miers

#### **2.4. Health care system**

Suriname's healthcare system is coordinated by the Ministry of Health which is headed by the Minister of Health and the Director of Health (the Chief Medical Officer). The main responsibilities of the ministry are the planning, coordination, inspection, and monitoring and evaluation of, as well as policy development and setting standards to the country's health system [43].

In 2014, the Ministry spent 5.7% of the country's gross domestic product for health expenditures which corresponded to an average *per capita* sum of USD 589. The costs of those who cannot afford these expenses are covered by the Ministry of Social Affairs. Government employees and employees of government-related companies are mandatory insured at the State Health Foundation. Essential pharmaceuticals including those for treating hypertension are imported, stocked, and distributed by the National Pharmaceutical Import and Distribution Company and are in general readily available. These medicines are identified by the Board for Essential Pharmaceuticals that consists of various players in the field of pharmacy and pharmacology in Suriname.

Primary healthcare in Suriname's coastal area and hinterlands is provided by the government-subsidized Regional Health Service and Medical Mission, respectively, each operating about 40 clinics which also dispense medicines. In 2004, Suriname had 0.45 physicians per 1000 population. Secondary care and specialist care including that for patients suffering from complications of hypertension are provided by two private and two government-supported hospitals in Paramaribo and one public hospital in the western district of Nickerie.

The Academic Hospital Paramaribo also functions as training facility for both general practitioners and medical specialists, and has to its disposal a Thorax Center for specialized cardiology care and cardiothoracic surgery. Patients with kidney failure are treated by the government-supported Kidney Dialysis Center. Cases of hypertensive crisis and other medical emergencies can get help around-the-clock from the First-aid Stations of the Academic Hospital Paramaribo and the Sint Vincentius Hospital Suriname.

Patients who need specialized therapy that is not available in Suriname (particularly those suffering from certain malignancies) are sent abroad – in general to the Netherlands or Colombia – for treatment. All expenses are covered by the Ministry of Health that has reserved a special budget for these cases.

#### **2.5. Use of traditional medicines against hypertension in Suriname**

Despite the broad availability of affordable and accessible modern health care throughout the entire country, the use of traditional medicines is deeply rooted in all ethnic groups in Suriname [21, 44]. This is probably for an important part attributable to the fact that all ethnic and cultural groups in the country have preserved much of their original cultural and ethnopharmacological practices as a means of strengthening the ethnic identity during the secluded lifestyle the former colonial authorities had forced them into [21, 22]. Furthermore, Suriname's large biodiversity provides ample and readily available raw material that can be processed into traditional medicines [23]. As a result, many disease conditions including hypertension are often treated with traditional plant-based medicines and may be used instead of, or in conjunction with prescription drugs.

in participants from Afro-Surinamese and Hindustani descent compared to white individuals [35, 38–40]. These differences were tentatively explained by ethnic disparities in the perception of hypertension (supporting one of the findings of the Suriname Heath Study [32]), as well in drug

Suriname's healthcare system is coordinated by the Ministry of Health which is headed by the Minister of Health and the Director of Health (the Chief Medical Officer). The main responsibilities of the ministry are the planning, coordination, inspection, and monitoring and evaluation of, as well as policy development and setting standards to the country's health

In 2014, the Ministry spent 5.7% of the country's gross domestic product for health expenditures which corresponded to an average *per capita* sum of USD 589. The costs of those who cannot afford these expenses are covered by the Ministry of Social Affairs. Government employees and employees of government-related companies are mandatory insured at the State Health Foundation. Essential pharmaceuticals including those for treating hypertension are imported, stocked, and distributed by the National Pharmaceutical Import and Distribution Company and are in general readily available. These medicines are identified by the Board for Essential Pharmaceuticals that consists of various players in the field of phar-

Primary healthcare in Suriname's coastal area and hinterlands is provided by the government-subsidized Regional Health Service and Medical Mission, respectively, each operating about 40 clinics which also dispense medicines. In 2004, Suriname had 0.45 physicians per 1000 population. Secondary care and specialist care including that for patients suffering from complications of hypertension are provided by two private and two government-supported

The Academic Hospital Paramaribo also functions as training facility for both general practitioners and medical specialists, and has to its disposal a Thorax Center for specialized cardiology care and cardiothoracic surgery. Patients with kidney failure are treated by the government-supported Kidney Dialysis Center. Cases of hypertensive crisis and other medical emergencies can get help around-the-clock from the First-aid Stations of the Academic

Patients who need specialized therapy that is not available in Suriname (particularly those suffering from certain malignancies) are sent abroad – in general to the Netherlands or Colombia – for treatment. All expenses are covered by the Ministry of Health that has reserved a special

Despite the broad availability of affordable and accessible modern health care throughout the entire country, the use of traditional medicines is deeply rooted in all ethnic groups in Suriname [21, 44]. This is probably for an important part attributable to the fact that all ethnic

hospitals in Paramaribo and one public hospital in the western district of Nickerie.

Hospital Paramaribo and the Sint Vincentius Hospital Suriname.

**2.5. Use of traditional medicines against hypertension in Suriname**

adherence, blood pressure control, and/or insurance status [38, 40–42].

**2.4. Health care system**

macy and pharmacology in Suriname.

budget for these cases.

system [43].

156 Herbal Medicine

The medicinal plants used throughout the country have extensively been discussed in the literature [45], and those used more commonly by Hindustanis, Maroons, and Javanese have also been reviewed [46–48]. Less comprehensive accounts of these plants have been presented as well [49–55]. Together, these publications have compiled 789 Surinamese medicinal plants, 65 of which (roughly 8%) are used for treating hypertension. The latter plants, plant parts, and methods of processing are given in **Table 1**. They belong to 38 different families, the most represented of which are the Fabaceae with 7 species, the Solanaceae with 5 species, the Malvaceae and the Piperaceae with 4 species each, and the Asteraceae and the Cucurbitaceae with 3 species each (**Table 1**). In 31 cases the leaves are used, in 9 cases the whole plant, in 6 cases the fruits, in 5 cases the bark, and in 1–3 cases other plant parts such as roots and flowers (**Table 1**).



**Family Species**

**(Vernacular names in English;** 

(Red hot cat's tail; pus'pusitere)

(Copaiba; hoepelhout)

(Beggar lice; toriman)

(West Indian locust; loksi)

(Manatee bush; brantimaka)

(Candle bush; slabriki)

(Tamarind; tamarinde)

(Avocado; advocaat)

(Roselle; syuru)

(Neem; nim)

(Shy plant; Sing sing tap yu koto)

(Amazonian basil; smeriwiwiri)

(Sea island cotton; redi katun)

(Sleepy morning; malva)

(Crabwood; witte krapa)

(Banana; banaan)

(Bilimbi; birambi)

(African crabwood; rode krapa)

**Part(s) used Mode of preparation**

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Roots Pressed to obtain sap to drink

Leaves Infusion

Plant-Based Ethnopharmacological Remedies for Hypertension in Suriname

Fresh stem bark Infusion

Stem bark Infusion

Leaves Infusion

Whole plant Infusion

Leaves Infusion

Leaves Infusion

Dried leaves Infusion

Leaves Infusion

Leaves Infusion

Leaves Infusion

Leaves Infusion

Dried stem bark Decoction

Dried stem bark Decoction

Leaves Infusion

Fresh fruits Pressed to obtain juice to drink

Whole plant Macerated for herbal bath

**Surinamese)**

Euphorbiaceae *Acalypha hispida* Burm. f.

Fabaceae *Copaifera guyanensis* Desf.

Fabaceae *Hymenaea courbaril* L.

Fabaceae *Mimosa pudica* L.

Fabaceae *Senna alata* (L.) Roxb.

Fabaceae *Tamarindus indica* L.

Lauraceae *Persea americana* Mill.

Malvaceae *Gossypium barbadense* L.

Malvaceae *Hibiscus sabdariffa* L.

Malvaceae *Waltheria indica* L.

Meliaceae *Azadirachta indica* A. Juss.

Meliaceae *Carapa guianensis* Aubl.

Musaceae *Musa sp., Musa x paradisiaca*

Meliaceae *Carapa procera* D.C.

Oxalidaceae *Averrhoa bilimbi* L.

Lamiaceae *Ocimum campechianum* Mill.

Fabaceae *Desmodium adscendens (*Sw.) DC.

Fabaceae *Machaerium lunatum* (L.f.) Ducke

#### Plant-Based Ethnopharmacological Remedies for Hypertension in Suriname http://dx.doi.org/10.5772/intechopen.72106 159


**Family Species**

158 Herbal Medicine

Arecaceae *Cosos nucifera* L.

Asteraceae *Ayapana triplinervis* (Vahl)

Asteraceae *Cyanthillium cinereum* (L.) H. Rob

Asteraceae *Melampodium camphoratum* (L.F.) Baker

Bignoniaceae *Mansoa alliacea* (Lam.) A.H. Genry

Boraginaceae *Cordia schomburgkii* DC.

Boraginaceae *Cordia tetrandra* Aubl.

Caricaceae *Carica papaya* L.

Cecropiaceae *Cecropia peltata* L.

Cecropiaceae *Cecropia sciadophylla* Mart.

Commelinaceae *Tripogandra serrulata* (Vahl.) Handlos.

Convolvulaceae *Ipomoea aquatica* Forssk.

Cucurbitaceae *Cucurbita moschata* Duchesne

Dilleniaceae *Davilla nitida (*Vahl.) Kubizki

Cucurbitaceae *Momordica charantia* L.

Cucurbitaceae *Cucumis sativus* L.

Combretaceae *Terminalia catappa* L.

**(Vernacular names in English;** 

(Water hemp; sekrepatuwiwiri)

(Little ironweed; doifiwiwiri)

(Sand bitters; kanfrubita)

(Canalette; blaka uma)

(Papaya; papaya)

(Clammy cherry; tafrabon)

(Trumpet tree; uma busipapaya)

(Congo pump; man busipapaya)

(Tropical almond; zoete amandel)

(Pink trinity; redi gado dede)

(Water spinach; dagublad)

(Cucumber; komkommer)

(Squash; pompoen)

(Bitter melon; sopropo)

(Sandpaper tree; schuurpapier)

(Garlic vine; konofrukutetey)

**Part(s) used Mode of preparation**

Dried husk fibers Infusion

Fresh or dried leaves Infusion

Whole plant Infusion

Whole plant Infusion

Leaves and hardwood Infusion

Fresh leaves Infusion

Dried leaves Infusion

Dried leaves Infusion

Dried leaves Infusion

Leaves Infusion

Dried leaves Infusion

Dried flowers Infusion

Dried whole plant Infusion

Young leaves and stem Cooked and eaten as a

Fresh fruits Pressed to obtain juice to drink

Stem Pressed to obtain sap to drink

vegetable

Fresh fruits None; fresh fruit eaten

**Surinamese)**

(Coconut tree; kronto)

R.M. King & H. Rob


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

**(Vernacular names in English;** 

(Bitayouli; uma parabita)

(African eggplant; antruwa)

(Coconilla; makadroyfi)

(Juhuna; droyfimaka)

**Surinamese)**

Solanaceae *Solanum leucocarpon* Dual.

Solanaceae *Solanum macrocarpum* L.

Solanaceae *Solanum subinerme* Jacq.

Solanaceae *Solanum stramoniifolium* Jacq.

**Table 1.** Plants used for treating hypertension in Suriname.

**(Vernacular name in English; Surinamese)**

(Minnieroot; watrakanu)

(Mango; manya)

(Soursop; zuurzak)

(Coconut; kronto)

tioned publications [45–55]. The data are summarized in **Table 2**.

**Preclinical evidence**

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-men-

> **Clinical evidence**

**Part(s) used Mode of preparation**

Plant-Based Ethnopharmacological Remedies for Hypertension in Suriname

Leaves Macerated for herbal bath

Fresh fruits Cooked and eaten as a

Fresh fruits None; fresh fruit eaten

Leaves Infusion

**Presumed key active constituent(s)**

No No Unknown Decreased blood

Yes No Mangiferin Vasodilation;

Yes Yes 3-n-butylphthalide Vasodilation,

Yes Yes Phenolics, flavonoids Vasodilation;

oils

Yes No Alkaloids, essential

**Presumed mechanism of action**

lipid levels

Vasodilation

stimulated diuresis

stimulated diuresis

decreased blood lipid levels; stimulated diuresis

vegetable

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161

**hypertension**

**Family Plant species**

Acanthaceae *Ruellia tuberosa* L.

Anacardiaceae *Mangifera indica* L.

Annonaceae *Annona muricata* L.

Apiaceae *Apium graveolens* L.

Arecaceae *Cocos nucifera* L.

(Celery; soepgroente)

**Family Species**


**Table 1.** Plants used for treating hypertension in Suriname.

**Family Species**

160 Herbal Medicine

Passifloraceae *Passiflora cocciea* Aubl.

Phytolaccaceae *Microtea debilis* Sw.

Piperaceae *Piper betle* L.

Piperaceae *Piper marginatum* Jacq.

Poaceae *Eleusine indica* L.

Rhamnaceae *Ziziphus jujuba* L.

Rubiaceae *Sipanea pratensis* Aubl.

Sapindaceae *Paullinia pinnata* L.

Scrophulariaceae *Scoparia dulcis* L.

Simarubaceae *Quassia amara* L.

Siparunaceae *Siparuna guianensis* Aubl.

Solanaceae *Physalis angulata* L.

Sapotaceae *Chrysophyllum cainito* L.

Poaceae *Zea mais* L.

**(Vernacular names in English;** 

(Scarlet passion flower; sneki

(Weak jumby pepper; eiwitblad)

(Pepper elder; konsakawiwiri)

(Swan spice; tinsensiwiwiri)

(Marigold pepper; aneysiwiwiri)

(Indian goosegrass; mangrasi)

(Betel; pahnblad)

(Maize; karu)

(Jujube; olijf)

(Water lagaga; wetibaka)

(Star apple; sterappel)

(Licorice weed; sibiwiwiri)

(Bitter wood; kwasibita)

(Ant bush; yarakopi)

(Angular winter cherry; batotobita)

(Bread and cheese; feyfifingawiwiri)

(Stonebreaker; finibita)

**Part(s) used Mode of preparation**

Infusion

drink

drink

Pressed to obtain sap to

Pressed to obtain sap to

Leaves and stem Infusion

Whole plant Infusion

Fresh or dried whole plant or leaves

Fresh leaves or whole

Fresh leaves or whole

Leaves Infusion

Leaves Infusion

Leaves Infusion

Ripe ears Decoction

Leaves Infusion

Leaves Infusion

Dried leaves Infusion

Aerial parts Infusion

Hard wood Infusion

Dried leaves Infusion

Leaves Pressed to obtain sap to drink

Aerial parts Macerated for herbal bath

plant

plant

**Surinamese)**

markusa)

Phyllanthaceae *Phyllanthus amarus* Schumach. & Thonn.

Piperaceae *Peperomia pellucida* (L.) Kunth.

Piperaceae *Peperomia rotundifolia* (L.) Kunth.
