Ingredients  of Shimbhala Heart Caps – clinical studies/Trials

Clinical Study-3

Terminalia arjuna – As an anti-ischemic agent

J Tradit Complement Med. 2014 Oct-Dec; 4(4): 224–231

doi:  10.4103/2225-4110.139103

PMCID: PMC4220499


This article has been selected from and cited by other articles in PMC


Arjuna bark from the Arjuna tree is a potential cardioprotective agent belonging to the Combretaceae family. It is an ayurvedic remedy that has been mentioned since pristine times in many ancient Indian medicinal texts

The bark has been described as an astringent, demulcent, expectorant, cardiotonic, styptic, antidysenteric, urinary astringent, and has shown to be useful in fracture, ulcers, leukorrhea, diabetes, anemia, cardiopathy, and cirrhosis.

In various clinical studies done Arjuna Effects on cardiac hemodynamics, coronary flow, and blood pressure have been recorded.

Bark stem of arjuna possesses diuretic, inotropic, and chronotropic properties

In the Langendorff’s rabbit heart preparation, the aqueous extract has demonstrated to cause an increase in the coronary flow. Confirming similar findings, recently, an experimental study showed that the aqueous extract of arjuna increased the force of contraction of cardiac muscle in the heart.

In a recent study the antioxidant and cardioprotective effect was observed of dried, pulverized arjuna bark augmenting endogenous antioxidant compounds of rat heart and preventing oxidative stress associated with ischemic–reperfusion injury of the heart.

In isoprenaline-induced myocardial ischemia (MI), arjuna has been found to possess prostaglandin E2-like activity with coronary vasodilatation and hypotension. The bark extract has shown to significantly prevent isoprenaline-induced increase in oxidative stress and decline in endogenous antioxidant level.Arjunolic acid has been found to prevent the decrease in the levels of superoxide dismutase, catalase, GPO, ceruloplasmin, α-tocopherol, reduced glutathione, ascorbic acid, lipid peroxide, and myeloperoxidase.

Detailed analysis of each subject in mid sample size revealed the bark extract exhibiting protective effects against doxorubicin-induced DNA damage and cardiotoxicity.

Kumar et al. showed that arjuna protects the heart against myocardial changes induced by chronic β-adrenoceptor stimulation.

Very recently, Mythili et al. confirmed the earlier findings that triterpenoids derived from arjunaextract containing arjunolic acid show cardioprotective activity by boosting endogenous antioxidant defense system.

Another study published in (Scientifica) Volume 2015 (2015), Article ID 138039,Concluded that “Terminalia arjuna bark powder has significant antioxidant action that is comparable to vitamin E. In addition, it also has a significant hypocholesterolaemic effect.”

Angina/myocardial infarction

The anti-ischemic effect of bark powder was evaluated in 30 patients of stable angina/post-infarct angina (500 mg tds). The authors observed that the mean anginal frequency decreased significantly, along with a significant decrease in systolic blood pressure (SBP), improvement in ECG changes, and reduction in plasma cortisol and serum cholesterol levels. In Cardiomyopathy, arjuna  reduced  LVM and improved  LVEF. A recent observational study revealed that when patients of dilated cardiomyopathy with reduced LVEF received arjuna in addition to their standard therapy, there was a significant improvement in left ventricular parameters as well as functional or physical tolerance capacity.


A sizeable  reduction in lipoprotein(a) levels as much as 44.71% following the administration of arjuna in a patient of β-thalassemia associated with hyper-lipoproteinemia and metabolic syndrome.

Endothelial dysfunction-In a double-blind, placebo-controlled, cross-over study involving 18 healthy male smokers and an equal number of age-matched non-smoker controls, it was observed that the hydroalcoholic extract of bark when given for 2 weeks led to significant regression of the endothelial abnormality amongst smokers.

Thrombotic condition-In a recent study done to investigate the in vitro thrombolytic and membrane-stabilizing action of arjuna, the methanol extract was found to possess significant thrombolytic activity (30.57%). It also greatly inhibited the hemolysis of RBCs in both hypotonic solution and heat-induced conditions. This showed that it has moderate thrombolytic activity.


The eternal interest in medicinal plants has led to the discovery of new chemical constituents and pharmacological actions of arjuna. Its efficacy as an anti-ischemic agent, a potent antioxidant, and an antiatherogenic agent has been amply demonstrated in various experimental and clinical studies. However, major lacunae of these studies include the lack of phytochemical standardization of the extract, bioavailability studies, and well-designed studies to evaluate its long-term toxicity effects