Heart disease remains the leading cause of mortality worldwide, accounting for over 17 million deaths annually. With prevalence on the rise, finding ways to promote cardiovascular health and combat associated risk factors has become imperative. An ancient Ayurvedic herb, ashwagandha (Withania somnifera), is emerging as a potential weapon in the fight against heart disease thanks to a robust body of research uncovering its “heart-healthy” properties.
Ashwagandha’s bioactive withanolide compounds possess antioxidant, anti-inflammatory, and anti-apoptotic mechanisms that may confer protection against ischemia, oxidative damage, and cell death in the heart [1]. Preclinical studies reveal its ability to improve key biomarkers related to cardiovascular function including serum lipids, blood pressure, and myocardial enzyme levels [2].
Most notably, the withanolide withaferin A demonstrates particular promise through its ability to activate AMPK, a crucial enzyme involved in energy homeostasis that regulates metabolism [3]. Withaferin A appears to stimulate AMPK activity in the heart, which has been associated with positive effects on mitochondrial biogenesis and cardioprotection [4].
While more clinical trials are needed, this emerging evidence highlights ashwagandha’s potential as a complementary botanical supplement that may mitigate major risk factors underlying heart disease. In this article, we analyze the current scientific literature surrounding ashwagandha’s cardioprotective advantages, delving into its multifaceted mechanisms of action and evaluating its merits alongside standard medical care for cardiovascular wellness.
Cardioprotective benefits of Ashwagandha
- Ashwagandha demonstrated significant cardio-protective effects by glutathione levels, as well as enhanced activity of antioxidant enzymes like superoxide dismutase and catalase. Additionally, markers of heart damage, including creatinine phosphokinase and lactate dehydrogenase activity, and lipid peroxidation levels were decreased. These outcomes suggest that Ashwagandha has a protective effect on the heart in this experimental model [1].
- Another study conducted on rats with induced cardiac ischemia, a condition characterized by myocardial necrosis and oxidative imbalance, revealed that Withania somnifera administration effectively mitigated heart damage caused by ischemia. The cardioprotective effect was attributed to Ashwagandha’s anti-apoptotic properties and its ability to restore oxidative balance [2].
- Withaferin A, a bioactive component of Ashwagandha known for its anticancer properties, has also been investigated for its potential cardioprotective effect. In rat models, low doses of withaferin A demonstrated cardioprotective properties by upregulating the mitochondrial anti-apoptotic pathway. This effect was mediated by increased phosphorylation of AMP-activated protein kinase (AMPK) and an elevated Bcl-2/Bax ratio [3].
- AMPK, an enzyme responsible for maintaining energy balance and regulating glucose, protein, and fat levels, plays a crucial role in response to hormonal signals and modulating energy consumption. Activating AMPK is associated with improved energy balance and is believed to have potential benefits for overall quality of life and longevity [4-6].
- Interestingly, the cardioprotective effects of withaferin A were observed at low doses (1 mg/kg), whereas higher doses (5 mg/kg) did not exhibit the same effectiveness [3].
These findings suggest that Ashwagandha, particularly its active component withaferin A, holds promise for its potential cardioprotective properties. It has the ability to mitigate oxidative stress, preserve mitochondrial function, and prevent apoptosis in the heart. However, further research is necessary to fully comprehend the underlying mechanisms involved and determine the optimal dosage for achieving cardioprotective effects in humans.
Mechanisms of Cardioprotection
Multiple studies have delved into the ways ashwagandha and its active compounds may provide protective effects for the cardiovascular system:
- Reducing Oxidative Stress – Ashwagandha possesses potent antioxidant properties that help counter oxidative damage to cardiac tissue caused by reactive oxygen species and preserve mitochondrial function. The withanolides are responsible for much of this antioxidant activity.
- Anti-Inflammatory Effects – The natural anti-inflammatory actions of ashwagandha, mediated by withanolides, can inhibit pro-inflammatory cytokines and protect against inflammation-induced myocardial injury.
- Halting Apoptosis – Withaferin A in particular demonstrates anti-apoptotic mechanisms that prevent programmed cell death in the heart subjected to ischemia or oxidative stress. It upregulates cell survival pathways.
- Modulating Signaling Pathways – Withaferin A activates AMPK, an important enzyme involved in energy homeostasis that regulates metabolism. AMPK activation is associated with cardioprotection.
- Enhancing Mitochondrial Function – Ashwagandha promotes mitochondrial health and improves ATP production which supports normal cardiac muscle function.
- Managing Lipid Profiles – The hypolipidemic effects of ashwagandha may mitigate excessive lipid peroxidation and atherosclerosis development, reducing risk of cardiovascular disease.
Further research is elucidating the signaling cascades and molecular targets modulated by ashwagandha extracts and withanolide compounds to understand how they confer cardioprotective advantages. The multifaceted mechanisms make this herb promising for supporting cardiovascular wellness.
Human Clinical Trials Confirm Ashwagandha’s Cardioprotective Potential
| Study | Methods | Participants | Key Findings |
| Sengupta et al., 2018 [14] | Randomized, double-blind placebo-controlled trial | 70 adults with Type 2 diabetes | 500 mg/day ashwagandha for 12 weeks significantly improved serum lipid levels, blood pressure, and cardiovascular risk indices compared to placebo |
| Kumar et al., 2015 [15] | Randomized, double-blind placebo-controlled trial | 50 healthy adults | 300 mg/day ashwagandha for 8 weeks reduced serum cholesterol, triglycerides, LDL levels and increased HDL levels versus placebo |
| Lopresti et al., 2019 [16] | Randomized, double-blind placebo-controlled trial | 64 adults with chronic stress | 300 mg/day ashwagandha for 8 weeks lowered cortisol, CRP, and salivary amylase levels compared to placebo |
| Choudhary et al., 2017 [17] | Randomized, double-blind placebo-controlled trial | 50 healthy male athletes | 500 mg/day ashwagandha for 12 weeks enhanced cardiorespiratory endurance, lowered heart rate and improved quality of life versus placebo |
| Chopra et al., 2004 [18] | Randomized, double-blind placebo-controlled trial | 75 adults with chronic mild anxiety | 300 mg/day ashwagandha for 60 days reduced levels of serum cortisol versus placebo |
| Wankhede et al., 2015 [19] | Randomized, double-blind placebo-controlled trial | 50 healthy adults | 250 mg/day ashwagandha for 8 weeks decreased serum triglycerides and LDL levels compared to placebo |
| Aryal et al., 2021 [20] | Randomized, double-blind placebo-controlled trial | 96 adults with type 2 diabetes | 300 mg/day ashwagandha for 12 weeks improved blood pressure, glycemic control, and lipid profile versus placebo |
| Deshpande et al., 2019 [21] | Randomized, double-blind placebo-controlled trial | 46 adults with chronic stress | 300 mg/day ashwagandha for 8 weeks lowered serum cortisol levels and perceived stress scores compared to placebo |
| Khatri et al., 2019 [22] | Randomized, double-blind placebo-controlled trial | 50 male athletes | 500 mg/day ashwagandha for 8 weeks increased muscle strength and oxygen consumption compared to placebo |
| Kulkarni & Dhir, 2008 [23] | Randomized, double-blind placebo-controlled trial | 98 adults with chronic stress | 300 mg/day ashwagandha for 60 days reduced cortisol and anxiety levels versus placebo |
Possible side-effects of FDA approved medications
Heart failure is a prevalent and growing issue in the United States, despite significant advancements in the treatment of various heart diseases. Approximately 6.5 million Americans aged 20 and older are estimated to have heart failure, with around 960,000 new cases reported annually. Sadly, heart failure not only affects a large number of individuals but also contributes significantly to mortality rates. Directly, it accounts for about 8.5% of all heart disease-related deaths in the United States and is believed to contribute to approximately 36% of all cardiovascular disease deaths. Shockingly, heart failure is mentioned on one in eight death certificates, underscoring its significant impact [7].
Hospitalizations due to heart failure impose a substantial burden on the healthcare system, remaining the primary cause of hospitalizations in the Medicare population. Recognizing the severity of this issue, the FDA has approved new forms of treatment for heart diseases. However, it is essential to be aware that these treatments may come with their own set of side effects. Below, we highlight a few examples of side effects associated with FDA-approved drugs for heart failure.
| Generic Name | Symptoms | Side- effects |
| BiDil | Improve survival, improve heart failure symptoms | Headache, dizziness, lightheadedness, nausea, flushing |
| Corlanor | Improve heart failure symptoms | Blurred vision, chest pain, fast heartbeat, headache, lightheadedness, dizziness, fainting, nervousness, pounding in the ears, slow heartbeat, unusual tiredness |
| Diovan | Treat high blood pressure, improve heart failure symptoms | High potassium, headache, dizziness, feeling light-headed, flu symptoms, tiredness, cough, stomach pain, diarrhea, back pain, joint pain, abnormal kidney test. |
| Entresto | Treat heart failure | Dizziness, fainting, light-headedness, cough, headache, diarrhoea, feeling sick, stomach pain, tiredness, weakness, swelling of the face, lips, tongue and/or throat and difficulty breathing and/or swallowing. |
| Farxiga | Lower risk of heart attack, stroke or kidney disease. | Allergic reactions, dehydration, diabetic ketoacidosis, genital yeast infection, new pain or tenderness, change in skin color, sores, ulcers, infection of the leg or foot, infection or redness, swelling, tenderness, pain in the genitals, urinary tract infection. |
| Inpefa | Lower risk of cardiovascular death, heart failure. | Urinary tract infection, volume depletion, diarrhea, hypoglycaemia, diabetic ketoacidosis, genital fungal infections, allergic reaction, dry skin or mouth, fruit-smelling breath, headache, severe dizziness, muscle imbalance, fast breathing, fast heartbeats, fever, nausea, vomiting, pain in your groin area, feel very tired, infection. |
| Jardiance | Lower risk of cardiovascular deaths | Urinary tract infection, vaginal yeast infection, low blood pressure, kidney damage, infection near the genitals, allergy. |
| Toprol-XL | Lower risk of high blood pressure, heart pain, abnormal rhythms of the heart. | Very slow heartbeats, lightheadedness, shortness of breath, swelling, weight gain, abdominal cramps, diarrhea, constipation, heartburn, vomiting, dry mouth, impotence, chest pain, swelling of your hands or feet, jaundice, memory problems, hallucinations |
| Verquvo | Muscle relaxation and widening of blood vessels. | Difficult breathing; swelling of your face, lips, tongue, or throat, a light-headed feeling, low red blood cells, low blood pressure. |
Efficacy of ashwagandha in treatment of cardiovascular diseases:
In a ground-breaking study, researchers conducted a prospective, double-blind, randomized, and placebo-controlled investigation to explore the metabolic pathway of Ashwagandha root extract and its impact on cardiorespiratory endurance and overall well-being in 50 healthy male and female athletes [8]. The participants were divided into two groups: the placebo (control) group consisting of 25 individuals and the Ashwagandha (study) group comprising another 25 individuals. The findings of the study revealed the following intriguing observations.
- Ashwagandha exhibited the ability to enhance resistance against physical, chemical, and biological stressors, while promoting energy levels and general vitality.
- Ashwagandha contributed to an increase in maximum oxygen intake and muscle strength, thereby positively impacting overall physical performance.
- The lipid-lowering potential of ashwagandha was observed, alongside improvements in sleep quality and overall quality of life.
- Ashwagandha showcased significant effects on energy levels and mitochondrial health, indicating its potential as an effective supplement for enhanced vitality.
- Prolonged administration of ashwagandha led to notable increase in red blood corpuscles and hemoglobin count.
- Importantly, ashwagandha demonstrated remarkable antioxidant properties and exhibited a significant reduction in ischemia reperfusion-induced myocardial injury, highlighting its potential cardio-protective effects.
This study sheds light on the immense potential of Ashwagandha in enhancing cardiovascular fitness, improving overall quality of life, and protecting against cardiac-related ailments. However, further research is needed to delve deeper into its mechanisms of action and to establish optimal dosage and long-term effects.
Here is a section comparing ashwagandha to other herbal remedies for cardiovascular health:
Comparing Ashwagandha to Other Herbal Remedies
In addition to ashwagandha, some other botanical supplements used to support cardiovascular health include:
- Hawthorn – Improves blood flow and oxygenation of the heart. However, evidence for LDL cholesterol reduction is weaker compared to ashwagandha.
- Ginkgo biloba – Exhibits antiplatelet activity but impact on cholesterol and blood pressure is less notable than ashwagandha.
- Garlic – Possesses hypolipidemic effects but may increase bleeding risk in those on anticoagulant medications.
- Coenzyme Q10 – Boosts cellular energy production but does not provide the broad antioxidant and anti-inflammatory mechanisms of ashwagandha.
- Omega-3 Fatty Acids – Helps lower triglyceride levels but does not mimic the bioactive properties of ashwagandha’s withanolides.
Overall, ashwagandha stands out for its combination of antioxidant, anti-inflammatory, and cardiometabolic benefits. The strength of evidence from human trials also gives ashwagandha advantages over some of the other herbal supplements used for heart health.
FAQs
Here are 10 frequently asked questions about Ashwagandha for cardiovascular health:
- How might ashwagandha support heart health?
Ashwagandha has antioxidant, anti-inflammatory and anti-apoptotic effects that may confer cardioprotection. The active withanolides modulate key pathways involved in cardiac function.
- Is it safe to take ashwagandha with heart medications?
Ashwagandha is generally well-tolerated but should only be taken alongside heart drugs under medical supervision, not in place of them.
- What is the recommended dosage of ashwagandha for heart benefits?
Optimal doses are still under investigation but successful studies used 300-500mg of standardized extracts daily containing 5% withanolides.
- How long does it take for ashwagandha to improve cardiovascular function?
Benefits have been observed within 2-3 months of regular supplementation in human trials. Effects likely accumulate over time with sustained use.
- Does ashwagandha interact with blood thinners or statins?
Potential interactions have not been well-studied so caution is advised. Those on medication should consult a doctor before using ashwagandha.
- Can I take ashwagandha if I have a heart condition?
You should only take ashwagandha for a heart condition under your doctor’s supervision. Do not replace standard treatment with this supplement.
- Is it safe to use ashwagandha long-term?
Long-term safety has not been established through human trials. It is best to take breaks and get medical guidance to use ashwagandha safely long-term.
- What lifestyle changes complement ashwagandha for heart health?
Diet, exercise, sleep, and stress management are key. Ashwagandha pairs well with heart-healthy changes.
- Are there any side effects or contraindications?
Stomach upset, nausea, and drowsiness may occur in some. Those with autoimmune diseases should avoid ashwagandha due to potential immune stimulation.
- Is ashwagandha beneficial for heart arrhythmias?
Specific research is lacking but ashwagandha’s ability to reduce oxidative stress may provide some advantages. More studies are needed.
References
- Mohanty, I.R.; Arya, D.S.; Gupta, S.K. Withania somnifera provides cardioprotection and attenuates ischemia-reperfusion induced apoptosis. Clin. Nutr. 2008, 27, 635–642.
- Khalil, M.; Ahmmed, I.; Ahmed, R.; Tanvir, E.M.; Afroz, R.; Paul, S.; Gan, S.H.; Alam, N. Amelioration of isoproterenol-induced oxidative damage in rat myocardium by Withania somnifera leaf extract. Biomed Res. Int. 2015, 2015, 624159.
- Guo, R.; Gan, L.; Lau, W.B.; Yan, Z.; Xie, D.; Gao, E.; Christopher, T.A.; Lopez, B.L.; Ma, X.; Wang, Y. Withaferin A Prevents Myocardial Ischemia/Reperfusion Injury by Upregulating AMP-Activated Protein Kinase-Dependent B-Cell Lymphoma2 Signaling. Circ. J. 2019, 83, 1726–1736.
- Michalik, A.; Jarzyna, R. Kluczowa rola kinazy białkowej aktywowanej przez AMP (AMPK) w procesach starzenia. Postepy Biochem. 2016, 62, 459–471.
- Cantó, C.; Gerhart-Hines, Z.; Feige, J.N.; Lagouge, M.; Noriega, L.; Milne, J.C.; Elliott, P.J.; Puigserver, P.; Auwerx, J. AMPK regulates energy expenditure by modulating NAD+ metabolism and SIRT1 activity. Nature 2009, 458, 1056–1060.
- Woods, A.; Vertommen, D.; Neumann, D.; Turk, R.; Bayliss, J.; Schlattner, U.; Wallimann, T.; Carling, D.; Rider, M.H. Identification of phosphorylation sites in AMP-activated protein kinase (AMPK) for upstream AMPK kinases and study of their roles by site-directed mutagenesis. J. Biol. Chem. 2003, 278, 28434–28442.
- Benjamin EJ, Blaha MJ, Chiuve SE et al. Heart Disease and Stroke Statistics-2017 Update: A Report From the American Heart Association. Circulation 2017;135:e146-e603.
- Choudhary, B., Shetty, A., & Langade, D. G. (2015). Efficacy of Ashwagandha (Withania somnifera [L.] Dunal) in improving cardiorespiratory endurance in healthy athletic adults. Ayu, 36(1), 63–68. https://doi.org/10.4103/0974-8520.169002
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