A Review of Plants Used in South African Traditional Medicine for the Management and Treatment of Hypertension

Abstract

South Africa contains 9% of the worldʼs higher plants, and despite its rich biodiversity, it has one of the highest prevalence of hypertension in Africa. This review provides information on medicinal plants embraced in South Africa for hypertension management, with the aim of reporting pharmacological information on the indigenous use of these plants as antihypertensives. This review not only focuses on the activity of antihypertensive medicinal plants but also reports some of its phytochemical constituents and other ethnopharmacological and therapeutic properties. Information obtained from scientific and or unpublished databases such as Science Direct, PubMed, SciFinder, JSTOR, Google Scholar, Web of Science, and various books revealed 117 documented antihypertensive plant species from 50 families. Interestingly, Asteraceae topped the list with 16 species, followed by Fabaceae with 8 species; however, only 25% of all plant species have demonstrated antihypertensive effects originating from both in vitro and in vivo studies, lending credence to their folkloric use. Only 11 plant species reportedly possess antihypertensive properties in animal models, with very few species subjected to analytical processes to reveal the identity of their bioactive antihypertensive compounds. In this review, we hope to encourage researchers and global research institutions (universities, agricultural research councils, and medical research councils), particularly those showing an interest in natural products, for the need for concerted efforts to undertake more studies aimed at revealing the untapped potential of these plants. These studies are very important for the development of new pharmaceuticals of natural origin useful for the management of hypertension.

Key words

Amaryllidaceae - antihypertensive - Apiaceae - Asteraceae - Cucurbitaceae - Fabaceae - high blood pressure - Lamiaceae - medicinal plants - Rutaceae - South Africa

• References

• 1 Naish J, Court DS. Medical Sciences. 2nd ed.. Amsterdam: Elsevier; 2014
• 2 Poulter NR, Prabhakaran D, Caulfield M. Hypertension. Lancet 2015; 386: 801-812
• 3 James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, Lackland DT, Lefevre ML, Mackenzie TD, Ogedegbe O, Smith SC, Svetley LP, Taler SJ, Townsend RR, Wright JT, Narva AS, Ortiz E. 2014 Evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA 2014; 311: 507-520 doi:10.1001/jama.2013.284427
• 4 Akinkugbe OO. The Nigerian hypertension programme. J Hum Hypertens 1996; 10: 543-546
• 5 Oates JA, Brown JA. Anthihypertensive Agents and the Drug Therapy of Hypertension. In: Hardman JG, Limbird LE. eds. Goodman and Gilmanʼs the Pharmacological Basis of Therapeutics. 10th ed. New York: McGraw-Hill Medical Publishing Division; 2001: 871-896
• 6 Bradshaw D, Steyn K, Levitt N, Nojilana B. Non-communicable Diseases in South Africa – A Race Against Time. Cape Town: Medical Research Council; 2011. Available at: http://www.health.uct.ac.za/usr/health/research/groupings/cdia/downloads/MRC_policy_brief.pdf Accessed July 1, 2018
• 7 Seedat YK. Control of hypertension in South Africa: time for action. SAMJ 2012; 102: 25-26
• 8 Ibrahim MM, Damasceno A. Hypertension in developing countries. Lancet 2012; 380: 611-619
• 9 Opie LH, Seedat YK. Hypertension in sub-Saharan African populations. Circulation 2005; 112: 3562-3568
• 10 NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in blood pressure from 1975 to 2015: a pooled analysis of 1479 population-based measurement studies with 19·1 million participants. Lancet 2017; 389: 37-55
• 11 Bradshaw D, Groenewald P, Laubscher R, Nannan N, Nolilana B, Norman R, Pieterse D, Schneider M, Bourne DE, Timaeus I, Dorrington R, Johnson L. Initial burden of disease estimates for South Africa, 2000. SAMJ 2003; 93: 682-688
• 12 Health24. Hypertension. Available at: https://www.health24.com/Medical/Hypertension/Faqs/What-is-the-prevalence-of-hypertension-20130205 Accessed July 4, 2018
• 13 Norman R, Gaziano T, Laubscher R, Steyn K, Bradshaw D. Estimating the burden of disease attributable to high blood pressure in South Africa 2000. SAMJ 2007; 97: 692-698
• 14 Leiter LA, Abbott D, Campbell NR, Mendelson R, Ogilvie RI, Chockalingcam A. Lifestyle modifications to prevent and control hypertension. Recommendations on obesity and weight loss. Canadian Hypertension Society, Canadian Coalition for High Blood Pressure Prevention and Control, Laboratory Centre for Disease Control at Health Canada, Heart and Stroke Foundation of Canada. CMAJ 1999; 160 (9 Suppl): S7-S12
• 15 Dickson B, Harvas S. Reducing the population burden of cardiovascular disease by reducing sodium intake: a report of the council on science and public health. Arch Intern Med 2007; 167: 1460-1468
• 16 Landazuri P, Chamorro NL, Cortes BP. Medicinal plants used in the management of hypertension. J Anal Pharm Res 2017; 5: 00134
• 17 Kiriyama A, Honbo A, Nishimura A, Shibata N, Iga K. Pharmacokinetic-pharmacodynamic analyses of antihypertensive drugs, nifedipine and propranolol, in spontaneously hypertensive rats to investigate characteristics of effect and side effects. Regul Toxicol Pharmacol 2016; 76: 21-29
• 18 Ramesar S, Baijnath H, Govender T, Mackraj H. Angiotensin I-converting enzyme inhibitor activity of nutritive plants in KwaZulu-Natal. J Med Food 2008; 11: 331-336
• 19 WHO. Traditional Medicine: Definitions. Available at: http://www.who.int/medicines/areas/traditional/definitions/en/index.html Accessed July 15, 2017
• 20 WHO. The World Health Report 2008: Primary Health Care. Available at: http://www.who.int/whr/2008/whr08_en.pdf Accessed July 15, 2017
• 21 Lambert G. Sympathetic nerve biology in essential hypertension. Clin Exp Pharmacol Physiol 2001; 28: 986-989
• 22 Nunes MGS, Bernardino A, Martins RD. Use of medicinal plants by people with hypertension. Rev da Rede Enferm do Nord 2015; 16: 775-781
• 23 Van Wyk BE, Gericke N. Peopleʼs Plants, a Guide to useful Plants of Southern Africa. Pretoria: Briza Publications; 2000
• 24 Van Wyk B, Van Oudshoorn B, Gericke N. Medicinal Plants of South Africa. Pretoria: Briza Publications; 1997
• 25 Watt JM, Breyer-Brandwijk MG. The Medicinal and poisonous Plants of Southern and Eastern Africa. London: Livingstone; 1962
• 26 Hutchings A, Scott AH, Lewis G, Cunningham AB. Zulu medicinal Plants: An Inventory. Pietermaritzburg: University of Natal Press; 1996
• 27 Thring TSA, Weitz FM. Medicinal plant use in the Bredasdorp/Elim region of the Southern Overberg in the Western Cape Province of South Africa. J Ethnopharmacol 2006; 103: 261-275
• 28 Moffett RO. Sesotho Plant and Animal Names and Plants used by the Basotho. Bloemfontein: Sun Press; 2010
• 29 Olorunnisola OS, Bradley G, Afolayan AJ. Ethnobotanical information on plants used for the management of cardiovascular diseases in Nkonkobe Municipality. S Afr J Med Plants Res 2011; 5: 4256-4260
• 30 Moteetee A, van Wyk BE. The medical ethnobotany of Lesotho. Bothalia 2011; 5: 209-228
• 31 Semenya S, Potgieter M, Tshisikhawe M, Shava S, Maroyi A. Medicinal utilization of exotic plants by Bapedi traditional healers to treat human ailments in Limpopo province, South Africa. J Ethnopharmacol 2012; 144: 646-655
• 32 De Wet H, Ramulondi M, Ngcobo ZN. The use of indigenous medicine for the treatment of hypertension by a rural community in northern Maputaland, South Africa. S Afr J Bot 2016; 103: 78-88
• 33 Davids D, Gibson D, Johnson Q. Ethnobotanical survey of medicinal plants used to manage high blood pressure and type 2 diabetes mellitus in Bitterfontein, Western Cape Province, South Africa. J Ethnopharmacol 2016; 194: 755-766
• 34 Duncan AC, Jäger AK, van Staden J. Screening of Zulu medicinal plants for angiotensin converting enzyme (ACE) inhibitors. J Ethnopharmacol 1999; 68: 63-70
• 35 Monterrosas-Brisson N, Arenas Ocampo ML, Jiménez-Ferrer E, Jiménez-Aparicio AR, Zamilpa Gonzalez-Cortazar M, Tortoriello J, Herrera-Ruiz M. Anti-Inflammatory activity of different Agave plants and the compound Cantalasaponin-1. Molecules 2013; 18: 8136-8146
• 36 Mannasaheb BAA, Kulkarni PV, Sangreskopp MA, Savant C, Mohan A. Protective effect of Agave americana Linn. leaf extract in acetic acid-induced ulcerative colitis in rats. Ayu 2015; 36: 101-106
• 37 Hutchings DE, Fico TA, Dow-Edwards DL. Prenatal cocaine: maternal toxicity, fetal effects and locomotor activity in rat offspring. Neurotoxicol Teratol 1989; 11: 65-69
• 38 Wintola OA, Afolayan AJ. Alepidea amatymbica Eckl. & Zeyh.: a review of its traditional uses, phytochemistry, pharmacology and toxicology. Evid Based Complement Alternat Med 2014; 2014: 284517
• 39 Tesfaye A, Mengesha W. Traditional uses phytochemistry and pharmacological properties of garlic (Allium Sativum) and its biological active compounds. Int J Scientific Res Sci Eng Technol 2015; 1: 142-148
• 40 Corzo-Martinez M, Corzo N, Villamiel M. Biological properties of onion and garlic. Trends Food Sci Technol 2007; 18: 609-625
• 41 Borborah K, Dutta B, Borthakur SK. Traditional uses of Allium L. species from North East India with special reference to their pharmacological activities. AJPCT 2014; 2: 1037-1051
• 42 Eidi A, Eidi M, Esmaeili E. Antidiabetic effect of garlic (Allium sativum L.) in normal and streptozotocin-induced diabetic rats. Phytomed 2006; 13: 624-629
• 43 Grubben GJH, Denton OA. eds. Plant Resources of tropical Africa 2. Vegetables. Leiden, Netherlands/CTA, Wageningen, Netherlands: PROTA Foundation, Wageningen, Netherlands/Backhuys Publishers; 2004: 72-76
• 44 Sama K, Sivaraj R, Abdul Salam H, Rajiv P. Pharmacognostical and phytochemical screening of Asystasia gangetica . Intl Res J Pharm 2013; 4: 161-163
• 45 Pradeep Kumar R, Sujatha D, Mohamed Saleem TS, Madhusudhana Chetty C, Ranganayakulu D. Potential hypoglycemic and hypolipidemic effect of Morus indica and Asystasia gangetica in alloxan induced diabetes mellitus. Int J Pharm Sci 2010; 1: 51-56
• 46 Mugabo P, Raji IA. Effects of aqueous leaf extract of Asystasia gangetica on the blood pressure and heart rate in male spontaneously hypertensive Wistar rats. BMC Complement Altern Med 2013; 13: 283
• 47 Chhetri BK, Awadh Ali NA, Setzer WN. A survey of chemical compositions and biological activities of Yemeni aromatic medicinal plants. Medicines 2015; 2: 67-92
• 48 Al-Hebshi NN, Skaug N. Khat (Catha edulis) – an updated review. Addict Biol 2005; 10: 299-307
• 49 Keglevich P, Hazai L, Kalaus G, Szántay C. Modifications on the basic skeletons of vinblastine and vincristine. Molecules 2012; 17: 5893-5914
• 50 Nisar A, Mamat AS, Hatim MI, Aslam MS, Ahmad MS. An updated review on Catharanthus roseus: phytochemical and pharmacological analysis. Ind Res J Pharm Sci 2016; 3: 632-653
• 51 Naznin A, Mamunar R, Shah Amran MD. Comparison of hypotensive and hypolipidemic effects of Catharanthus roseus leaves extract with atenolol on adrenaline induced hypertensive rats. Pakistan J Pharm 2009; 22: 267-271
• 52 Kabubii ZA, Mbaria JM, Mbaabu M. Acute toxicity studies of Catharanthus roseus aqueous extract in male Wistar rats. Afr J Pharmacol Ther 2015; 4: 130-134
• 53 Sujitha MV, Kannan S. Green synthesis of gold nanoparticles using citrus fruits (Citrus limon, Citrus reticulata and Citrus sinensis) aqueous extract and its characterization. Spectrochim Acta A Mol Biomol Spectrosc 2012; 102: 15-23
• 54 Sidana J, Saini V, Dahiya S, Nain P, Bala S. A review on citrus – the boon of nature. Int. J Pharm Sci Rev Res 2013; 18: 20-27
• 55 Vijaylakshmi P, Radha R. An overview: Citrus maxima . J Phytopharmacol 2015; 4: 263-267
• 56 Oboh G, Bello FO, Ademosun AO. Hypocholesterolemic properties of grapefruit (Citrus paradisii) and Shaddock (Citrus maxima) juices and inhibition of angiotensin-1-converting enzyme activity. J Food Drug Anal 2014; 22: 477-484
• 57 Arbab IA, Ahmad BA, Mohamed A, Rasedee A, Siddig IA, Mohamed YI, Landa ZA. A review of traditional uses, phytochemical and pharmacological aspects of selected members of Clausena genus (Rutaceae). J Med Plants Res 2012; 6: 5107-5118
• 58 Ojewole JAO. Hypoglycaemic effect of Clausena anisata (Willd) Hook methanolic root extract in rats. J Ethnopharmacol 2002; 81: 231-237
• 59 Lechaba NMT, Schutte PJ, Hay L, Böhmer L, Govender MM. The effects of an aqueous leaf extract of Clausena anisata (Willd.) Hook.f.ex Benth. on blood pressure, urine output, angiotensin II levels and cardiac parameters in spontaneously hypertensive rats. J Med Plants Res 2016; 10: 425-434
• 60 Cao Z, Yang P, Zhou Q. Multiple biological functions and pharmacological effects of lycorine. Sci China Chem 2013; 56: 1382-1391
• 61 Dictionary of Natural products (DNP) on CD-ROM. London: Chapman and Hall; 1996
• 62 Persson KG, Burger AP, Mugabo P, Green I. In vivo Effects of Crinum macowanii on the Rat cardiovascular System [Dissertation]. Western Cape: University of Western Cape; 2007
• 63 Mugabo P, Philander A, Raji I, Dietrich D, Green I. Effects of hippadine on the blood pressure and heart rate in male spontaneously hypertensive Wistar rats. J Ethnopharmacol 2014; 158: 123-131
• 64 Mugabo P, Obikeze K, Njagi A, Burger A, Dietrich D, Green I. Cardiovascular effects of the alkaloid hippadine on the isolated perfused rat heart. Int J Med Aromatic Plants 2014; 2: 172-177
• 65 Pujol J. Naturafrica – The Herbalist Handbook. Durban: Jean Pujol Natural Healersʼ Foundation; 1990
• 66 Reid KA, Jager AK, Van Staden J. Pharmacology and phyto-chemical properties of Dombeya rotundifolia . S Afr J Bot 2001; 67: 349-353
• 67 Ndwigah SN, Thoithi GN, Mwangi JW, Kibwage IO. Constituents of the stem bark of Dombeya rotundifolia Hochst. East Central Afr J Pharm Sci 2005; 8: 40-42
• 68 Kamadyaapa DR, Gondwe MM, Moodley K, Ojewole JAO, Musabayane CT. Cardiovascular effects of Ekebergia capensis Sparrm [Maliaceae] ethanolic leaf extract in experimental animal paradigms. Cardiovasc J Afr 2009; 20: 162-167
• 69 Musabayane CT. The effects of medicinal plants on renal function and blood pressure in diabetes mellitus. Cardiovasc J Afr 2012; 23: 462-468
• 70 Fitzpatrick DF, Hirschfield SL, Ricci T, Jantzen P, Coffey RG. Endothelium-dependent vasorelaxation caused by various plant extracts. J Cardiovas Pharmacol 1995; 26: 90-95
• 71 Somova LI, Nadar A, Rammanan P, Shode FO. Cardiovascular, antihyperlipidemic and antioxidant effects of oleanolic and ursolic acids in experimental hypertension. Phytomed 2003; 10: 115-121
• 72 Singh P, Mishra A, Singh P, Goswami S, Singh A, Tiwari KD. Hypertension and herbal plants for its treatment: a review. Ind J Res Pharm Biotechnol 2015; 3: 358-366
• 73 Ochwang DO, Kimwele CN, Oduma JA, Gathumbi PK, Mbaria JM, Kiama SG. Medicinal plants used in treatment and management of cancer in Kakamega County, Kenya. J Ethnopharmacol 2014; 151: 1040-1055
• 74 Balogun FO, Tshabalala NT, Ashafa AOT. Antidiabetic medicinal plants used by the Basotho tribe of Eastern Free State: a review. J Diabetes Res 2016; 2016: 4602820
• 75 Ojewole J, Kamadyaapa D, Musabayane C. Some in vitro and in vivo cardiovascular effects of Hypoxis hemerocallidea Fisch & CA Mey (Hypoxidaceae) corm (African potato) aqueous extract in experimental animal models. Cardiovasc J S Afr 2006; 17: 166-171
• 76 Deepak M, Dipankar G, Prashanth D, Asha MK, Amit A, Venkataraman BV. Tribulosin and β-sitosterolD-glucoside, the anthelmintic principles of Tribulus terrestris . Phytomed 2002; 9: 753-756
• 77 Thakur GS, Bag M, Sanodiya BS, Bhadauriya M, Debnath M, Prasad GBKS, Bisen PS. Momordica balsamina: a medicinal and neutraceutical plant for health care management. Curr Pharm Biotechnol 2009; 10: 667-682
• 78 Wang L, Waltenberger B, Pferschy W, Eva M, Blunder M, Liu X, Malainer C, Blazevic T, Schwaiger S, Rollinger JM, Heiss EH, Schuster D, Kopp B, Bauer R, Stuppner H, Dirsch VM, Atanasov AG. Natural product agonists of peroxisome proliferator-activated receptor gamma (PPARγ): a review. Biochem Pharmacol 2014; 92: 73-89
• 79 Kumar DS, Sharathnath KV, Yogeswaran P, Harani A, Sudhakar K, Sudha P, Banji D. A medicinal potency of Momordica charantia . Int J Pharmaceut Sci Review Res 2010; 1: 95-100
• 80 Gupta M, Sharma S, Gautam AK, Bhadauria R. Momordica charantia Linn. (karela): natureʼs silent healer. Int J Pharm Sci Rev Res 2013; 11: 32-37
• 81 Chopra RN, Nayar SL, Chopra IC. Glossary of Indian medicinal Plants (Including the Supplement). New Delhi: Council of Scientific and Industrial Research; 1986
• 82 Ismail M. Central properties and chemical composition of Ocimum basilicum essential oil. Pharm Biol 2006; 44: 619-626
• 83 Miraj S, Sadegh K. Study of pharmacological effect of Ocimum basilicum: a review. Der Pharmacia Lett 2016; 8: 276-280
• 84 Hashmi MA, Afsar K, Muhammad H, Umar F, Perveen S. Traditional uses, phytochemistry, and pharmacology of Olea europaea (Olive). Evid Based Complement Alternat Med 2015; 2015: 541591
• 85 Santos Díaz MD, de la Rosa AB, Héliès-Toussaint C, Guéraud F, Nègre-Salvayre A. Opuntia spp.: characterization and benefits in chronic diseases. Oxid Med Cell Longev 2017; 2017: 8634249
• 86 Kaur M, Kaur A, Sharma R. Pharmacological actions of Opuntia ficus indica: a review. J Appl Pharm Sci 2012; 2: 15-18
• 87 Yasir M, Das S, Kharya MD. The phytochemical and pharmacological profile of Persea americana Mill. Pharmacogn Rev 2010; 4: 77-84
• 88 Tcheghebe TO, Nyamen LD, Tatong NF, Seukep AJ. Ethnobotanical uses, phytochemical and pharmacological profiles, and toxicity of Persea americana Mill.: an overview. Pharmacol Online 2016; 215: 213-221
• 89 Mosa RA, Lazarus GG, Gwala PE, Oyedeji AO, Opoku AR. In vitro anti-platelet aggregation, antioxidant and cytotoxic activity of extracts of some Zulu medicinal plants. J Nat Prod 2011; 4: 136-146
• 90 Mabhida SE, Mosa RA, Penduka D, Osunsanmi FO, Dludla PV, Djarova TG, Opoku AR. A lanosteryl triterpene from Protorhus longifolia improves glucose tolerance and pancreatic beta cell ultrastructure in type 2 diabetic rats. Molecules 2017; 22: E1252
• 91 Gutiérrez RM, Mitchell S, Solis RV. Psidium guajava: a review of its traditional uses, phytochemistry and pharmacology. J Ethnopharmacol 2008; 117: 1-27
• 92 Díaz-de-Cerio E, Verardo V, Gómez-Caravaca AM, Fernández-Gutiérrez A, Segura-Carretero A. Health effects of Psidium guajava L. leaves: an overview of the last decade. Int J Mol Sci 2017; 18: 1-31
• 93 Ojewole JAO. Hypoglycaemic and hypotensive effects of Psidium gajava Linn. (Myrtaceae) leaf aqueous extract. Methods Find Exp Clin Pharmacol 2005; 27: 689
• 94 Ramoulondi M. Toxicology and herb-drug Interaction of selected anti-hypertension Plants used by lay Persons in northern KwaZulu-Natal (South Africa) [Dissertation]. KwaZulu-Natal: University of Zululand; 2017
• 95 Milugo T, Omosa L, Ochanda J, Owuor B, Wamunyokoli F, Oyugi J, Ochieng J. Antagonistic effect of alkaloids and saponins on bioactivity in the Quinine Tree (Rauvolfia Caffra Sond.): further evidence to support biotechnology in traditional medicinal plants. BMC Complement Altern Med 2013; 13: 285-290
• 96 Mlala S, Oyedeji OO, Nkeh-Chungag BN. Chemical Constituents and biological Studies of Tagetes minuta L. and Rauvolfia caffra Sond. [Dissertation]. Eastern Cape: University of Forte Hare, South Africa; 2014
• 97 Bruneton J. Pharmacognosy, Phytochemistry, medicinal Plants. Hamshire: Intercept; 1995
• 98 Ojewole JA. Analgesic, anti-inflammatory and hypoglycaemic effects of Rhus chirindensis (Baker F.) [Anacardiaceae] stem-bark aqueous extract in mice and rats. J Ethnopharmacol 2007; 113: 338-345
• 99 Ojewole JAO, Mawoza T, Chiwororo WDH, Owira PMO. Sclerocarya birrea (A. Rich) Hochst. [‘Marula’] (Anacardiaceae): a review of its phytochemistry, pharmacology and toxicology and its ethnomedicinal uses. Phytother Res 2010; 24: 633-639
• 100 Ojewole JA. Analgesic, antiinflammatory and hypoglycemic effects of Sutherlandia frutescens R. BR. (variety Incana E. MEY.) [Fabaceae] shoot aqueous extract. Methods Find Exp Clin Pharmacol 2004; 26: 409
• 101 Ojewole JAO. Vasorelaxant and hypotensive effects of Sclerocarya birrea (A Rich) Hochst (Anacardiaceae) stem bark aqueous extract in rats. Cardiovasc J S Afr 2006; 17: 117-123
• 102 Nair JJ, van Staden J. Isolation and quantification of the toxic methylazoxymethanol glycoside macrozamin in selected South African cycad species. S Afr J Bot 2012; 82: 108-112
• 103 Moodley K, Joseph K, Naidoo Y, Islam S, Mackraj I. Antioxidant, antidiabetic and hypolipidemic effects of Tulbaghia violacea Harv. (wild garlic) rhizome methanolic extract in a diabetic rat model. BMC Complement Altern Med 2015; 15: 408
• 104 Raji I, Mugabo P, Obikeze K. Effect of Tulbaghia violacea on the blood pressure and heart rate in male spontaneously hypertensive Wistar rats. J Ethnopharmacol 2012; 140: 98-106
• 105 Raji I, Obikeze K, Mugabo P. Comparison of the acute effects of Tulbaghia violacea William Henry Harvey (Alliaceae) on blood pressure and heart rate of ageing male normotensive Wistar kyoto rats and adult male spontaneously hypertensive rats. Trop J Pharm Res 2016; 15: 2429-2434
• 106 Kuglerova M, Tesarova H, Grade JT, Halamova K, WanyanaMaganyi O, Van Damme P, Kokoska L. Antimicrobial and antioxidative effects of Ugandan medicinal barks. Afr J Biotechnol 2011; 10: 3628-3632
• 107 Mulholland DA, Monkhe TV, Coombes PH, Rajab MS. Limonoids from Turraea holstii and Turraea floribunda . Phytochem 1998; 49: 2585-2590
• 108 Mcfarland K, Mulholland DA, Fraser LA. Limonoids from Turraea floribunda (Meliaceae). Phytochem 2004; 65: 2031-2037
• 109 Mengistu M, Abebe Y, Mekonnen Y, Tolessa T. In vivo and in vitro hypotensive effect of aqueous extract of Moringa stenopetala . Afr Health Sci 2012; 12: 545-551
• 110 Department of Forestry and Fisheries, South Africa. Medicinal plants of South Africa; 2013. Available at: http://www.daff.gov.za/Daffweb3/Portals/0/Brochures and Production guidelines/Brochure Medical Plants Of South Africa.pdf Accessed June 8, 2017
• 111 Nciki S, Vuuren S, van Eyk A, de Wet H. Plants used to treat skin diseases in northern Maputaland, South Africa: antimicrobial activity and in vitro permeability studies. Pharm Biol 2016; 54: 2420-2436
• 112 Adedapo AA, Jimoh FO, Afolayan AJ, Masika PJ. Antioxidant activities and phenolic contents of the methanol extracts of the stems of Acokanthera oppositifolia and Adenia gummifera . BMC Complement Altern Med 2008; 8: 54
• 113 Paddy V, van Tonder JJ, Steenkamp V. In vitro antidiabetic activity of a polyherbal tea and its individual ingredients. Br J Pharmaceut Res 2015; 6: 389-401
• 114 Hikuam WC, Marnewick JL, Gelderblom WCA. Modulation of the redox Status, Phase 2 Drug metabolizing Enzymes and fumonisin-induced Cancer Promotion in Rat Liver by selected Southern African medicinal Plants [Dissertation]. Western Cape: Cape Peninsula University of Technology; 2014
• 115 Somova LI, Shode FO, Moodley K, Govender Y. Cardiovascular and diuretic activity of kaurene derivatives of Xylopia aethiopica and Alepidea amatymbica . J Ethnopharmacol 2001; 77: 165-174
• 116 Sunmonu TO, Afolayan AJ. Evaluation of the antidiabetic activity and associated toxicity of Artemisia afra aqueous extract in Wistar rats. Evid Based Complement Altern Med 2013; 2013: 929074
• 117 Sunmonu TO, Afolayan AJ. Protective effect of Artemisia afra Jacq. on isoproterenol-induced myocardial injury in Wistar rats. J Food Chem Toxicol 2010; 48: 1969-1972
• 118 Balogun FO, Ashafa AOT. Aqueous root extract of Dicoma anomala (Sond.) extenuates postprandial hyperglycaemia in vitro and its modulation on the activities of carbohydrate-metabolism enzymes in streptozotocin-induced diabetic Wistar rats. S Afr J Bot 2017; 112: 102-112
• 119 Balogun FO, Ashafa AOT. Antioxidant and hepatoprotective activities of aqueous root extracts of Dicoma anomala (Sond.) against carbon tetrachloride-induced liver damage in rats. J Trad Chin Med 2016; 36: 505-513
• 120 Deutschländer MS, van de Venter M, Roux S, Louwc J, Lall N. Hypoglycaemic activity of four plant extracts traditionally used in South Africa for diabetes. J Ethnopharmacol 2009; 124: 619-624
• 121 Deutschländer MS, Lall N, Van de Venter M, Dewanjee S. The hypoglycemic activity of Euclea undulata Thunb. var. myrtina (Ebenaceae) root bark evaluated in a streptozotocin-nicotinamide induced type 2 diabetes rat model. S Afr J Bot 2012; 80: 9-12
• 122 Jimoh FO, Adedapo AA, Afolayan AJ. Comparison of the nutritional value and biological activities of the acetone, methanol and water extracts of the leaves of Solanum nigrum and Leonotis leonorus . Food Chem Toxicol 2010; 48: 964-971
• 123 Ojewole JA. Antinociceptive, antiinflammatory and antidiabetic effects of Leonotis leonurus (L.) R. BR. [Lamiaceae] leaf aqueous extract in mice and rats. Methods Find Exp Clin Pharmacol 2005; 27: 257-264
• 124 Obikeze K, Mugabo P, Green I, Dietrich D, Burger A. Effects of a methanol fraction of the leaves of Leonotis leonurus on the blood pressure and heart rate of normotensive male Wistar rats. Intl J Med Health Pharm Biomed Eng 2013; 7: 266-269
• 125 Chadwick WA, Roux S, van de Venter M, Louw J, Oelofsen W. Anti-diabetic effect of Sutherlandia frutescens in Wistar rats fed a diabetogenic diet. J Ethnopharmacol 2007; 109: 121-127
• 126 Katerere DR, Graziani G, Thembo KM, Nyazema NZ, Alberto R. Antioxidant activity of some African medicinal and dietary leafy African vegetables. Afr J Biotechnol 2012; 11: 4103-4108
• 127 Odeleye OM. Investigation of chemical Constituents, antimicrobial and antioxidant Activities; and pharmacognostic Characters of the Leaves of Momordica foetida and Berkheya bergiana [Dissertation]. KwaZulu-Natal: University of Zululand, South Africa; 2010
• 128 van de Venter M, Roux S, Bungu LC, Louw J, Crouch NR, Grace OM, Maharaj V, Pillay P, Sewnarian P, Bhagwandin N, Folb P. Antidiabetic screening and scoring of 11 plants traditionally used in South Africa. J Ethnopharmacol 2008; 119: 81-86
• 129 Makhubu FN. Isolation of bioactive Compounds and in vitro Studies on Pentanisia prunelloides (Klotzsch ex Eckl. & Zeyh.) Walp. used in the eastern Free State for the Management of Diabetes mellitus [Dissertation]. Free State: University of the Free State, South Africa; 2017
• 130 Frum Y, Viljoen AM. In vitro 5-lipoxygenase and anti-oxidant activities of South African medicinal plants commonly used topically for skin diseases. Pharmacol Physiol 2006; 19: 329-335