“Extracts of Ginkgo biloba are among the most sold supplements worldwide, which justifies the need for a deeper knowledge of its cardiovascular effects, especially in healthy subjects,” the researchers wrote. “Although scarce, recent evidence suggests that individual metabolism of Ginkgo biloba in different subjects is an important determinant of the nature and magnitude of vascular response.”
According to the 2021 Herb Market Report, which recorded near-record sales driven by pandemic-related wellness concerns, Ginkgo biloba placed among the top 20 herbal supplements with US mainstream channel sales of $29,175,299 (up 8.5% from 2020) and US natural channel sales of $5,057,675 (up 5.1% from 2020).
‘Considerably undervalued’ data
Ginkgo biloba has been used clinically for the prevention and treatment of various conditions ranging from hypertension and cerebrovascular disease to Raynaud’s phenomenon and neurogenerative diseases.
The researchers noted that although systematic reviews and meta-analyses of clinical studies have shown that Ginkgo biloba is beneficial in only a few cardiovascular conditions, data in healthy subjects “has been considerably undervalued.”
As such, they conducted a comprehensive review of the mechanisms affecting blood pressure and hemodynamics (measures of cardiovascular function) to determine the cardiovascular activities of Ginkgo biloba and its compounds in healthy subjects. Underlying mechanism explored included significant antioxidant activity in vitro in a wide range of tissues, modulation of ion channel activity and vasorelaxation via acetylcholine-mediated calcium uptake.
“It displays myocardial suppressant and vasorelaxant activities ex vivo, potentiating endothelial-dependent and -independent pathways,” the researchers wrote. “It improves perfusion in different vascular beds, namely ocular, cochlear, cutaneous, cerebral and coronary.”
A case for individual metabolism
In exploring these mechanisms, the review highlights that vascular effects may depend on individual metabolism of Ginkgo biloba and respond to factors like age, race/ethnicity, formulation, dose and timing.
Researchers identified several perfusion (blood flow at the capillary level in tissue) studies that reinforce Ginkgo biloba’s heterogenous effect on different populations. As case study, it compares the results of the botanical and its compounds in both a healthy young and healthy middle-aged subjects, which generated opposing findings.
“These results suggest that the vascular response to Ginkgo biloba may be related to individual metabolism,” the researchers wrote, adding that quantification techniques, treatment course, dose and body posture during measurement could also play a role.
The review also noted that Ginkgo biloba is considered to be generally safe, with a low frequency of adverse reactions, and that future clinical studies should be controlled to identify the target populations that may benefit the most from pharmacotherapeutic interventions involving Ginkgo biloba.
Published online: doi.org/10.3390/biology12010015
“Cardiovascular Activity of Ginkgo biloba—An Insight from Healthy Subjects.”
Authors: Henrique Silva and Filipe Gazalho Martins