International Journal of Clinical Case Reports 2024, Vol.14, No.5, 262-275 http://medscipublisher.com/index.php/ijccr 262 Research Report Open Access Hypotensive Effects of Eucommia ulmoides and its Mechanisms RanXin1, QinWang 2, Degang Zhao2,3 1 Key Laboratory of Cell Engineering of Guizhou Province, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, Guizhou, China 2 The Key Laboratory of Plant Resources Conservation and Germplasm Innovation in Mountainous Region (Ministry of Education), College of Life Sciences/Institute of Agro- Bioengineering,Guizhou University, Guiyang, 550025, Guizhou, China 3 Plant Conservation & Breeding Technology Center, Guizhou Key Laboratory of Agricultural Biotechnology/Biotechnology Institute of Guizhou Province, Guizhou Academy of Agricultural Sciences, Guiyang, 550006, Guizhou, China. Corresponding author: dgzhao@gzu.edu.cn International Journal of Clinical Case Reports 2024, Vol.14, No.5 doi: 10.5376/ijccr.2024.14.0027 Received: 30 Jul., 2024 Accepted: 02 Sep., 2024 Published: 04 Oct., 2024 Copyright © 2024 Xin et al., This is an open access article published under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Preferred citation for this article: Xin R., Wang Q., and Zhao D.G., 2024, Hypotensive effects of Eucommia ulmoides and its mechanisms, International Journal of Clinical Case Reports, 14(5): 262-275 (doi: 10.5376/ijccr.2024.14.0027) Abstract Eucommia ulmoides, a traditional Chinese medicinal herb, has been extensively studied for its hypotensive effects and underlying mechanisms. This study synthesizes findings from various studies to elucidate the antihypertensive properties of Eucommia ulmoides and its active components. Research indicates that Eucommia ulmoides lignans (EuL) significantly lower blood pressure in spontaneously hypertensive rats (SHRs) by modulating nitric oxide (NO) levels and the renin-angiotensin system (RAS), and by directly relaxing arterial vessels. Additionally, Eucommia ulmoides bark extract has been shown to reduce blood pressure and inflammation by regulating gut microbiota, particularly enriching the Parabacteroides strain, which contributes to its antihypertensive effects. The leaf extract, known as Tochu tea, and its component geniposidic acid, have also demonstrated blood pressure-lowering effects by improving renal hemodynamics and suppressing NADPH oxidase activity. Furthermore, lignan extracts fromEucommia ulmoides bark have been found to prevent hypertensive cardiac remodeling, likely through aldose reductase inhibition. These findings collectively highlight the potential of Eucommia ulmoides as a natural therapeutic agent for hypertension, acting through multiple mechanisms including vascular relaxation, modulation of gut microbiota, and inhibition of oxidative stress pathways. Keywords Eucommia ulmoides; Hypertension; Nitric oxide; Renin-angiotensin system; Gut microbiota 1 Introduction Hypertension, commonly known as high blood pressure, is a prevalent condition that significantly increases the risk of heart disease, stroke, and other health complications, these complications are develop over a longer period of exposure to high hypertension, consistent observational evidence suggests high BP is the leading cause of long-term consequences such as heart failure (Fuchs et al., 2020). It is a major public health issue worldwide, affecting millions of individuals and contributing to a substantial burden on healthcare systems. The management of hypertension often involves lifestyle modifications and pharmacological interventions, yet many patients struggle to achieve optimal blood pressure control, highlighting the need for alternative therapeutic strategies. Eucommia ulmoides, also known as the hardy rubber tree, has been utilized in traditional Chinese medicine for centuries. The bark of this tree, in particular, has been renowned for its medicinal properties, including its ability to treat hypertension. Historical texts and modern research alike have documented the use of Eucommia ulmoides extracts to improve cardiovascular health and manage high blood pressure (Li et al., 2013; Yan et al., 2022). The active compounds in Eucommia ulmoides, such as lignans, have been shown to exert various beneficial effects, including anti-inflammatory and antioxidant activities (Gu et al., 2011; Li et al., 2013). Geniposidic acid, an iridoid extracted from EU, lowers blood pressure by inhibiting the expression of NADPH oxidase, upregulating endothelial nitric oxide synthase, and improving renal plasma flow (Ishimitsu et al., 2021). Given the global impact of hypertension and the historical use of Eucommia ulmoides in traditional medicine, it is crucial to scientifically investigate the hypotensive effects of its extracts. Recent studies have begun to elucidate the mechanisms by which Eucommia ulmoides exerts its blood pressure-lowering effects. For instance, research has demonstrated that Eucommia ulmoides bark extract can reduce blood pressure and inflammation by regulating
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