Preeclampsia, a hypertensive disorder of pregnancy, is the most common direct cause of maternal deaths in South Africa. Current management strategies of preeclampsia primarily involve the use of pharmaceutical drugs such as angiotensin-converting enzyme inhibitors (ACEI), which are frequently associated with undesirable side-effects. Additionally, the use of ACEI’s is costly, thus not easily accessible to patients from lower socio-economic backgrounds. As a result, many patients in South Africa rely on traditional medicine obtained from medicinal plants to manage health-related conditions.

Research funded by the NRF reviewed traditional medicinal plants from South Africa with the potential to be used in the treatment of hypertension in pregnancy.  The study found that only 12 plant species, endemic to South Africa, displayed strong ACEI potential in vitro (greater than 50% ACEI). These include:

• Adenopodia spicata – traditionally known as Spiny Splinter bean (Ubobo)
• Agapanthus africanus – traditionally known as African Lily (Ubani)
• Amaranthus dubius – traditionally known as Wild Spinach (Imbuya)
• Asystasia gangetica (Acanthaceae) – traditionally known as Creeping foxglove (Isihobo)
• Clausena anisate – traditionally known as Horsewood (Umnukambhiba)
• Dietes iridioides (Iridaceae) – traditionally known as African iris (Isishuphe somfula)
• Dombeya rotundifolia – traditionally known as Wild pear (iNhlizinyonkhulu)
• Protorhus longifolia (Anacardiaceae)- traditionally known as Red beech (Uzintlwa)
• Rhus chirindensis (Anacardiaceae) – traditionally known as Red currant (Umhlabamvudu)
• Sclerocarya birrea (Anacardiaceae)- traditionally known as Marula (Ukanyi)
• Stangeria eriopus (Zamiaceae) – traditionally known as Natal Grass Cycad (Umfigwani)
• Tulbaghia violacea (Alliaceae) – traditionally known as Garlic (isihaqa)

According to the study, these traditional medicinal plants are widespread throughout the country, and different morphological parts of the plant are used for treatment, but mainly the leaves. The study emphasises that there is a need for in-vitro screening of medicinal plants to support in-vivo studies, which shows clear evidence of its effectiveness to progress to the pre-clinical trial stage. Furthermore, large scale studies are also recommended to evaluate the safety of ACEI rich herbs compared to synthetic ACEI in pregnancy.

Access the full paper published in the Journal of Ayurvedda and Integrative Medicine  here.