Ginkgo for stroke and heart diseases

Ginkgo leaves with the distinctive fan shape.

Ginkgo (Ginkgo biloba) is known as yin xing (银杏)in Chinese. The name literally means silver apricot although the plant is not related to apricot in any way. Ginkgo nuts are commonly used in Chinese dishes, such as congee or stew as well as in desserts. Due to the white shells covering the edible yellow ginkgo nuts within, it is also commonly called bai guo (白果) or white fruit.

Nutritionally, ginkgo nuts are low in calories compared to other tree nuts such as walnuts and almonds. They are a source of B-complex groups of vitamins such as riboflavin, niacin, thiamin, pantothenic acid, vitamin B-6, and folates. 7 Ginkgonuts also contain trace minerals include copper and iron [1]. The Ginkgonuts, however, should only be taken in small quantity since they have a small amount of poisonous substance called ginkgotoxin. Overconsumption can trigger vomiting and seizure [2]. To be safe, children should not eat more than 7 ginkgo nuts, whereas adults should consume below 40 nuts at any one time. With its mild toxicity, ginkgo nuts are used traditionally in Chinese medicine as a remedy for respiratory health (cooked) and antimicrobial agent (raw) [3].

Ginkgo nuts can be poisonous if overdose.

Ginkgo has been used in traditional Eastern cultures as food and medicine for thousands of years. It is the Europeans, however, who popularised its pharmaceutical use. Ginkgo leaf extract was first produced by the Germans in 1965. Still, the first commercially available extract registered for human use was only commercially available in France in 1974 [4]. Since then, ginkgo leaf extract has become one of the bestselling herbal remedies worldwide. Ginkgo leaf extract is popularly used to improve cognitive impairment and dementia, depression, and cardiovascular disease. It is also indicated for a variety of other conditions such as sexual dysfunction, vertigo, tinnitus, vitiligo, macular degeneration, glaucoma, and altitude sickness [5]. In here, we will discuss the use of Ginkgo leaf extract in reducing the risk of stroke and heart attack in more details.

Ginkgo leaf extract is a popular herbal supplement.

Ginkgo leaf extract can be useful for the heart and blood vessel due to its antioxidant activities. It can help to reduce the damage of reactive oxygen species in the brain and blood vessels [6]. Ginkgo leaf extract can also help to relax the blood vessels, which, in turn, reduce blood pressure and improve blood flow to the heart [7]. Furthermore, the ginkgo leaf extract is known as a natural inhibitor for platelet activation factor (PAF) in blood. During inflammation or bleeding, PAF will activate the platelet in the blood to become sticky and form a plug to stop bleeding. While essential for wound healing, the activation of PAF during inflammation runs the risk of causing blood clots that can cause a stroke or heart attack [8]. Ginkgo leaf extract can reduce the activation of PAF and thus reduce the risk of clot formation. Unlike other blood-thinning drugs such as warfarin has higher bleeding risk, the ginkgo leaf extract is considered safe and does not increase the bleeding risk.

Ginkgo leaf extract can improve blood flow and prevent blood clot.

Ginkgo leaf extract is commonly used in China for stroke patients with good results. It is also combined with aspirin (a known blood thinner) as a treatment for stroke patients immediately after the incident. In one study, patients who were given aspirin plus ginkgo leaf extract recover significantly better compared to patients who received aspirin only [9]. Analysis of data from 15 clinical studies found that ginkgo leaf extract can improve the brain function and reduce the dependence of stroke patients better than conventional treatment alone [10]. Hence, ginkgo leaf extract is proven to be effective in stroke recovery.

Ginkgo leaf extract can also potentially prevent the occurrence and reduce the severity of heart attack due to its antioxidant and anti-inflammatory properties. Such effects have been demonstrated in several animal studies [11–13]. However, an earlier study which assessed whether taking 120mg of ginkgo leaf extract can help to prevent heart attack did not find enough evidence [14]. Though taking ginkgo leaf extract can help patients with coronary artery disease through increasing blood flow [7]. It can also be beneficial for patients with check pain [15].   

Ginkgo leaf extract can speed up the recovery from stroke.

In summary, ginkgo has been used as food and medicine for millennials. The leaf extract of ginkgo is widely used as a herbal supplement to improve brain and heart functions. Mainly, ginkgo can be used as a natural blood thinner to improve blood flow and prevent blood clot. It has been shown to improve recovery of stroke patients and reduce the risk of heart diseases, without increasing the risk of bleeding.  

References

[1]        Ginkgo nuts (银杏坚果) nutrition facts, medicinal properties and health benefits, (n.d.). https://www.nutrition-and-you.com/ginkgo-nuts.html (accessed November 10, 2020).

[2]        Y. Kosaki, H. Naito, T. Nojima, A. Nakao, Epileptic Seizure from Ginkgo Nut Intoxication in an Adult, Case Rep. Emerg. Med. 2020 (2020) 5072954. doi:10.1155/2020/5072954.

[3]        本草綱目/果之二 – 维基文库,自由的图书馆, (n.d.). https://zh.wikisource.org/wiki/本草綱目/果之二#銀杏 (accessed November 10, 2020).

[4]        T. Isah, Rethinking Ginkgo biloba L.: Medicinal uses and conservation, Pharmacogn. Rev. 9 (2015) 140–148. doi:10.4103/0973-7847.162137.

[5]        T. Nguyen, T. Alzahrani, Ginkgo Biloba, in: StatPearls (Internet), StatPearls Publishing, Treasure Island, FL, 2020.

[6]        J. Tian, Y. Liu, K. Chen, Ginkgo biloba extract in vascular Protection: Molecular mechanisms and clinical applications., Curr. Vasc. Pharmacol. 15 (2017) 532–548. doi:10.2174/1570161115666170713095545.

[7]        Y. Wu, S. Li, W. Cui, X. Zu, J. Du, F. Wang, Ginkgo biloba extract improves coronary blood flow in healthy elderly adults: role  of endothelium-dependent vasodilation., Phytomedicine. 15 (2008) 164–169. doi:10.1016/j.phymed.2007.12.002.

[8]        M. Koupenova, B.E. Kehrel, H.A. Corkrey, J.E. Freedman, Thrombosis and platelets: an update, Eur. Heart J. 38 (2017) 785–791. doi:10.1093/eurheartj/ehw550.

[9]        S. Li, X. Zhang, Q. Fang, J. Zhou, M. Zhang, H. Wang, Y. Chen, B. Xu, Y. Wu, L. Qian, Y. Xu, Ginkgo biloba extract improved cognitive and neurological functions of acute ischaemic stroke: a randomised controlled trial, stroke Vasc. Neurol. 2 (2017) 189–197. doi:10.1136/svn-2017-000104.

[10]      H. Ji, X. Zhou, W. Wei, W. Wu, S. Yao, Ginkgol Biloba extract as an adjunctive treatment for ischemic stroke: A systematic review and meta-analysis of randomized clinical trials, Medicine (Baltimore). 99 (2020) e18568–e18568. doi:10.1097/MD.0000000000018568.

[11]      S. Bent, C. Kane, K. Shinohara, J. Neuhaus, Saw Palmetto for Benign Prostatic Hyperplasia, N. Engl. J. Med. 354 (2006) 557–566. doi:10.1056/NEJMoa053085.

[12]      W. Li, Z. Luo, X. Liu, L. Fu, Y. Xu, L. Wu, X. Shen, Effect of Ginkgo biloba extract on experimental cardiac remodeling., BMC Complement. Altern. Med. 15 (2015) 277. doi:10.1186/s12906-015-0719-z.

[13]      T.R.R. Mesquita, I.C.G. de Jesus, J.F. Dos Santos, G.K.M. de Almeida, C.M.L. de Vasconcelos, S. Guatimosim, F.N. Macedo, R. V Dos Santos, J.E.R. de Menezes-Filho, R. Miguel-Dos-Santos, P.T.D. Matos, S. Scalzo, V.J. Santana-Filho, R.L.C. Albuquerque-Júnior, R.N. Pereira-Filho, S. Lauton-Santos, Cardioprotective Action of Ginkgo biloba Extract against Sustained β-Adrenergic Stimulation Occurs via Activation of M(2)/NO Pathway, Front. Pharmacol. 8 (2017) 220. doi:10.3389/fphar.2017.00220.

[14]      L.H. Kuller, D.G. Ives, A.L. Fitzpatrick, M.C. Carlson, C. Mercado, O.L. Lopez, G.L. Burke, C.D. Furberg, S.T. DeKosky, Does Ginkgo biloba reduce the risk of cardiovascular events?, Circ. Cardiovasc. Qual. Outcomes. 3 (2010) 41–47. doi:10.1161/CIRCOUTCOMES.109.871640.

[15]      T. Sun, X. Wang, H. Xu, Ginkgo Biloba extract for angina pectoris: a systematic review., Chin. J. Integr. Med. 21 (2015) 542–550. doi:10.1007/s11655-015-2070-0.

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