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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Rustom Jal Vakil returned to India in 1938 after earning his medical degree from the University of London and focused on the treatment of heart ailments at a time when cardiology was not a distinct subspecialty in India. In 1949, after years of scrupulous collation and analysis of data, he published a watershed paper on the antihypertensive properties of Rauwolfia serpentina and effected a paradigm shift in the management of hypertension. Rauwolfia was the world's 1st successful blood-pressure-lowering agent, and its acceptance encouraged research scientists to pursue the development of other hypotensive drugs. Vakil was a prolific researcher whose contributions to Indian cardiovascular epidemiology--and to the whole of medical literature--were enormous. He was also a fine clinician with a remarkable gift for communication, be it with his patients, students, peers, or the lay public. All of this came together to make him the embodiment of a medically competent India.
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PMID:Rustom Jal Vakil: his contributions to cardiology. 1687 18

Reserpine, the purified alkaloid of Rauwolfia serpentina, was the first potent drug widely used in the long-term treatment of hypertension. Rauwolfia serpentina is a tropical woody plant of the Apocyanaceae family ingenious to Asia, South America and Africa. Extracts of its different parts and of plants resembling to rauwolfia were used in Hindu medicine for snakebite, insomnia, insanity and many other diseases and complaints. In Europe, Georg Eberhard Rumpf first reported about rauwolfia in his Herbarium amboinense, 1755. The first modern paper about therapeutic applications of the whole root of rauwolfia was published in 1931 in the Indian Medical Journal by Sen and Bose, and many papers dealing with botanics, chemistry and pharmacology then appeared in Indian and European periodics. In 1949, Vakil published the first report of the antihypertensive effect of rauwolfia in the British Heart Journal. In the Ciba laboratories in Basel, Switzerland, Mueller, Schlittler and Bein analysed various rauwolfia alkaloids and published in 1952 the first complete report about their chemistry and pharmacology. In the same year, reserpine was introduced under the name Serpasil in the treatment of hypertension, tachycardia and thyreotoxicosis. The combination of reserpine, dihydroergocristine and a diuretic is still on the market (Brinerdin, Crystepin). In psychiatry, reserpine was prescribed as a tranqulizing agent until modem synthetic antidepressant and antipsychotic drugs were introduced. The author also briefly summarizes the chemistry, pharmacology and clinical use of reserpine.
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PMID:[Milestones of cardiovascular therapy. IV. Reserpine]. 1772 43

Dr Rustom Jal Vakil was India's pioneer in cardiology. He introduced the discipline of cardiology in his country. His mixture of clinical acumen, research and writing has survived him. Through his work with an ancient Indian folk remedy, Rauwolfia serpentina, he ushered in the modern era of effective pharmacotherapy of hypertension. His work was particularly significant since it galvanized other workers into finding more effective agents for the treatment of hypertension. He is remembered fondly by his acquaintances as an unassuming man in whom a multitude of choicest qualities blended seamlessly with each other.
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PMID:Rustom Jal Vakil and the saga of Rauwolfia serpentina. 1817 58

Rauwolfia serpentina is a safe and effective treatment for hypertension. The plant was used by many physicians throughout India in the 1940s and then was used throughout the world in the 1950s, including in the United States and Canada. It fell out of popularity when adverse side effects, including depression and cancer, became associated with it. This author reviews the scientific literature with regard to the use of Rauwolfia and the treatment of hypertension. The author reviews the plant's botany, chemistry, and pharmacology and provides a researched and documented method of action for the active ingredients. With special emphasis on the plant's role in treating high blood pressure, the author looks at medical uses of the plant, critically examining its adverse side effects, toxicology, and carcinogenicity. The author refutes the association between the plant and carcinogenicity and discusses the importance of correct dosing and of screening patients to minimize the occurrence of depression. He concludes with the recommendation of use of low dose Rauwolfia (LDR) for suitable patients with hypertension. The plant provides clinicians with a safe and effective adjunct to pharmaceuticals in the treatment of high blood pressure.
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PMID:Rauwolfia in the Treatment of Hypertension. 2677 Jan 46

Rauwolfia species (Apocynaceae) are medicinal plants well known worldwide due to its potent bioactive monoterpene indole alkaloids (MIAs) such as reserpine, ajmalicine, ajmaline, serpentine and yohimbine. Reserpine, ajmalicine and ajmaline are powerful antihypertensive, tranquilizing agents used in hypertension. Yohimbine is an aphrodisiac used in dietary supplements. As there is no report on the comparative and comprehensive phytochemical investigation of the roots of Rauwolfia species, we have developed an efficient and reliable liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for ethanolic root extract of Rauwolfia species to elucidate the fragmentation pathways for dereplication of bioactive MIAs using high-performance liquid chromatography coupled with electrospray ionization quadrupole time-of-flight tandem mass spectrometry (HPLC-ESI-QTOF-MS/MS) in positive ion mode. We identified and established diagnostic fragment ions and fragmentation pathways using reserpine, ajmalicine, ajmaline, serpentine and yohimbine. The MS/MS spectra of reserpine, ajmalicine, and ajmaline showed C-ring-cleavage whereas E-ring cleavage was observed in serpentine via Retro Diels Alder (RDA). A total of 47 bioactive MIAs were identified and characterized on the basis of their molecular formula, exact mass measurements and MS/MS analysis. Reserpine, ajmalicine, ajmaline, serpentine and yohimbine were unambiguously identified by comparison with their authentic standards and other 42 MIAs were tentatively identified and characterized from the roots of Rauwolfia hookeri, Rauwolfia micrantha, Rauwolfia serpentina, Rauwolfia verticillata, Rauwolfia tetraphylla and Rauwolfia vomitoria. Application of LC-MS followed by principal component analysis (PCA) has been successfully used to discriminate among six Rauwolfia species.
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PMID:Structural characterization of monoterpene indole alkaloids in ethanolic extracts of Rauwolfia species by liquid chromatography with quadrupole time-of-flight mass spectrometry. 2940 5

Rauwolfia serpentina has a wide range of therapeutic effects so this study was planned to explore the antihypertensive and antihyperlipidemic therapeutic responses of R serpentina doses using albino rats by measuring the blood pressure, biochemical parameters, and histological architecture of liver and kidney tissues. Thirty albino rats were divided into 5 groups (n = 6) as G1 (normal Control) received normal diet, G2 (positive control) received only 8% NaCl added diet (high salt diet); G3 was given atenolol (standard drug control) 50 mg/kg body weight, G4 and G5 groups were given methanolic plant extract as low dose (100 mg/kg body weight) and high dose (200 mg/Kg body weight) daily along with high salt diet for 4 weeks, respectively. Rauwolfia serpentina significantly (P < .05) decreased the blood pressure in G4 and G5 groups as compared to G2 and G3. Significant (P < .05) impact was reported, on serum lipid profile and serum proteins as well as hepatoprotective and renoprotective potential on studying tissues sections under microscope, in animal groups given herbal extract as compared to control groups. It could be concluded that R serpentina has therapeutic effect to manage the hypertension and hypercholesterolemia most probably via protecting the liver and renal architectures.
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PMID:Antihypertensive and Antihyperlipidemic Activity of Aqueous Methanolic Extract of Rauwolfia Serpentina in Albino Rats. 3278 48