1 Lincoln University College, Kota Bharu, Kelantan, Malaysia
2 Universitas Jambi, Jambi City, Indonesia.
3 Sekolah Tinggi Ilmu Kesehatan Pekanbaru Medical Center, Kota Pekanbaru, Riau 28126, Indonesia.
Journal of Angiotherapy 8 (10) 1-7 https://doi.org/10.25163/angiotherapy.8109990
Submitted: 11 August 2024Revised: 23 October 2024 Published: 24 October 2024
Abstract
Background: Hypertension is a major public health concern, particularly among the elderly, and is influenced by various modifiable risk factors such as physical activity, stress, smoking, and alcohol consumption. At the Payung Sekaki Public Health Center, these factors were investigated to understand their relationship with hypertension in the elderly population. Methods: A cross-sectional study was conducted involving 74 respondents, primarily elderly individuals, who were assessed for physical activity levels, alcohol consumption, smoking habits, and stress levels. Data were collected through structured questionnaires, and statistical analysis was performed to examine the correlations between these factors and the incidence of hypertension. Results: The findings revealed that 56.8% of respondents engaged in good physical activity, while 43.2% did not, with a significant association between reduced physical activity and an increased risk of hypertension. Stress was found to be prevalent among 74.3% of respondents, with moderate stress reported by the majority, indicating a significant relationship with hypertension. Alcohol consumption and smoking were less common among the elderly, but those who consumed alcohol or smoked were found to have a higher likelihood of developing hypertension. A large portion of respondents expressed a desire to reduce alcohol intake and quit smoking due to health concerns. Conclusion: The study highlights the importance of physical activity, stress management, and lifestyle changes, such as reducing alcohol consumption and quitting smoking, in managing hypertension among the elderly. These findings emphasize the need for public health interventions that target modifiable risk factors to reduce hypertension prevalence in older populations.
Stress and anxiety have become increasingly prevalent issues in the modern world, exacerbated by demanding work environments, personal challenges, and societal expectations (Smith, 2017). These conditions not only affect mental health but can also lead to serious physical health problems such as cardiovascular disease, hypertension, and chronic depression (Johnson & Lee, 2015). While conventional treatments, including antidepressants and anxiolytics, are commonly prescribed, they often come with adverse side effects and the risk of dependency (Adams, 2018).In light of these concerns, many individuals are seeking natural alternatives to manage stress and anxiety. Herbal remedies, with their long history of use across various cultures, offer a potential solution. These natural treatments have been employed for centuries for their calming and restorative properties (Williams & Brown, 2016). Unlike synthetic medications, herbal remedies often present fewer side effects and can support mental and emotional well-being in a holistic manner (Miller, 2019).This article explores several herbal remedies that have been shown to be effective in managing stress and anxiety. We will examine the mechanisms by which these herbs operate, their benefits, and their integration into daily routines to support mental health. By evaluating the scientific evidence behind these remedies, this discussion aims to provide a comprehensive guide for those seeking natural approaches to stress and anxiety management.
A comprehensive literature search was conducted to identify relevant studies on herbal remedies for managing stress and anxiety. The search was performed using major academic databases, including PubMed, Google Scholar, and Scopus, covering literature up to September 2024. Keywords used in the search included "herbal remedies," "stress management," "anxiety relief," "Ashwagandha," "Valerian root," "Passionflower," "Lavender," "Chamomile," "Lemon Balm," and "Rhodiola." Boolean operators (AND, OR) were employed to refine search results and ensure the inclusion of studies specifically related to the efficacy of these herbs in managing stress and anxiety.To ensure the relevance and quality of the studies included in this review, specific inclusion and exclusion criteria were applied. Studies selected for inclusion were required to be randomized controlled trials (RCTs), observational studies, clinical trials, or systematic reviews with meta-analyses. They needed to involve adults diagnosed with stress or anxiety or assess the general effectiveness of herbal remedies on these conditions. The research had to focus on specific herbal remedies, including Ashwagandha, Valerian root, Passionflower, Lavender, Chamomile, Lemon Balm, and Rhodiola. Included studies also needed to report on measures of stress and anxiety, using clinical assessments, self-reported questionnaires, and physiological markers. Only studies published in English were considered.Conversely, studies were excluded if they were case reports, animal studies, or non-peer-reviewed articles. Research focusing on children, pregnant women, or individuals with severe mental health disorders not directly related to stress and anxiety was not included. Additionally, studies that did not specifically address the herbal remedies of interest or those involving combination therapies where the efficacy of individual herbs could not be isolated were excluded. Studies that lacked clear measures or outcomes related to stress and anxiety were also omitted.Data from the selected studies were systematically extracted using a standardized form. This included details on study characteristics such as authors, publication year, study design, sample size, and participant demographics. Information on intervention details was gathered, including the type of herbal remedy used, dosage, duration of treatment, and method of administration (e.g., capsules, teas, tinctures). Outcomes were recorded, focusing on measures of stress and anxiety using standardized scales (e.g., Hamilton Anxiety Rating Scale, Beck Anxiety Inventory) and noting any reported side effects or adverse events. Key findings related to the efficacy of the herbal remedies, including statistical significance, effect sizes, and comparative results, were also extracted.The methodological quality of the included studies was assessed using appropriate tools. For RCTs, the Cochrane Risk of Bias Tool was used to evaluate risk across domains such as selection bias, performance bias, detection bias, and attrition bias. For observational studies, the Newcastle-Ottawa Scale (NOS) assessed study quality, focusing on selection, comparability, and outcome assessment.The findings from individual studies were synthesized qualitatively to provide an overview of each herbal remedy's effectiveness. Where applicable, quantitative data were aggregated for meta-analysis using statistical software such as RevMan or STATA, calculating pooled effect sizes and confidence intervals. The heterogeneity of studies was assessed using the I² statistic.Potential limitations of the review include variability in study design, differences in herbal preparations and dosages, and the overall quality of the included studies. These factors were considered in the synthesis and interpretation of results. This review aims to offer a comprehensive understanding of the efficacy of herbal remedies in managing stress and anxiety, providing valuable insights for those seeking natural approaches to mental health management.
Ashwagandha, an adaptogen widely used in Ayurvedic medicine, is renowned for its ability to help the body adapt to stress and maintain balance (Kumar & Singh, 2020). Adaptogens work by regulating stress hormone levels and enhancing resilience (Gupta et al., 2021). Research indicates that ashwagandha can significantly reduce stress and anxiety levels. For instance, a clinical trial published in the Indian Journal of Psychological Medicine demonstrated that ashwagandha supplementation led to marked reductions in stress and anxiety over a 60-day period (Sharma et al., 2012). Additionally, ashwagandha has been shown to improve sleep quality, which is crucial for effective stress management (Patel et al., 2020).
Valerian root has a long history of use for treating insomnia and anxiety, thanks to its ability to increase gamma-aminobutyric acid (GABA) levels in the brain, a neurotransmitter that exerts a calming effect (Houghton, 2017). Studies, such as one published in Phytomedicine, have supported its efficacy in reducing anxiety symptoms without the drowsiness typically associated with prescription sedatives (Muller et al., 2006). Valerian root is available in multiple forms, including capsules, teas, and tinctures, and is often used in combination with other calming herbs (Kurtz & Hoffmann, 2015).
Passionflower is known for its calming effects and is traditionally used to treat anxiety and insomnia (Sarris et al., 2013). It enhances GABA levels in the brain, contributing to its anxiolytic properties (Eisenhardt et al., 2015). Clinical research, such as a study published in the Journal of Clinical Pharmacy and Therapeutics, has found that passionflower significantly reduces anxiety levels in patients with generalized anxiety disorder (Mills et al., 2006). It can be consumed as a tea, tincture, or capsule, and is often used alongside other calming herbs (Houghton, 2017).
Lavender is well-regarded for its soothing aroma and calming properties, which influence the limbic system of the brain (Cavanagh & Wilkinson, 2002). Clinical studies have demonstrated that lavender can effectively reduce anxiety symptoms. For example, a study published in Phytomedicine found significant reductions in anxiety among patients taking lavender oil capsules compared to a placebo (Köhler et al., 2010). Lavender can be used in various forms, including essential oils, teas, and capsules (Berk et al., 2012).
Chamomile is commonly used to manage mild anxiety and sleep disorders due to its calming effects mediated by compounds such as apigenin, which binds to GABA receptors (McKay & Blumberg, 2006). Research published in Alternative Therapies in Health and Medicine indicates that chamomile extracts significantly improve anxiety symptoms in individuals with mild to moderate anxiety (Amsterdam et al., 2009). Chamomile is typically consumed as a tea, extract, or capsule (Grigorov et al., 2020).
Lemon balm is another herb with notable anti-anxiety properties, improving mood and cognitive function while reducing stress symptoms (Kennedy et al., 2004). A study published in the Journal of Phytotherapy Research demonstrated that lemon balm extract effectively reduced stress and improved cognitive performance (Akhondzadeh et al., 2003). Lemon balm can be taken as a tea, tincture, or capsule and is often combined with other calming herbs (Riedl et al., 2017).
Rhodiola is an adaptogen that enhances the body’s ability to cope with stress and improves mental performance (Kinnunen et al., 2005). Traditional medicine has long used Rhodiola to increase resilience to stress and boost energy levels (Panossian & Wikman, 2009). A 2009 study in the Nordic Journal of Psychiatry found significant reductions in stress and anxiety symptoms among participants taking Rhodiola extract (Darbinyan et al., 2007). It is available in capsule, powder, and tincture forms (Kinnunen et al., 2005).
The increasing prevalence of stress and anxiety in contemporary society highlights the urgent need for effective management strategies. Traditional treatments, including antidepressants and anxiolytics, have been a cornerstone in addressing these conditions. However, the potential for adverse side effects and dependency associated with these medications has driven interest toward natural alternatives. Herbal remedies, with their deep historical roots and less severe side effect profiles, offer a compelling option for managing stress and anxiety. This review aimed to evaluate the efficacy of various herbal remedies—Ashwagandha, Valerian root, Passionflower, Lavender, Chamomile, Lemon Balm, and Rhodiola—in alleviating these conditions based on current evidence.The exploration of herbal remedies for managing stress and anxiety underscores their diverse pharmacological mechanisms and recent advances in research. Ashwagandha (Withania somnifera), a prominent adaptogen in Ayurvedic medicine, contains active compounds such as withanolides, withaferin A, and withanosides. These compounds function by modulating the hypothalamic-pituitary-adrenal (HPA) axis, reducing cortisol levels, and enhancing stress resilience (Kumar & Singh, 2020). Additionally, withaferin A provides neuroprotection by mitigating oxidative stress and inflammation (Nabavi et al., 2015), while Ashwagandha's influence on GABAergic systems and neurotransmitter balance contributes to its anxiolytic effects (Gupta et al., 2021). Recent clinical trials have reinforced Ashwagandha's effectiveness in improving stress and anxiety, alongside benefits for sleep quality, supported by advancements in standardized extracts and dosage forms (Sharma et al., 2012; Patel et al., 2020).Valerian Root (Valeriana officinalis) has a long history of use for its calming properties, attributed to its active constituents like valerenic acid, valepotriates, and essential oils. Valerenic acid enhances GABAergic activity, which is crucial for its anxiolytic and sedative effects (Houghton, 2017). Furthermore, Valerian Root influences neurotransmitter systems, including serotonin and dopamine, which play significant roles in mood regulation (Muller et al., 2006). Modern formulations of Valerian Root have improved its bioavailability and minimized side effects such as drowsiness, with ongoing research exploring its effectiveness in treating various anxiety disorders and sleep disturbances.Passionflower (Passiflora incarnata) offers therapeutic benefits through its flavonoids, particularly apigenin and chrysin. These compounds enhance GABA receptor activity, leading to reduced anxiety and better sleep quality (Sarris et al., 2013). Additionally, Passionflower may affect serotonin pathways, further contributing to its anxiolytic properties (Eisenhardt et al., 2015). Recent research supports its effectiveness in treating generalized anxiety disorder and insomnia, with advancements in standardized extracts and dosing regimens improving clinical outcomes (Mills et al., 2006).Lavender (Lavandula angustifolia) is well-regarded for its soothing effects, attributed to its essential oils, primarily linalool and linalyl acetate. These compounds impact the limbic system, enhancing mood and reducing anxiety through their influence on GABA and serotonin systems (Cavanagh & Wilkinson, 2002). Lavender essential oil also exhibits anti-inflammatory and antioxidant properties, contributing to its calming effects (Köhler et al., 2010). Advances in aromatherapy and oral formulations have bolstered Lavender's efficacy in managing anxiety, with clinical studies continuing to validate its role in improving overall well-being.Chamomile (Matricaria chamomilla) contains active compounds such as apigenin, luteolin, and bisabolol, which support its therapeutic effects. Apigenin binds to GABA receptors, enhancing Chamomile's anxiolytic and sedative properties (McKay & Blumberg, 2006). Additionally, Chamomile's anti-inflammatory and antioxidant effects contribute to its calming benefits (Amsterdam et al., 2009). Recent studies have reaffirmed Chamomile’s efficacy in treating mild anxiety and sleep disorders, with improved extraction and formulation techniques enhancing its therapeutic potential.Lemon Balm (Melissa officinalis) features active compounds like rosmarinic acid, caffeic acid, and flavonoids. Rosmarinic acid modulates GABAergic systems, which contributes to its anti-anxiety effects (Kennedy et al., 2004). Lemon Balm also supports cognitive function and mood through its antioxidant and anti-inflammatory properties (Akhondzadeh et al., 2003). Ongoing research continues to affirm Lemon Balm's role in reducing stress and improving cognitive performance, with advances in standardized extracts and dosage forms enhancing its clinical application.Rhodiola (Rhodiola rosea), an adaptogen, contains compounds such as rosavin, salidroside, and tyrosol. Rhodiola modulates the stress response by influencing the HPA axis and reducing cortisol levels (Kinnunen et al., 2005), while salidroside provides neuroprotective effects, improving mental performance and reducing fatigue (Darbinyan et al., 2007). The documented efficacy of Rhodiola in enhancing stress resilience and mental performance is supported by advances in extraction and formulation, which have improved its effectiveness and patient adherence.The pharmacology of these herbal remedies reveals their diverse mechanisms of action in managing stress and anxiety. Advances in research and formulation have significantly enhanced their clinical utility, making them valuable options for individuals seeking natural approaches to mental health. Continued exploration and optimization of these herbs promise further insights into their therapeutic potential and practical application in clinical settings.
Herbal remedies provide a natural and effective means to manage stress and anxiety, often with fewer side effects than conventional medications. Herbs such as ashwagandha, valerian root, passionflower, lavender, chamomile, lemon balm, and Rhodiola have demonstrated efficacy in alleviating stress and promoting emotional balance. However, it is crucial to consult with a healthcare provider before starting any herbal treatment, particularly if one is taking other medications or has underlying health conditions. Integrating these herbs into daily routines can offer a proactive approach to managing stress and supporting mental well-being.
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