High prevalence but lack of awareness of hypertension in South Africa, particularly among men and young adults.

Cardiovascular disease (CVD) is a leading cause of death in South Africa (SA) and high blood pressure (BP) is the primary risk factor. However, hypertension prevalence is high, BP control is poor and CV events occur at a younger age than in Europe or America. Increasing screening, raising awareness and improving management of hypertension are critical to prevent CVD in SA. May Measurement Month (MMM) is a global initiative of the International Society of Hypertension aimed at raising awareness of high BP. As part of the MMM campaign, in SA (2017, 2018, 2019 and 2021), BP measurements and a cross-sectional survey of volunteers aged ≥ 18years were performed. Of 11,320 individuals (age 36.6 ± 16.8years) screened, 29.7% had hypertension (systolic BP/diastolic BP ≥ 140/90 mmHg or antihypertensive medication use) and the prevalence was higher (p < 0.0001) in men (35.6%) than in women (26.3%). Of those with hypertension, only 54.3% were aware and 46.8% were receiving antihypertensive medication, and 53.7% of these had controlled BP. In men with hypertension, awareness (45.2%, treatment (38.2%) and controlled BP on antihypertensive medication (45.2%) were lower (p < 0.0001) than in women (awareness: 60.8%; treatment: 53.5%; controlled BP: 58.3%). In young participants (age < 40years), 15.6% had hypertension, 18.6% of these were on treatment but 76.0% were not aware, and only 57.7% had controlled BP. The high prevalence of hypertension, but low levels of awareness, treatment, and BP control in SA, especially in young adults and men, highlight the need for systematic BP screening programmes and improvements in education and management of hypertension.

An Overview of Vascular Dysfunction and Determinants: The Case of Children of African Ancestry.

The balance between dilatory and constrictive factors is important as it keeps blood vessels in a homeostatic state. However, altered physiological processes as a result of obesity, hypertension, oxidative stress, and other cardiovascular risk factors may lead to vascular damage, causing an imbalance of vasoactive factors. Over time, the sustained imbalance of these vasoactive factors may lead to vascular dysfunction, which can be assessed by non-invasive methods, such as flow-mediated dilation, pulse wave velocity, flow-mediated slowing, retinal vessel analysis, peripheral vascular reactivity, and carotid intima-media thickness assessment. Although there is increasing prevalence of cardiovascular risk factors (obesity and hypertension) in children in sub-Saharan Africa, little is known about how this may affect vascular function. This review focuses on vasoactive factors implicated in vascular (dys)function, highlighting the determinants and consequences of vascular dysfunction. It further describes the non-invasive methods used for vascular (dys)function assessments and, last, describes the impact of cardiovascular risk factors on vascular dysfunction in children of African ancestry.

Athrixia phylicoides tea infusion (bushman tea) improves adipokine balance, glucose homeostasis and lipid parameters in a diet-induced metabolic syndrome rat model.

BACKGROUND: Central obesity and insulin resistance are associated with metabolic syndrome (MetS) which is aggravated by diet and sedentary lifestyle. Athrixia phylicoides (AP) is reported by rural communities to have medicinal benefits associated with MetS such as obesity and type 2 diabetes. This study was aimed to investigate the effects of AP on diet-induced MetS in Wistar rats to validate its ethnopharmacological use. METHODS: AP was profiled for phytochemicals by LC-MS. After induction of MetS with high energy diet (HED), 30 male rats were divided into five treatment groups (n = 6): normal diet control, HED control, HED + AP 50 mg/Kg BW, HED + AP 100 mg/Kg BW and HED + 50 mg/Kg BW metformin. The rats were treated daily for 8 weeks orally after which weight gain, visceral fat, total cholesterol, free fatty acids (FFAs) and adipokine regulation; leptin: adiponectin ratio (LAR) were assessed. Also, glucose homeostatic parameters including fasting blood glucose (FBG), oral glucose tolerance test (OGTT), glucose transporter 4 (GLUT 4), insulin and homeostatic model assessment of insulin resistance (HOMA-IR) were determined. RESULTS: Findings showed that AP was rich in polyphenols. The HED control group showed derangements of the selected blood parameters of MetS. AP reversed diet-induced weight gain by reducing visceral fat, total blood cholesterol and circulating FFAs (p ≤ 0.05). Treatment with AP improved adipokine regulation depicted by reduced LAR (p<0.05). Treatment with AP improved parameters of glucose homeostasis as demonstrated by reduced FBG and HOMA-IR (p ≤ 0.05) and increased GLUT 4 (p<0.05). CONCLUSION: Athrixia phylicoides tea infusion was shown to possess anti-obesity and anti-inflammatory properties, improved glucose uptake and reduce insulin resistance in diet-induced MetS in rats which could be attributed to its richness in polyphenols. Therefore, AP could have potential benefits against type 2 diabetes and obesity which are components of MetS validating its ethnopharmacological use.

Relationship between Endothelial Function, Antiretroviral Treatment and Cardiovascular Risk Factors in HIV Patients of African Descent in South Africa: A Cross-Sectional Study.

Limited information on the effect of antiretroviral treatment (ART) on vascular function in South Africans of African descent living with human immunodeficiency virus (HIV) is available. The relationship between ART, vascular function and cardiovascular risk factors in South Africans of African ancestry with HIV was therefore studied. This cross-sectional study recruited 146 HIV-positive individuals on ART (HIV+ART+), 163 HIV-positive individuals not on ART (HIV+ART-) and 171 individuals without HIV (HIV-) in Mthatha, Eastern Cape Province of South Africa. Flow-mediated dilation (FMD) test was performed to assess endothelial function. Anthropometry and blood pressure parameters were measured. Lipid profile, glycaemic indices, serum creatinine as well as CD4 count and viral load were assayed in blood. Urinary albumin to creatinine ratio (ACR) was determined as a marker of cardiovascular risk. Obesity and albuminuria were positively associated with HIV, and HIV+ART+ participants had significantly higher HDL cholesterol. Dyslipidaemia markers were significantly higher in hypertensive HIV+ART+ participants compared with the controls (HIV+ART- and HIV- participants). FMD was not different between HIV+ART+ participants and the controls. Moreover, HIV+ART+ participants with higher FMD showed lower total cholesterol and LDL cholesterol comparable to that of HIV- and HIV+ART- participants. A positive relationship between FMD and CD4 count was observed in HIV+ART+ participants. In conclusion, antiretroviral treatment was associated with cardiovascular risk factors, particularly dyslipidaemia, in hypertensive South Africans of African ancestry with HIV. Although, ART was not associated with endothelial dysfunction, flow-mediated dilatation was positively associated with CD4 count in HIV-positive participants on ART.

Cardiovascular Risk Factors and Their Relationship with Vascular Dysfunction in South African Children of African Ancestry.

Vascular dysfunction is known to be an initiator of the development and progression of cardiovascular diseases (CVDs). However, there is paucity of information on the relationship of vascular dysfunction with cardiovascular risk factors in children of African ancestry. This study investigated the relationship between cardiovascular risk factors and vascular function in South African children of African ancestry. A cross-sectional study on 6-9-year-old children in randomly selected rural and urban schools of the Eastern Cape Province of South Africa was conducted. General anthropometric indices were measured, followed by blood pressure (BP) measurements. The pulse wave velocity (PWV) was measured using a Vicorder. Albumin to creatinine ratio (ACR), asymmetric dimethylarginine (ADMA), 8-hydroxy-2deoxyguanosine (8-OHdG) and thiobarbituric acid reactive substance (TBARS) were assayed in urine. Children from urban settings (10.8%) had a higher prevalence of overweight/obesity than their rural counterparts (8.5%) while the prevalence of elevated/high blood pressure was higher in rural (23.2%) than urban children (19.0%). Mean arterial blood pressure (MAP) and diastolic blood pressure (DBP) increased with increasing PWV (p < 0.05). Body mass index (BMI), diastolic blood pressure (DBP) and mean arterial blood pressure (MAP) positively associated (p < 0.05) with PWV. Creatinine, albumin and ACR significantly (p < 0.005) increased with increasing ADMA. ADMA associated positively (p < 0.05) with creatinine and 8-OHdG. In conclusion, vascular dysfunction was associated with obesity, high blood pressure, oxidative stress and microalbuminuria in South African children of African ancestry.

Gut permeability is associated with hypertension and measures of obesity but not with Endothelial Dysfunction in South African youth.

BACKGROUND: Though gut permeability has shown to be associated with measures of obesity and hypertension, its relationship with endothelial dysfunction, an early predictor for cardiovascular diseases remains unknown. OBJECTIVE: This study assessed the relationship between hypertension, measures of obesity, gut permeability and endothelial dysfunction. METHODS: A cross-sectional quantitative study which enrolled 151 South African youths was conducted. Anthropometric and blood pressure measurements were performed. Zonulin, a marker for gut permeability; adiponectin, an anti-inflammatory molecule, as well as asymmetric dimethylarginine (ADMA) and Nitric oxide (NO) which are markers for endothelialfunction were assayed. RESULTS: Approximately eighteen percent (17.88%) of the participants were hypertensive while 40.4% were pre-hypertensive. Adiponectin significantly increased in hypertensive subjects and negatively correlated (p<0.05) with measures of obesity but was not associated with gut permeability and endothelial dysfunction. Increased body mass index (BMI) and visceral fat (VF) predicted reduced adiponectin (inflammation). Zonulin was significantly higher (p<0.05) in hypertensive subjects and positively associated (p<0.05) with systolic blood pressure (SBP) in females. A positive relationship (p<0.05) was observed between zonulin and measurements of obesity. Moreover, zonulin negatively associated (p<0.05) with ADMA but positively associated (p<0.05) with NO in males. Increased VF and waist circumference predicted gut permeability. CONCLUSION: Gut permeability was associated with hypertension and measures of obesity but not with markers of endothelial dysfunction in a South African youth population.

The prevalence of pediatric metabolic syndrome-a critical look on the discrepancies between definitions and its clinical importance.

INTRODUCTION: The Metabolic Syndrome (MetS) describes the clustering of cardio-metabolic risk factors-including abdominal obesity, insulin resistance, elevated blood pressure, high levels of triglycerides, and low levels of high-density lipoproteins-that increase the risk for developing cardiovascular diseases and type 2 diabetes mellitus. However, a generally accepted definition of MetS in pediatric patients is still lacking. OBJECTIVES: The aim was to summarize current prevalence data of childhood MetS as well as to discuss the continuing disagreement between different pediatric definitions and the clinical importance of such diagnosis. METHODOLOGY: A systematic literature search on the prevalence of pediatric MetS was conducted. Articles that were published during the past 5 years (2014-2019), using at least one of four predetermined classifications (International Diabetes Federation, Cook et al., Ford et al., and de Ferranti et al.), were included. RESULTS: The search resulted in 1167 articles, of which 31 publications met all inclusion criteria. DISCUSSION: The prevalence of MetS ranged between 0.3 and 26.4%, whereby the rising number of children and adolescents with MetS partly depended on the definition used. The IDF definition generally provided the lowest prevalences (0.3-9.5%), whereas the classification of de Ferranti et al. yielded the highest (4.0-26.4%). In order to develop a more valid definition, further research on long-term consequences of childhood risk factors such as abdominal obesity, insulin resistance, hypertension, and dyslipidemia is needed. There is also a temptation to suggest one valid, globally accepted definition of metabolic syndrome for pediatric populations but we believe that it is more appropriate to suggest definitions of MetS that are specific to males vs. females, as well as being specific to race/ethnicity or geographic region. Finally, while this notion of definitions of MetS specific to certain subgroups is important, it still needs to be tested in future research.

Association of Hypertension and Obesity with Risk Factors of Cardiovascular Diseases in Children Aged 6-9 Years Old in the Eastern Cape Province of South Africa.

Cardiovascular disease (CVD) risk factors are known to begin early in life, but limited data on the relationship of obesity and hypertension with other known CVD risk factors, such as endothelial dysfunction, oxidative stress, and chronic low-grade inflammation is available on children. In this cross-sectional study involving 6-9 years old school children aged from the Eastern Cape Province of South Africa the relationship between obesity/hypertension and other risk factors for CVDs was investigated. General anthropometric parameters were measured, followed by blood pressure (BP) measurements and pulse wave velocity (PWV). Urine samples were collected for the determination of albumin, creatinine, asymmetric dimethylarginine (ADMA), 8-hydroxy-2deoxyguanosine (8-OHdG), and thiobarbituric acid-reactive substance (TBARS). Overweight/obesity (19.28%) and pre-hypertension/hypertension (42.16%) were prevalent in children. Mid-upper arm circumference (MUAC), a marker of obesity, was positively correlated with ADMA, while ADMA and PWV were significantly different (p < 0.05) between hypertensive and normotensive children. Also, TBARS and 8-OHdG were significantly (p < 0.05) increased in hypertensive subjects. Creatinine was significantly (p < 0.05) increased in obese, as well as in hypertensive children, and positively associated with waist circumference (WC) and neck circumference (NC). In conclusion, obesity and hypertension were associated with renal-cardiovascular disease risk, while oxidative stress showed a possible association with obesity in 6 to 9 year old South African children of African descent. This suggests that South African children of African descent may be becoming more prone to developing CVDs, and therefore may require early intervention for the prevention of CVDs in the near future.

In Vitro and In Vivo Antioxidant Properties of Taraxacum officinale in Nω-Nitro-l-Arginine Methyl Ester (L-NAME)-Induced Hypertensive Rats.

Oxidative stress has gained attention as one of the fundamental mechanisms responsible for the development of hypertension. The present study investigated in vitro and in vivo antioxidant effects of 70% ethanol-water (v/v) leaf and root extracts of T. officinale (TOL and TOR, respectively). Total phenolic and flavonoid content of plant extracts were assessed using Folin Ciocalteau and aluminium chloride colorimetric methods; while, 2,2-diphenyl-1-picrlhydrazyl (DPPH), 2,2-azinobis (3-ethylbenzothiazoline-6-sulfonic acid (ABTS) and ferric reducing antioxidant power (FRAP) protocols were used to determine the free radical scavenging and total antioxidant capacities (TAC), respectively. The in vivo total antioxidant capacity and malondialdehyde acid (MDA) levels for lipid peroxidation tests were performed on organ homogenate samples from Nω-nitro-L-arginine methyl ester (L-NAME)-induced hypertensive rats treated with leaf extract, TOL (500 mg/kg/day) and TOR (500 mg/kg/day) for 21 days. Results showed that compared to TOR, TOL possessed significantly higher (p < 0.01) polyphenol (4.35 ± 0.15 compared to 1.14 ± 0.01) and flavonoid (23.17 ± 0.14 compared to 3 ± 0.05) content; free radical scavenging activity (EC50 0.37 compared to 1.34 mg/mL) and total antioxidant capacities (82.56% compared to 61.54% ABTS, and 156 ± 5.28 compared to 40 ± 0.31 FRAP) and both extracts showed no toxicity (LD50 > 5000 mg/kg). TOL and TOR significantly (p < 0.01) elevated TAC and reduced MDA levels in targets organs. In conclusion, T. officinale leaf extract possesses significant anti-oxidant effects which conferred significant in vivo antioxidant protection against free radical-mediated oxidative stress in L-NAME-induced hypertensive rats.

Semisynthesis of Derivatives of Oleanolic Acid from Syzygium aromaticum and Their Antinociceptive and Anti-Inflammatory Properties.

Oleanolic acid is a pentacyclic triterpenoid compound widely found in plants and well known for its medicinal properties. Oleanolic acid (OA) was isolated from the ethyl acetate extract of Syzygium aromaticum flower buds. Semisynthesis afforded both acetate and ester derivatives. The derived compounds were monitored with thin layer chromatography and confirmed with nuclear magnetic resonance (NMR) spectroscopy, mass spectrometry (MS), Fourier infrared (FT-IR) spectroscopy, and melting point (Mp). All these compounds were evaluated for their analgesic and anti-inflammatory properties at a dose of 40 mg/kg. Significant analgesic and anti-inflammatory effects were noted for all OA-derived compounds. In the formalin-induced pain test, the derivatives showed better analgesic effects compared to their precursor, whereas, in the tale flick test, oleanolic acid proved to be superior in analgesic effects compared to all its derivatives with the exception of the acetyl derivative. Acute inflammatory tests showed that acetyl derivatives possessed better anti-inflammatory activity compared to the other compounds. In conclusion, semisynthesis of oleanolic acid yielded several derivatives with improved solubility and enhanced analgesic and anti-inflammatory properties.

Synthesis of Silver Nanoparticles Using Buchu Plant Extracts and Their Analgesic Properties.

We herein report for the first time the synthesis and analgesic properties of silver nanoparticles (Ag-NPs) using buchu plant extract. The as-synthesised Ag-NPs at different temperatures were characterised by UV-Vis spectroscopy, Fourier transform infra-red spectroscopy (FTIR) and transmission transform microscopy (TEM) to confirm the formation of silver nanoparticles. Phytochemical screening of the ethanolic extract revealed the presence of glycosides, proteins, tannins, alkaloids, flavonoids and saponins. The absorption spectra showed that the synthesis is temperature and time dependent. The TEM analysis showed that the as-synthesised Ag-NPs are polydispersed and spherical in shape with average particle diameter of 19.95 ± 7.76 nm while the FTIR results confirmed the reduction and capping of the as-synthesised Ag-NPs by the phytochemicals present in the ethanolic extract. The analgesic study indicated that the combined effect of the plant extract and Ag-NPs is more effective in pain management than both the aspirin drug and the extract alone.

Prevalence of hypertension and pre-hypertension in 13-17 year old adolescents living in Mthatha - South Africa: a cross-sectional study.

BACKGROUND: Hypertension is one of the most common risk factors for cardiovascular diseases (CVDs), yet not much effort is being invested in early diagnosis and control of the condition in susceptible children. The aim of this study was to,investigate the prevalence of pre-hypertension and hypertension in peri-urban school-attending adolescents and explore the relationship between blood pressure and selected anthropometric measurements. METHODS: A cross-sectional study of adolescents aged 13-17 years was performed. Data on height, weight, waist and hip circumferences as well as blood pressure were collected from all participants. Body mass index (BMI) and blood pressure percentiles were calculated. Results: The overall prevalence of obesity was 20.4% while the prevalence of hypertension and pre-hypertension was 21.2% and 12.3%, respectively. The prevalence of hypertension and pre-hypertension in males was 22.0% and 13.6% compared to 20.9% and 16.5% in females, respectively. Both conditions were associated with higher BMI in both girls and boys. While mean systolic blood pressure (SBP) was positively associated with higher BMI and waist circumference (WC) in males and females, it correlated negatively with hip circumference (HC) in males. On the other hand, mean diastolic blood pressure (DBP) correlated better with HC in males but only weakly in females. CONCLUSION: Adolescent learners in Mthatha had a high prevalence of hypertension and pre-hypertension which were associated with overweight and obesity. Results highlight the urgent need for screening in view of early detection and implementation of intervention strategies to prevent a high incidence of CVDs in this country.

Association of waist and hip circumferences with the presence of hypertension and pre-hypertension in young South African adults.

BACKGROUND: Obesity is one of the most important risk factors for cardiovascular diseases (CVDs) including hypertension (HT) which is itself a risk factor for CVDs. Recent studies suggest that waist circumference (WC) may be more sensitive than Body Mass Index (BMI) in determining individual risk scores for CVDs. OBJECTIVES: The current study aimed at investigating the influence of various anthropometric variables on blood pressure status in a group of students from Walter Sisulu University. METHODS: Informed consent was obtained from 216 male and female students from Walter Sisulu University with a mean age of 22.1±0.2 years. Anthropometric measurements were performed for each participant. Blood pressure was measured in triplicates after 10 minutes of rest and the average computed. RESULTS: Just over 46% of the subjects were diagnosed with hypertension (HT) and pre-HT. The gender specific prevalence of HT/pre-HT was higher in the male (76.7%) compared to the female (30.5%) group. Waist circumference (WC) and total body fat (TBF) correlated significantly with blood pressure and HT/pre-HT in females but not males. ROC analysis showed that with the exception of waist-to-hip (WHR), all other anthropometric measurements and ratios studied can be used to discriminate blood pressure in young adult females not males. CONCLUSION: Increased WC and HC were associated with HT and pre-HT in young adult females in the Walter Sisulu University.

Chemical composition and anti-inflammatory activities of the essential oils from Acacia mearnsii de Wild.

The volatile oils of the leaves and the stem bark of Acacia mearnsii de Wild obtained by hydro-distillation were analysed by gas chromatography-mass spectrometry. A total of 20, 38, 29 and 38 components accounted for 93.8%, 92.1%, 78.5% and 90.9% of the total oils of the fresh, dry leaves and fresh, dry stem bark, respectively. The major components of the oil were octadecyl alcohol (25.5%) and phytol (10.5%); cis-verbenol (29.5%); phytol (10.1%) and phytol (23.4%) for the fresh leaves, dried leaves, fresh stem, dry stem bark, respectively. Oral administration of essential oils at a dose of 2% showed significant (p < 0.05) anti-inflammatory properties in the albumin-induced test model in rats. Oils from the fresh leaves and dry stems inhibited inflammation beyond 4 h post treatment. The potent anti-inflammatory activity of essential oils of A. mearnsii hereby confirmed its traditional use in treating various inflammatory diseases.

Anti-inflammatory and membrane-stabilizing properties of two semisynthetic derivatives of oleanolic acid.

Acetylation and methylation semisynthesis of oleanolic acid (OA) isolated from Syzygium aromaticum L. yielded two compounds: 3-acetoxyoleanolic acid (3-AOA) and 3-acetoxy, 28-methylester oleanolic acid (3-A,28-MOA). Anti-inflammatory properties of these compounds were assessed using the serotonin and fresh egg albumin-induced inflammatory test models in male Wistar rats weighing 250-300 g. Furthermore, erythrocyte membrane-stabilizing property of these compounds was evaluated in the heat- and hypotonicity-induced in vitro hemolysis test models. The two semisynthetic compounds significantly (p < 0.05) inhibited albumin-induced inflammation better than OA and indomethacin from 1-5 h post administration. Both compounds were membrane stabilizing in heat-induced hemolysis test while only 3-AOA showed membrane-stabilizing effects in a hypotonic milieu. Semisynthesis of OA yielded two compounds which had better in vivo anti-inflammatory and in vitro membrane-stabilizing properties.

In vivo and in vitro estrogenic activity of extracts from Erythrina poeppigiana (Fabaceae).

In developing countries, around 80% of the population still resorts on traditional medicine for their primary health care. Erythrina poeppigiana (Walp.) O.F. Cook, one of these medicinal plants, was found to be particularly rich in isoflavonoids which exhibited, individually, significant estrogenic activity in vitro. The possible combined effects of these bioactive isoflavones, as they are naturally found in the crude extracts of E. poeppigiana, prompted us to assess their in vivo estrogenicity. We first tested the ability of the extracts to transactivate estrogen receptor alpha (ERα) in vitro using U2OS human osteosarcoma cells. We next investigated their effects in vivo in an uterotrophic assay, using ovariectomized rats treated with the extracts at the doses of 50, 100, 200, and 400 mg/kg BW/d orally for 3 days. Finally, we assessed their ability to relieve hot flushes, using data loggers. At the end of treatments, animals were sacrificed, and organs (mammary glands, vagina, and uteri) were collected for histo-morphometric analyses. The methanol extract significantly and dose-dependently transactivated ERα at all tested doses. All extracts induced significant increases of vaginal and uterine epithelial heights. Only the dichloromethane extract could significantly relieve hot flushes as estradiol. These results indicate that E. poeppigiana extracts have estrogen-like effects in vivo, suggesting that its active principles act in synergy when they are taken in combination in the crude extract. These findings, therefore, support the traditional use of E. poeppigiana to alleviate some menopausal problems; our previous phytochemical investigations contribute to the standardization of this phytomedicine.

Investigation of the antinociceptive and anti-inflammatory properties of Heteromorpha arborescens (Apiaceae).

Heteromorpha arborescens belongs to the family Apiaceae. It is commonly known as the parsley tree. One of its uses in the Eastern Cape Province of South Africa is for the treatment of abdominal pains. The therapeutic effects of the methanolic and aqueous root extracts of H. arborescens were investigated at two dose levels respectively on experimental models of pain and inflammation in rodents. The antinociceptive activity was evaluated using the hot-plate, abdominal constriction and formalin tests. The anti-inflammatory properties of these extracts were assessed using albumin and carrageenan as phlogistic agents. Both extracts produced significant (P<0.05, P<0.01) inhibition of thermal nociception induced by a hot plate. On chemical nociception induced by intraperitoneal acetic acid and subplantar formalin injection, both extracts significantly (P<0.05, P<0.01) decreased the number of writhing episodes and the licking time in a dose dependent manner. Treatment with the extracts at the same doses produced a significant (P<0.05, P<0.01) pain inhibition of the carrageenan induced inflammatory pain. Similarly, both extracts produced a significant (P<0.05, P<0.01) reduction of edema induced by albumin and carrageenan. These results suggest that both extracts of H. arborescens may act by inhibition of the mediators of inflammation. These findings seem to justify the use of the plant in traditional medicine in the management of pain and inflammation related diseases.