Skip to main content
SpringerLink
Log in

Cardiovascular Toxicities of Herbal Products: An Overview of Selected Compounds

  • Chapter
  • First Online:
Toxicology of Herbal Products

  • 1335 Accesses

Abstract

The use of herbal products for a wide variety of health and medicinal purposes by all ethnic groups worldwide is prevalent and rising, despite a conspicuous lack of rigorous scientific evidence regarding their safety and efficacy. While these products are frequently considered safe by patients and healthcare practitioners alike, they may cause adverse effects that frequently involve the cardiovascular system. A spectrum of chemical compounds is usually present in these products, some of which cause direct cardiovascular toxicity, and others to which clinically relevant herb-allopathic drug interactions may be attributed when taken concomitantly with conventional therapies. The objective of this chapter is to provide an overview of selected herbs that manifest cardiovascular toxicity and those for which herb-allopathic drug interactions affecting the cardiovascular system have been described. Furthermore, the general principles of diagnosis and management of cardiovascular toxicity of these remedies are also discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 199.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Adkins JE, Boyer EW, McCurdy CR (2011) Mitragyna speciosa, a psychoactive tree from Southeast Asia with opioid activity. Curr Top Med Chem 11(9):1165–1175

    Article  CAS  PubMed  Google Scholar 

  • Akhavein F, St-Michel EJ, Seifert E, Rohlicek CV (2007) Decreased left ventricular function, myocarditis, and coronary arteriolar medial thickening following monocrotaline administration in adult rats. J Appl Physiol 103(1):287–295

    Article  CAS  PubMed  Google Scholar 

  • Arora S, Alfayoumi F, Srinivasan V (2006) Transient left ventricular apical ballooning after cocaine use: is catecholamine cardiotoxicity the pathologic link? Mayo Clin Proc 81(6):829–832

    Article  PubMed  Google Scholar 

  • Babu KM, McCurdy CR, Boyer EW (2008) Opioid receptors and legal highs: Saliva divinorum and Kratom. Clin Toxicol (Phila) 46(2):146–152. doi:10.1080/15563650701241795

    Article  CAS  Google Scholar 

  • Bandara V, Weinstein SA, White J, Eddleston M (2010) A review of the natural history, toxicology, diagnosis and clinical management of Nerium oleander (common oleander) and Thevetia peruviana (yellow oleander) poisoning. Toxicon 56(3):273–281. doi:10.1016/j.toxicon.2010.03.026

    Article  CAS  PubMed  Google Scholar 

  • Bauman JL, Grawe JJ, Winecoff AP, Hariman RJ (1994) Cocaine-related sudden cardiac death: a hypothesis correlating basic science and clinical observations. J Clin Pharmacol 34(9):902–911

    Article  CAS  PubMed  Google Scholar 

  • Bessen HA (1986) Therapeutic and toxic effects of digitalis: William Withering, 1785. J Emerg Med 4(3):243–248

    Article  CAS  PubMed  Google Scholar 

  • Bhalla V, Hallows KR (2008) Mechanisms of EnaC regulation and clinical implications. J Am Soc Nephrol 19(10):1845–1854. doi:10.1681/ASN.2008020225

    Article  CAS  PubMed  Google Scholar 

  • Botha CJ, Penrith ML (2008) Poisonous plants of veterinary and human importance in southern Africa. J Ethnopharmacol 119(3):549–558. doi:10.1016/j.jep.2008.07.022

    Article  CAS  PubMed  Google Scholar 

  • Botha CJ, Penrith ML (2009) Potential plant poisonings in dogs and cats in southern Africa. J S Afr Vet Assoc 80(2):63–74

    Article  CAS  PubMed  Google Scholar 

  • Centers for Disease Control and Prevention (CDC) (1993) Jin bu huan toxicity in adults-Los Angeles. MMWR Morb Mortal Wkly Rep 42(47):920–922

    Google Scholar 

  • Chambers HF, Morris DL, Täuber MG, Modin G (1987) Cocaine use and the risk for endocarditis in intravenous drug users. Ann Int Med 106(6):833–836

    Article  CAS  PubMed  Google Scholar 

  • Chan TY (2009) Aconite poisoning. Clin Toxicol (Phila) 47(4):279–285. doi:10.1080/15563650902904407

    Article  CAS  Google Scholar 

  • Chen X, Sneed KB, Pan S, Pan SY, Cao C, Kanwar JR, Chew H, Zhou SF (2012) Herb-drug interactions and mechanistic and clinical considerations. Curr Drug Metab 13(5):640–651

    Article  CAS  PubMed  Google Scholar 

  • Chittrakarn S, Keawpradub N, Sawangjaroen K, Kansenalak S, Janchawee B (2010) The neuromuscular blockade produced by pure alkaloid, mitragynine and methanol extract of kratom leaves (Mitragyna speciosa Korth.). J Ethnopharmacol 129(3):344–349. doi:10.1016/j.jep.2010.03.035

    Article  CAS  PubMed  Google Scholar 

  • Cohen PA, Ernst E (2010) Safety of herbal supplements: a guide for cardiologists. Cardiovasc Ther 28:246–253. doi:10.1111/j.1755-5922.2010.00193.x

    Article  PubMed  Google Scholar 

  • Cravotto G, Boffa L, Genzini L, Garella D (2010) Phytotherapeutics: an evaluation of the potential of 1,000 plants. J Clin Pharm Ther 35(1):11–48. doi:10.1111/j.1365-2710.2009.01096.x

    Article  CAS  PubMed  Google Scholar 

  • Daniel JC, Huynh TT, Zhou W, Kougias P, El Sayed HF, Huh J, Coselli JS, Lin PH, LeMaire SA (2007) Acute aortic dissection associated with use of cocaine. J Vasc Surg 46(3):427–433

    Article  PubMed  Google Scholar 

  • Ernst E (2007) Herbal medicines: balancing benefits and risks. Novartis Found Symp 282:154–167, discussion 167-172, 212-218

    Article  PubMed  Google Scholar 

  • Fatovich DM (1992) Aconite: a lethal Chinese herb. Ann Emerg Med 21(3):309–311

    Article  CAS  PubMed  Google Scholar 

  • FDA (2004) FDA acts to remove ephedra-containing dietary supplements from market. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/2004/ucm108379.htm. Accessed Nov 2014

  • Flores ED, Lange RA, Cigarroa RG, Hillis LD (1990) Effect of cocaine on coronary artery dimensions in atherosclerotic coronary artery disease: enhanced vasoconstriction at sites of significant stenoses. J Am Coll Cardiol 16(1):74–79

    Article  CAS  PubMed  Google Scholar 

  • Friese J, Gleitz J, Gutser UT, Heubach JF, Matthiesen T, Wilffert B, Selve N (1997) Aconitum sp. alkaloids: the modulation of voltage-dependent Na+ channels and antinociceptive properties. Eur J Pharmacol 337(2–3):165–174

    Article  CAS  PubMed  Google Scholar 

  • Gange CA, Madias C, Felix-Getzik EM, Weintraub AR, Estes NA (2006) Variant angina associated with bitter orange in a dietary supplement. Mayo Clin Proc 81(4):545–548

    Article  PubMed  Google Scholar 

  • Goldfrank LR, Flomenbaum NE, Lewin NA, Howland MA, Hoffman RS, Nelson LS (2006) Goldfrank’s Toxicologic Emergencies, 8th edn. McGraw-Hill, New York

    Google Scholar 

  • Hauptman PJ, Kelly RA (1999) Digitalis. Circulation 99(9):1265–1270

    Article  CAS  PubMed  Google Scholar 

  • Havranek EP, Nademanee K, Grayburn PA, Eichhorn EJ (1996) Endothelium-dependent vasorelaxation is impaired in cocaine-arteriopathy. J Am Coll Cardiol 28(5):1168–1174

    Article  CAS  PubMed  Google Scholar 

  • Hebert SC, Desir GV, Giebisch G, Wang WH (2005) Molecular diversity and regulation of renal potassium channels. Physiol Rev 85(1):319–371

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Heesch CM, Wilhelm CR, Ristich J, Adnane J, Bontempo FA, Wagner WR (2000) Cocaine activates platelets and increases the formation of circulating platelet containing microaggregates in humans. Heart 83(6):688–695

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Hirasawa M, Nishihara M, Takahashi M (1998) Activity of ventromedial hypothalamic neurons suppressing heart rate is associated with paradoxical sleep in the rat. Brain Res 797(1):103–108

    Article  CAS  PubMed  Google Scholar 

  • Horowitz RS, Feldhaus K, Dart RC, Stermitz FR, Beck JJ (1996) The clinical spectrum of Jin Bu Huan toxicity. Arch Intern Med 156(8):899–903. doi:10.1001/archinte.1996.00440080101012

    Article  CAS  PubMed  Google Scholar 

  • Hsue PY, McManus D, Selby V, Ren X, Pillutla P, Younes N, Goldschlager N, Waters DD (2007) Cardiac arrest in patients who smoke crack cocaine. Am J Cardiol 99(6):822–824

    Article  CAS  PubMed  Google Scholar 

  • Hunt KJ, Coelho HF, Wider B, Perry R, Hung SK, Terry R, Ernst E (2010) Complementary and alternative medicine use in England: results from a national survey. Int J Clin Pract 64(11):1496–1502. doi:10.1111/j.1742-1241.2010.02484.x

    Article  CAS  PubMed  Google Scholar 

  • Izzo AA, Ernst E (2009) Interactions between herbal medicines and prescribed drugs: an updated systematic review. Drugs 69:1777–1798. doi:10.2165/11317010-000000000-00000

    Article  CAS  PubMed  Google Scholar 

  • Joint FAO/WHO food standards programme codex committee on contaminants in food, 5th session. The Hague 21–25 March 2011. Discussion paper on pyrrolizidine alkaloids ftp://ftp.fao.org/codex/meetings/cccf/cccf5/cf05_14e.pdf. Accessed Nov 2014

  • Kang YX, Luczaj LJ, Ye S (2012) The highly toxic Aconitum carmichaelii Debeaux as a root vegetable in the Qinling Mountains (Shaanxi, China). Genet Resour Crop Evol 59(7):1569–1575

    Article  CAS  Google Scholar 

  • Khan AU, Gilani AH (2008) Cardiovascular inhibitory effects of Hyoscyamus niger. Methods Find Exp Clin Pharmacol 30(4):295–300. doi:10.1358/mf.2008.30.4.1186075

    Article  CAS  PubMed  Google Scholar 

  • Kumar A, De T, Mishra A, Mishra AR (2013) Oleandrin: a cardiac glycosides with potent cytotoxicity. Pharmacogn Rev 7(14):131–139. doi:10.4103/0973-7847.120512

    Article  PubMed  PubMed Central  Google Scholar 

  • Lange RA, Cigarroa RG, Yancy CW, Willard JE, Popma JJ, Sills MN, McBride W, Kim AS, Hillis LD (1989) Cocaine-induced coronary-artery vasoconstriction. N Engl J Med 321(23):1557–1562

    Article  CAS  PubMed  Google Scholar 

  • Larrey D (1997) Hepatotoxicity of herbal medicines. J Hepatol 26(Suppl 1):48–49

    Google Scholar 

  • Lau WC, Welch TD, Shields T, Rubenfire M, Tantry US, Gurbel PA (2011) The effect of St. John’s wort on the pharmacodynamic responses of clopidogrel in hyporesponsive volunteers and patients: increased platelet inhibition by enhancement of CYP3A4 metabolic activity. J Cardiovasc Pharmacol 57(1):86–93. doi:10.1097/FJC.0b013e3181ffe8d0

    Article  CAS  PubMed  Google Scholar 

  • Lawler PR, Bergmark BA, Laubach JP, Lakdawala NK (2014) Having a heavy heart: approaches to infiltrative cardiomyopathy. Circulation 129(16):1703–1711. doi:10.1161/CIRCULATIONAHA.113.006932

    Article  PubMed  Google Scholar 

  • Lee NH, Yoo SR, Kim HG, Cho JH, Son CG (2012) Safety and tolerability of Panax ginseng root extract: a randomized, placebo-controlled, clinical trial in healthy Korean volunteers. J Altern Complement Med 18(11):1061–1069. doi:10.1089/acm.2011.0591

    Article  PubMed  PubMed Central  Google Scholar 

  • Li YP, Wang YM (1988) Evaluation of tussilagone: a cardiovascular-respiratory stimulant isolated from Chinese herbal medicine. Gen Pharmacol 19(2):261–263

    Article  CAS  PubMed  Google Scholar 

  • Li J, Shi J, Yu XW, Sun J, Men Q, Kang T (2011) Chemical and pharmacological researches on Hyoscyamus niger. Chin Herb Med 3(2):117–126. doi:10.3969/j.issn.1674-6384.2011.02.006

    CAS  Google Scholar 

  • Liaudet L, Calderari B, Pacher P (2014) Pathophysiological mechanisms of catecholamine and cocaine-mediated cardiotoxicity. Heart Fail Rev 19:815–824

    Article  CAS  PubMed  Google Scholar 

  • Lin CC, Chan TY, Deng JF (2004) Clinical features and management of herb-induced aconitine poisoning. Ann Emerg Med 43(5):574–579

    Article  PubMed  Google Scholar 

  • Lu HR, De Clerck F (1993) R56 865, a Na+/Ca2+-overload inhibitor, protects against aconitine-induced cardiac arrhythmias in vivo. J Cardiovasc Pharmacol 22(1):120–125

    Article  CAS  PubMed  Google Scholar 

  • Lubbe WF, Podzuweit T, Opie LH (1992) Potential arrhythmogenic role of cyclic adenosine monophosphate (AMP) and cytosolic calcium overload: implications for prophylactic effects of beta-blockers in myocardial infarction and proarrhythmic effects of phosphodiesterase inhibitors. J Am Coll Cardiol 19(7):1622–1633

    Article  CAS  PubMed  Google Scholar 

  • Maraj S, Figueredo VM, Lynn Morris D (2010) Cocaine and the heart. Clin Cardiol 33(5):264–269. doi:10.1002/clc.20746

    Article  PubMed  Google Scholar 

  • McVann A, Havlik I, Joubert PH, Monteagudo FS (1992) Cardiac glycoside poisoning involved in deaths from traditional medicines. S Afr Med J 81(3):139–141

    CAS  PubMed  Google Scholar 

  • Mendell J, Zahir H, Matsushima N, Noveck R, Lee F, Chen S, Zhang G, Shi M, Merritt-Charles L (2013) Drug-drug interaction studies of cardiovascular drugs involving P-Glycoprotein, an efflux transporter, on the pharmacokinetics of edoxaban, an oral factor Xa inhibitor. Am J Cardiovasc Drugs 13:331–342. doi:10.1007/s40256-013-0029-0

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Merritt-Charles L (2011) The prevalence of herbal medicine use among surgical patients in Trinidad. Focus Altern Complement Ther 16:266–270

    Article  Google Scholar 

  • Mo W, Singh AK, Arruda JA, Dunea G (1998) Role of nitric oxide in cocaine-induced acute hypertension. Am J Hypertens 11(6 Pt 1):708–714

    Article  CAS  PubMed  Google Scholar 

  • Moses GM, McGuire TM (2010) Drug interactions with complementary medicines. Aust Prescr 33(6):177–180

    Article  Google Scholar 

  • Mugabo P, Khan F, Burger A (2012) Effects of Leonotis leonuris aqueous extract on the isolated perfused rat heart. Int J Med Aromat Plants 2:281–292

    Google Scholar 

  • National Center for Complementary and Alternative Medicine (NCCAM) (2012) http://nccam.nih.gov/health/bitterorange. Accessed Nov 2014

  • Naudé TW (1997) The occurrence and significance of South African cardiac glycosides. J S Afr Biol Soc 18:7–20

    Google Scholar 

  • Omar HR, Komarova I, El-Ghonemi M, Fathy A, Rashad R, Abdelmalak HD, Yerramadha MR, Ali Y, Helal E, Caporesi EM (2012) Licorice abuse: time to send a warning message. Ther Adv Endocrinol Metab 3(4):125–138. doi:10.1177/2042018812454322

    Article  PubMed  PubMed Central  Google Scholar 

  • Peregoy JA, Clarke TC, Jones LI, Stussman BJ, Nahin RL (2014) NCHS data brief, no. 146, April 2014. http://www.cdc.gov/nchs/data/databriefs/db146.pdf. Accessed Nov 2014

  • Poppenga RH (2010) Poisonous plants: molecular, clinical and environmental toxicology. In: Luch A (ed) Clinical toxicology, vol 2. Birkhäuser Verlag AG, Basel

    Google Scholar 

  • Posadzki P, Watson LK, Ernst E (2012) Herb-drug interactions: an overview of systematic reviews. Br J Clin Pharmacol 75(3):603–618. doi:10.1111/j.1365-2125.2012.04350.x

    Google Scholar 

  • Posadzki P, Watson LK, Alotaibi A, Ernst E (2013) Prevalence of use of complementary and alternative medicine (CAM) by patients/consumers in the UK: systematic review of surveys. Clin Med 13(2):126–131. doi:10.7861/clinmedicine.13-2-126

    Article  Google Scholar 

  • Prozialeck WC, Jivan JK, Andurkar SV (2012) Pharmacology of kratom: an emerging botanical agent with stimulant, analgesic and opioid-like effects. J Am Osteopath Assoc 112(12):792–799

    PubMed  Google Scholar 

  • Riezzo I, Fiore C, De Carlo D, Pascale N, Neri M, Turillazzi E, Fineschi V (2012) Side effects of cocaine abuse: multiorgan toxicity and pathological consequences. Curr Med Chem 19(33):5624–5646

    Article  CAS  PubMed  Google Scholar 

  • Ruiz-Granados ES, Shouls G, Sainsbury C, Antonios T (2012) A salty cause of severe hypertension. BMJ Case Rep. doi:10.1136/bcr.12.2011.5336, pii: bcr1220115336

    PubMed  PubMed Central  Google Scholar 

  • Sahoo N, Manchikanti P, Dey S (2010) Herbal drugs: standards and regulation. Fitoterapia 81(6):462–471. doi:10.1016/j.fitote.2010.02.001

    Article  PubMed  Google Scholar 

  • Schwartz BG, Rezkalla S, Kloner RA (2010) Cardiovascular effects of cocaine. Circulation 122(24):2558–2569. doi:10.1161/CIRCULATIONAHA.110.940569

    Article  PubMed  Google Scholar 

  • Singh S (2009) The hidden risks of alternative medicine. Focus Alt Complement Ther 14:175–176

    Article  Google Scholar 

  • Singhuber J, Zhu M, Prinz S, Kopp B (2009) Aconitum in traditional Chinese medicine: a valuable drug or an unpredictable risk? J Ethnopharmacol 126:18–30

    Article  PubMed  Google Scholar 

  • Snyman LD, Schulz RA, Van den Berg H (2011) Variability of yellow tulp (Moraea pallida Bak.) toxicity. J S Afr Vet Assoc 82:131–132

    Article  CAS  PubMed  Google Scholar 

  • Spoerke DG, Hall AH, Dodson CD, Stermitz FR, Swanson CH, Rumack BH (1987) Mystery root ingestion. J Emerg Med 5:385–388

    Article  CAS  PubMed  Google Scholar 

  • Tachjian A, Maria V, Jahangir A (2010) Use of herbal products and potential interactions in patients with cardiovascular diseases. J Am Coll Cardiol 55(6):515–525. doi:10.1016/j.jacc.2009.07.074

    Article  PubMed  PubMed Central  Google Scholar 

  • Tai Y, Lau C, Young K, But PP (1992) Cardiotoxicity after herb-induced aconite poisoning. Lancet 340(8830):1254–1256. doi:10.1016/0140-6736(92)92951-B

    Article  CAS  PubMed  Google Scholar 

  • Takayama H, Ishikawa H, Kurihara M, Kitajima M, Aimi N, Ponglux D, Koyama F, Matsumoto K, Moriyama T, Yamamoto LT, Watanabe K, Murayama T, Horie S (2002) Studies on the synthesis and opioid agonistic activities of mitragynine-related indole alkaloids: discovery of opioid agonists structurally different from other opioid ligands. J Med Chem 45(9):1949–1956

    Article  CAS  PubMed  Google Scholar 

  • Thomas JE, Munir JA, McIntyre PZ, Ferguson MA (2009) STEMI in a 24-year-old man after use of a synephrine-containing dietary supplement: a case report and review of the literature. Tex Heart Inst J 36(6):586–590

    PubMed  PubMed Central  Google Scholar 

  • United Nations Office on Drugs and Crime (UNODC) (n.d.) World drug report 2014. http://www.unodc.org/wdr2014/. Accessed Nov 2014

  • University of Washington (n.d.) Dabigatran drug interaction potential. Published on anticoagulation services. http://depts.washington.edu/anticoag/home. Accessed Nov 2014

  • Urkin J, Shalev H, Sofer S, Witztum A (1991) Henbane (Hyoscyamus reticulatus) poisoning in children in the Negev. Harefuah 120(12):714–716

    CAS  PubMed  Google Scholar 

  • Van der Bijl P Jr, Van der Bijl P Sr (2012) Cardiotoxicity of plants in South Africa. Cardiovasc J Afr 23(9):476–477

    PubMed  Google Scholar 

  • Vita JA, Treasure CB, Yeung AC, Vekshtein VI, Fantasia GM, Fish RD, Ganz P, Selwyn AP (1992) Patients with evidence of coronary endothelial dysfunction as assessed by acetylcholine infusion demonstrate marked increase in sensitivity to constrictor effects of catecholamines. Circulation 85(4):1390–1397

    Article  CAS  PubMed  Google Scholar 

  • Vogl S, Picker P, Mihaly-Bison J, Fakhrudin N, Atanasov AG, Heiss EH, Wawrosch C, Reznicek G, Dirsch VM, Saukel J, Kopp B (2013) Ethnopharmacological in vitro studies on Austria’s folk medicine − an unexplored lore in vitro anti-inflammatory activities of 71 Austrian traditional herbal drugs. J Ethnopharmacol 149(3):750–771. doi:10.1016/j.jep.2013.06.007

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Wang W (2006) Regulation of ROMK (Kir1.1) channels: new mechanisms and aspects. Am J Physiol Renal Physiol 290(1):F14–F19. doi:10.1152/ajprenal.00093.2005

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Wilbert-Lampen U, Seliger C, Zilker T, Arendt RM (1998) Cocaine increases the endothelial release of immunoreactive endothelin and its concentrations in human plasma and urine: reversal by coincubation with sigma-receptor antagonists. Circulation 98(5):385–390

    Article  CAS  PubMed  Google Scholar 

  • Yamanaka H, Doi A, Ishibashi H, Akaike N (2002) Aconitine facilitates spontaneous transmitter release at rat ventromedial hypothalamic neurons. Br J Pharmacol 135(3):816–822

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Zuzak TJ, Boňková J, Careddu D, Garami M, Hadjipanayis A, Jazbec J, Merrick J, Miller J, Ozturk C, Persson IA, Petrova G, Saz Peiró P, Schraub S, Simões-Wüst AP, Steinsbekk A, Stockert K, Stoimenova A, Styczynski J, Tzenova-Savova A, Ventegodt S, Vlieger AM, Längler A (2013) Use of complementary and alternative medicine by children in Europe: published data and expert perspectives. Complement Ther Med Suppl 1:S34–S47. doi:10.1016/j.ctim.2012.01.001

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Cardiology, Department of Internal Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, Cape Town, South Africa

    Pieter van der Bijl Jr.

  2. Formerly, Department of Pharmacology, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, Cape Town, South Africa

    Pieter van der Bijl Sr.

Authors
  1. Pieter van der Bijl Jr.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Pieter van der Bijl Sr.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Pieter van der Bijl Sr. .

Editor information

Editors and Affiliations

  1. Department of Pharmacology & Toxicology, University of Oulu, Oulu, Finland

    Olavi Pelkonen

  2. Service de Chimie Thérapeutique et de Pharmacognosie, University of Mons, Mons, Belgium

    Pierre Duez

  3. Faculty of Pharmacy, University of Helsinki, Helsinki, Finland

    Pia Maarit Vuorela

  4. Faculty of Pharmacy, University of Helsinki, Helsinki, Finland

    Heikki Vuorela

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing Switzerland

About this chapter

Cite this chapter

van der Bijl, P., van der Bijl, P. (2017). Cardiovascular Toxicities of Herbal Products: An Overview of Selected Compounds. In: Pelkonen, O., Duez, P., Vuorela, P., Vuorela, H. (eds) Toxicology of Herbal Products. Springer, Cham. https://doi.org/10.1007/978-3-319-43806-1_15

Download citation

Publish with us

Policies and ethics

Search

Navigation