Professional Documents
Culture Documents
CARDIOVASCULAR PARAMETERS
BY
AKANO, OYEDAYO PHILLIPS
MATRIC NO: 073007
DECEMBER, 2012.
CERTIFICATION
This is to certify that this project work was carried out by Akano Oyedayo Phillips
------------------------------------------- ------------------------------------
Supervisor
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Dr Afolabi Date
Head of Department
DEDICATION
This research project is dedicated to God Almighty, the giver of life and all
knowledge.
ACKNOWLEDGEMENT
All glory to God Almighty who has been with me all through my course of study in
LAUTECH, I thank him for his divine guidance and providence. I acknowledge the head of
physiology department Dr. Afolabi and the motherly support of my God sent supervisor
Mrs. F. O Ajao, I will be an ingrate if the effort and professionalism of Dr A.M. Adesola prior,
during and after this research work is not given full recognition, you are wonderful sir.
investigation is duly appreciated, may God meet all your needs. Also the support received
from the Sport unit and all the coaches will forever be remembered.
and Deaconess M.O Akano for their full support and for believing in me, you were there
spiritually, financially and morally, may you reap the fruit of your labor in good health and
Toluwanimi for your understanding and prayers, you guys have been a source of
happiness, joy and inspiration, you will excel in all your endeavors.
I am equally grateful to my angel Agboola Rachel Omobola, you are indeed a gem
God will reward your contribution to my success. Also my peeps Olumurewa Abimbola
Sola, Bolarinwa Abimbloa Abake, Dupe, Sola, my late friend Anthony (RIP) and my school
Sam, Elder and Dns. Oluide, you will go from strength to strengths in Jesus name.
I will not end this acknowledgement without appreciating Pa. and Madam Olaoti,and
Contents Pages
Title page i
Certification ii
Dedication iii
Acknowledgement iv
Table of contents vi
List of tables x
List of graphs xi
Abstract xiii
CHAPTER ONE
1.0 Introduction 1
1.2 Hypothesis 3
1.3 Aim 4
2.1 Exercise 5
2.3.5.1Cardiac Glycosides 59
2.3.5.3Phenalkylamines 63
CHAPTER THREE
3.1Materials 65
3.2 Methodology 65
3.2.1 Subjects 65
3.2.3 Measurements 66
3.2.3.1 Pretest 66
3.2.3.2 Posttest 68
4.0 Results 69
CHAPTER FIVE
5.1Discussion 77
5.3 Recommendations 81
REFERENCES 82
APPENDIX 116
LIST OF TABLES
Table 2.4 Average resting heart rate in correlation with age in male 46
Table 2.5 Average resting heart rate in correlation with age in female 47
Appendix 1.0 Cardiovascular parameters of control group during pretest and posttest
Fig 2.3 Curve of the arterial pressure during one cardiac cycle 40
Fig 4.1 A graph showing the weight of control and experimental subjects 69
Fig 4.2 A graph showing the systolic Bp of control and experimental subjects 69
Fig 4.3 A graph showing the diastolic Bp of control and experimental subjects 70
Fig 4.4 A graph showing the pulse pressure of control and experimental subjects 71
Fig 4.5 A graph showing the heart rate of control and experimental subjects 72
Fig 4.6 A graph showing the Max VO2 t of control and experimental subjects 73
Fig 4.8 A graph showing the cardiac output of control and experimental subjects 74
Fig 4.8 A graph showing the stoke volume of control and experimental subjects 76
LIST OF PICTURES
The main aim of this investigation was to determine the effect of Moringa oleifera
seeds and exercise on the cardiovascular parameters. Ten male subjects (N =10) between
Ages 20-25 were employed in this research five of which are athletes (experimental) while
Before the experiment, their Age (yrs), weight (kg), height (m) and cardiovascular
parameters heart rate (B/min), blood pressure (mmhg), pulse pressure (mmhg), MaxVO2
(L), cardiac output (L) and stroke volume (ml/min)- were measured and recorded as
pretest parameters. The athletes were subjected to five weeks of training (four sessions in
a week) and two Moringa oleifera seeds daily, while the nonathletes were only subjected to
eating two Moringa oleifera seeds daily without training sessions. Exercise training
included uphill riding on tread mill, bicycle egormeter and gym apparatus.
After the five weeks of training and eating of Moringa oleifera seeds, the above
The result showed that the weight was slightly reduced, blood pressure, heart rate and
pulse pressure reduced (P<0.05). The cardiac output, MaxVO2 and stroke volume were
The combination of Moringa oleifera seeds and exercise has beneficial therapeutic effects
on the cardiovascular system of both athletes and nonathletes and help athletes to perform
1.0 INTRODUCTION
Physical exercise is any bodily activity that enhances or maintains physical fitness
and overall health and wellness. It is performed for various reasons including
strengthening muscles and the cardiovascular system, honing athletic skills, weight loss or
maintenance, as well as for the purpose of enjoyment. (Stampfer et al., 2000). Frequent and
regular physical exercise boosts the immune system, and helps prevent the "diseases of
affluence" such as heart disease, cardiovascular disease, Type 2 diabetes and obesity.
Regular physical exercise and good physical condition are widely accepted as factors that
reduce all-cause mortality and improve a number of health outcomes (Stampfer et al.,
2000; Hu et al., 2006). The beneficial effect of exercise on the cardiovascular system is well
documented.
Physical exercises are generally grouped into three types, (Your Guide to Physical
Activity, 2007) depending on the overall effect they have on the human body: Flexibility
exercises, such as stretching, improve the range of motion of muscles and joints (O'Connor
et al., 2005), Aerobic exercises, such as cycling, swimming, walking, skipping rope, rowing,
and Knuttgen, 2003) and Anaerobic exercises, such as weight training, functional training,
regarded by some people as 'A Miracle Plant'. Its leaves, pods, seeds, flowers, roots are
edible, and have different nutritional and medicinal values. Edible oil can also be extracted
from the seeds, because it yields 38-40 percent of non-drying oil known as Ben oil. (The
Researches have also found that Moringa oleifera has no proven bad effects and is
heart problems. Moringa oleifera that contains the cardiac glycosides are used throughout
the world for the treatment of heart failure and arrythmias. It speeds recovery from heart
attacks and lowers essential hypertension. Used in conjunction with other hypotensives,
Moringa oleifera seed will help keep the heart healthy, preventing the development of
coronary disease. In such conditions these herbs help increase the strength of heart beat,
and normalize the rate of beat. Athletes all over the world boost their performance abilities
by taking huge quantities of the leaf, to keep them fit both mentally and physically. It is
their secret weapon. Even for senior citizens who are losing their sharpness of mind, the
Moringa tree leaf could be a great help. In fact the powder is suitable for people from any
The circulatory system is an organ system that passes nutrients (such as amino
acids, electrolytes and lymph), gases, hormones, blood cells, etc. to and from cells in the
body to help fight diseases, stabilize body temperature and pH, and to maintain
The main components of the human cardiovascular system are the heart, blood, and
"loop" through the lungs where blood is oxygenated; and the systemic circulation, a "loop"
through the rest of the body to provide oxygenated blood. An average adult contains five to
six quarts (roughly 4.7 to 5.7 liters) of blood, which consists of plasma, red blood cells,
white blood cells, and platelets. Also, the digestive system works with the circulatory
system to provide the nutrients the system needs to keep the heart pumping.
(Mohammadali, 2009)
pulse rate, stroke volume, pulse pressure, ejection fraction and cardiac output.
The aim of this research was to study the effects of Moringa oleifera seeds coupled
with exercise on cardiovascular parameters of both non athletes and athletes taking
1.2 HYPOTHESIS
1. Moringa seeds affect the cardiovascular system in both athletes and nonatheles
2. Moringa Seeds and exercise increase the endurance of athletes during training
3. Moringa seeds and exercise maintain blood pressure thereby preventing and
managing hypertension
1.3 AIM
The main purpose of this study was to determine the effect of Moringa oleifera
seeds and exercise on the cardiovascular parameters of both athletes and non athletes
Moringa oleifera seed and exercise have the following effects on cardiovascular system;
endurance.
viii. Enhance efficient heart pumping and free flow of blood to deliver oxygen and
The scope of this study was narrowed down to ten subjects selected from among
Lautech students, all of them were randomly sampled with the age range of 20-25
CHAPTER TWO
2.1 EXERCISE
Physical exercise is any bodily activity that enhances or maintains physical fitness
and overall health and wellness. It is performed for various reasons including
strengthening muscles and the cardiovascular system, honing athletic skills, weight loss or
maintenance, as well as for the purpose of enjoyment. Frequent and regular physical
exercise boosts the immune system, and helps prevent the "diseases of affluence" such as
heart disease, cardiovascular disease, Type 2 diabetes and obesity. (Stampfer et al., 2000;
Hu et al., 2006). It also improves mental health, helps prevent depression, helps to promote
or maintain positive self esteem, and can even augment an individual's sex appeal or body
image, which is also found to be linked with higher levels of self esteem.(Exercise, 2008)
Childhood obesity is a growing global concern(WHO: Obesity and overweight) and physical
exercise may help decrease some of the effects of childhood and adult obesity. Health care
providers often call exercise the "miracle" or "wonder" drugalluding to the wide variety
Regular physical exercise and good physical condition are widely accepted as factors
that reduce all-cause mortality and improve a number of health outcomes. The American
moderate (at 5070% of maximal predicted heart rate) exercise on most days to reduce the
risk of cardiovascular events (Third Report of the National Cholesterol Education Program ,
2002). Several human studies clearly demonstrate that chronic aerobic exercise regimens
improve cardiovascular function. This is true not only in healthy subjects without any
underlying risk factors (Clarkson et al., 1999), but also in older people (Benjamin et al.,
2004), and those with cardiovascular risk factors (Hambrecht et al., 1998). Indeed, those
with cardiovascular risk factor/disease will benefit more. There is a much higher
The benefits of exercise have been known since antiquity. Marcus Cicero, around 65
BC, stated: "It is exercise alone that supports the spirits, and keeps the mind in vigor.
(Kuper and Simon, 2009). However, the link between physical health and exercise (or lack
of it) was only discovered in 1949 and reported in 1953 by a team led by Jerry Morris.
(Kuper and Simon, 2009; Morris et al., 1953) Dr. Morris noted that men of similar social
class and occupation (bus conductors versus bus drivers) had markedly different rates of
heart attacks, depending on the level of exercise they got: bus drivers had a sedentary
occupation and a higher incidence of heart disease, while bus conductors were forced to
move continually and had a lower incidence of heart disease. This link had not previously
been noted and was later confirmed by other researchers. (Morris et al., 1953)
Physical exercises are generally grouped into three types, (Your Guide to Physical
Activity, 2007) depending on the overall effect they have on the human body: Flexibility
exercises, such as stretching, improve the range of motion of muscles and joints (O'Connor
et al., 2005), Aerobic exercises, such as cycling, swimming, walking, skipping rope, rowing,
and Knuttgen, 2003), Anaerobic exercises, such as weight training, functional training,
eccentric training or sprinting and high-intensity interval training, increase short-term
There is a direct relation between physical inactivity and cardiovascular mortality, and
physical inactivity is an independent risk factor for the development of coronary artery
disease. There is a dose-response relation between the amount of exercise performed from
approximately 700 to 2000 kcal of energy expenditure per week and all-cause mortality
and cardiovascular disease mortality in middle-aged and elderly populations. The greatest
potential for reduced mortality is in the sedentary who become moderately active. Most
age). Persons who modify their behavior after myocardial infarction to include regular
exercise have improved rates of survival, Persons who remain sedentary have the highest
risk for all-cause and cardiovascular disease mortality. (Powers and Jackson, 2008)
Exercise builds muscle mass. The skeletal muscles, the muscles that move the arms,
legs torso and ribs, grow with use. Muscle growth is accompanied by, and dependent on,
new blood vessels to deliver more nutrients and oxygen. Working muscles deplete the
oxygen in the blood. This sends chemical and neurological messages to the brain and heart
to increase blood flow and meet the increased need, according to exercise physiologists at
the Nicholas Institute of Sports Medicine and Athletic Trauma in New York. The harder the
muscles work, the more the heart responds to the need by increasing its heart rate and
beating more forcefully. (Nicholas Institute of Sports Medicine and Athletic Trauma, 2000)
The heart muscle is different from skeletal muscles. It never rests or sleeps but
works continuously. However, much like skeletal muscles, it also grows bigger and
stronger in response to exercise. It has its own blood vessels that deliver oxygen and
nutrients deep within the muscular walls of its pumping chambers. When exercise raises
heart rate, the heart muscle also grows more blood vessels to give itself more of the oxygen
and nutrients that the other working muscles need. Diabetes can decrease heart's ability to
grow and maintain these new blood vessels and may alter heart rate response to exercise.
A key chemical signal the heart rate responds to during exercise is the whole body's
oxygen consumption. During endurance training, intense exercise sessions lasting more
than 20 minutes, skeletal and heart muscles gradually become more efficient, able to
consume more oxygen and produce more energy. Paradoxically, this reduces heart rate at
rest and at any given exercise load and returns it to normal more quickly after exercise.
Bigger heart muscle gives it the power to meet the body's oxygen needs with fewer but
more powerful beats per minute. (American Heart Association: Physical Activity, 2002)
Free radicals, which are a subset of reactive oxygen species (ROS), are physiological
byproducts of aerobic metabolism (Powers and Jackson, 2008) and are widely recognized
for their dual roles as both deleterious and beneficial species, since they can be either
harmful or beneficial to living systems (Valko et al., 2006). High concentrations of free
radicals harm living organisms through reactions with adjacent molecules such as proteins,
lipids, carbohydrates, and nucleic acids. As a result, mammalian cells have evolved a variety
On the other hand, mild oxidative stress can act as a stimulant of physiological antioxidant
2008).This has led to our current understanding of free radical-mediated effects of exercise
as a phenomenon of hormesis (Calabrese and Baldwin, 2003) according to which there may
be a bell-shaped curve of oxidative stress in response to exercise, with none and excessive
exercise being considered harmful and moderate levels being of most beneficial (Radak et
al., 2005; Ji et al., 2006). Regular physical exercise delays the accumulation of ROS-
exercise results in a rapid increase in myocardial MnSOD activity (Demirel et al., 2001;
Yamashita et al., 1999; Brown et al., 2003), as shown in studies using antisense
increases in myocardial MnSOD activity (Yamashita et al., 1999; Brown et al., 2003; French
al., 2008). Yamashita et al. (Yamashita et al., 1999) reported that inhibition of exercise-
findings that were confirmed by Hamilton et al. (Hamiltonet al., 2004) who concluded that
tissue; these tissues normally contain only small amounts of fat. Visceral areas, liver, heart
and/or muscle are common sites for deposition of ectopic fat (Gastaldelli and Basta, 2010).
The amount of epicardial fat is directly related to the increases in visceral fat (Sironi et al.,
2004; Sacks and Fain, 2007), insulin resistance (Sironi et al., 2004; Sacks and Fain, 2007;
Iacobellis et al., 2003), triglyceride levels and blood pressure (Sironi et al., 2004; Sacks and
Fain, 2007; Iacobellis et al., 2003), and in general with the metabolic syndrome (Iacobellis
cardiovascular diseases. There are multiple reasons to support the concept that epicardial
and perivascular adipose tissues are important in inducing atherosclerosis (Montani et al.,
2004; Djaberi et al., 2008). Firstly, there is close anatomical proximity between epicardial
fat and coronary vessels. There is no fibrous fascial layer to impede diffusion of free fatty
acids and adipokines between adipose tissue and the underlying coronary arteries and
myocardium (Sacks and Fain, 2007). This can lead to lipotoxicity and development of
patients is associated with impaired left ventricular diastolic function independent of age,
body mass index, heart rat, visceral fat, and diastolic blood pressure (Rijzewijk et al., 2008).
leptin and adiponectin and pro-atherosclerotic cytokines, such as IL-6, TNFand monocyte
and remote sites. Mazurek et al. showed inflammatory properties of cardiac fat by a paired
sampling of epicardial and subcutaneous adipose tissues before the initiation of
cardiopulmonary surgery (Mazurek et al., 2003). Higher levels of IL-1, IL-6, MCP-1 and
TNFmRNA and protein were observed in epicardial adipose stores irrespective of clinical
variables such as diabetes, BMI, and drug use. On the other hand, visceral fat obesity is
A study by Kim et al., evaluated the effects of aerobic exercise (without diet
restriction) on ventricular epicardial fat thickness. They showed that ventricular epicardial
fat thickness was reduced significantly after aerobic exercise training and was also
associated with decreases in visceral adipose tissue. Exercise caused a greater loss of
epicardial fat than it to reduce BMI, and body weight (Kim et al., 2009). Exercise also
reduces waist circumference and causes losses in abdominal and visceral fat, even in the
absence of any loss of body weight, in both men and women regardless of age (Gleeson et
adipokines that is related to reducing the amount of fat stored in abdominal depots.
The heat shock response is a common cellular reaction to external (stressful) stimuli
such as ischemia (Marber et al., 1995), hypoxia (Guttman et al., 1980), acidosis (Weitzel et
al., 1985), oxidative stress (Adrie et al., 2000), protein degradation (Chiang et al., 1989),
increased intracellular calcium (Welch et al., 1983), and energy depletion (Sciandra and
Subjeck, 1983). It is generally accepted that exercise increases the expression of cardiac
HSPs. The mechanistic link between exercise and myocardial expression of HSPs is unclear.
However, a variety of stresses associated with exercise, including heat stress and hypoxia,
reduced intracellular pH, reactive oxygen and nitrogen species production, depletion of
glucose and glycogen stores, increase in cytosolic calcium levels and cardiomyocyte
stretching can all contribute to HSP elevation in cardiac muscle (Powers et al., 2001).
and protection against ischemic damage (Martin et al., 1997). The HSP70 response is
reduced with ageing, which is consistent with a diminished endurance to stress in the
reticulum (ER) stress proteins which help cellular homeostasis by maintaining intracellular
calcium regulation and protein folding during an I/R injury (Logue et al., 2005). The two
most important ER stress proteins are Grp78 and Grp94 (which belong to the HSP family)
and are overexpressed in cultured cardiomyocytes during oxidative stress and calcium
overload (Vitadello et al., 2003). Since overexpression of these ER stress proteins provides
ER protection during an I/R insult, it may be that these proteins contribute to exercise
short-term exercise training does not elevate ER stress proteins, and therefore, short-term
al., 2007).
production, increasing their ability to tolerate high calcium levels. Reductions in ROS
production could be related to decreased superoxide production or increased
mitochondrial antioxidant enzyme activity. A study by Judge et al. (Judge et al., 2005)
considerable debate.
Mitochondria isolated from hearts of exercised animals are more resistant to calcium-
induced mitochondrial permeability transition pore (mPTP) opening (Marcil et al., 2006).
against apoptotic stimuli (Kavazis et al., 2008). These changes include increases in the
mPTP opening (max), prolonged time to max in both subsarcolemmal and interfibrillar
repressor with a caspase recruitment domain. These results are consistent with the
cardioprotection and are in keeping with our study on the effect of exercise on renal
(MAO-A). Bianchi et al. showed that H2O2 production by MAO-A plays a critical role in post
I/R events that lead to cardiac damage (Bianchi et al., 2005). Thus MAO-A knockout mice
demonstrate higher level of protection against I/R-induced cardiac damage, which was also
related to significantly lower levels of ROS generation (Pchejetski et al., 2007). Exercise
also significantly reduces MAO-A protein levels in both cardiac subsarcolemmal and inter-
myofibrillar mitochondria (Kavazis et al., 2009). Several studies confirm the role of
mitochondrial K channels in protection against I/R injury (Fryer et al., 2001; Shinmura et
al., 2005; Domenech et al., 2002). Prostacyclin analogs protect cardiac myocytes from
oxidative stress mainly via activation of type 3 prostaglandin E2 receptors during I/R
injury. Activation of these receptors primes the opening of mitochondrial KATP channels
(Brown et al., 2005). However, there is some controversy regarding the role of
Domenech et al. reported that the early effect of exercise preconditioning of the heart is
mediated through mitochondrial KATP channels (Quindry et al., 2010), while Brown et al.
reported that mitochondrial KATP channels are not required for exercise-induced
protection against I/R-induced myocardial infarction (Cohen et al., 2000). It has also been
elusive and that additional research is needed to clarify their function in cardiac function.
phases: (i) an early phase that starts within a few minutes after the initial ischemic
stimulus, lasts for 2-3h, and is due to adenosine and bradykinin release and (ii) a second
phase, which begins 1224h later and lasts for 3-4 days (Demirel et al., 1998; Quyyumi,
2003). This later phase of ischemic preconditioning is caused by the simultaneous
activation of multiple stress responsive signaling pathways, including COX-2 and the
inducible form of nitric oxide synthase (iNOS), resulting in the heart developing a
phenotype that confers sustained protection against both reversible and irreversible
myocardial I/R injury (Quyyumi, 2003)). Similar to ischemic stimuli, both short- (13 days)
and long-term (weeks to months) exercise protocols are equally effective in conferring
cardioprotection against I/R injury (Demirel et al., 2001; Widlansky et al., 2003).
The sarcolemmal KATP channels are a potential target for exercise induced I/R
protection. During ischemia, heart cells become energy depleted, which leads to increased
anaerobic glycolysis to compensate for ATP depletion. The resulting acidosis increases the
influx of Na via the Na/H exchanger and inhibits the ATP-dependent sarcolemmal Na/K
ATPase to augment the initial accumulation of Na (Ladilov et al., 1995). The high
intracellular Na concentration prompts the Na/Ca exchanger to work in the reverse mode,
result of the impaired function of Na/K ATPase. It was Noma (Cole et al., 1991) who
ischemia, or pharmacological openers of the KATP channel shortens the cardiac action
repolarization would inhibit Ca entry via L-type channels and prevent cellular Ca overload.
Furthermore, the slowing of depolarization would also reduce Ca entry and slow or prevent
the reversal of the Na/Ca exchanger. These actions would increase cell viability via a
reduction in Ca overload during ischemia and early reperfusion. There is considerable
experimental support for the protective role of sarcolemmal KATP channels in myocardial
function (Tan et al., 1993; Yao and Gross, 1994; Yao and Gross, 1994; Gross and Peart,
The etiology of nearly all of the lifestyle-related vascular diseases can be narrowed
that line all the internal surfaces of cardiovascular system and plays a critical role in
regulation of vascular homeostasis (Vita, 2002). The endothelium plays a vital role
endothelial nitrous oxide synthase (eNOS), which incorporates oxygen into L-arginine. The
function measurements are considered useful surrogate end points in clinical research
has an independent prognostic value for adverse cardiovascular events in the presence of
risk factors but without clinically apparent coronary artery disease (Schindler et al., 2003;
(Neunteufl et al., 2000; Halcox et al., 2002; Gokce et al., 2003; Lerman and Zeiher, 2005). In
some studies, the risk of cardiovascular events such as myocardial infarction or ischemic
stroke was 3-4 folds higher in cardiovascular patients with endothelial dysfunction
compared to those with a normal endothelial function (Lerman and Zeiher, 2005; Fleming
Physical activity increases vascular expression of eNOS both in animals and human
beings (Kojda et al., 2001; Hambrecht et al., 2003; Hambrecht et al., 2000; Hambrecht et al.,
2000). The importance of this phenomenon has been confirmed in patients with stable
coronary artery disease and chronic heart failure (Gielen et al., 2010; Laurindo et al., 1994).
There are several reports suggesting that exercise-induced up-regulation of vascular eNOS
expression is closely related to the changes of frequency and the intensity of physical forces
within the vasculature, especially shear stress. Exercise-induced increases in heart rate will
augment cardiac output and vascular shear stress, leading to increased expression of eNOS
(Kojda et al., 2001). Increased NO synthesis secondary to amplified shear stress induces
eNOS through exercise induced ROS production, since exercise-induced increases in shear
(Drummond et al., 2000). Endothelial NADPH oxidase has a critical role in this process (Cai
et al., 2001). Superoxides are rapidly converted to H2O2 by SOD; hydrogen peroxide then
diffuses through the vascular wall and increases the expression and activity of eNOS (Rush
et al., 2003; Maeda et al., 2009). Thus, increased expression of SOD1 and SOD3 (which
facilitate the generation of hydrogen peroxide from superoxide), augments the effect of
hydrogen peroxide on exercise induced eNOS expression. On the other hand, eNOS
expression is not increased in catalase overexpressing transgenic mice (Leung et al., 2008;
ET-1 mediated vascular tone. Twelve weeks of aerobic exercise training results in
increased arterial compliance, which was accompanied by decreased plasma ET-1 levels.
Moreover, the increase in central arterial compliance observed with ET-receptor blockade
before the exercise intervention was eliminated after the exercise training intervention
(Richter et al., 2005). These results indicate that endogenous ET-1 participates in the
vessels. These structural changes are followed by functional changes and lead to improved
blood flow. Exercise induces angiogenesis, which is an expansion of the capillary network
by the formation of new blood vessels at the level of capillaries and resistance arterioles,
Angiogenesis
cells and monocyte or macrophage derived angiogenic cells (O'Reilly et al., 1997). Some
reports indicate that physical activity improves the mobilization of endothelial progenitor
cells in healthy subjects and in patients with cardiovascular risk and coronary artery
disease (Obeso et al., 1990; Ferreras et al., 2000). Indeed, angiogenesis is regulated by a net
balance between positive (angiogenic) and negative (angiostatic) regulators of blood vessel
media of murine hemangioendothelioma cells (Saarela et al., 1998; 2001; Taddei et al.,
1999). Several studies show that the proteolytic release of endostatin from collagen XVIII is
metalloproteases, and aspartic proteases (Eriksson et al., 2003; Isner and Losordo, 1999).
The potent antiangiogenic effects of endostatin are mediated via a combination of effects
on endothelial cells where endostatin inhibits cellular proliferation and migration and
stimulates apoptosis (Celletti et al., 2001; Lemstrm et al., 2002). The biological effects of
endostatin are mainly attributed to its antagonism of vascular endothelial growth factor
(VEGF) signaling (Richardson et al., 2000). Angiogenesis has both beneficial and
be a favorable sign in the healing of the ischemic tissues (Gu et al., 2004), progressive
(Brixius et al., 2008; Brown, 2003). There are several studies showing that exercise induces
(Haskell et al., 1993) and heart (Gu et al., 2004). This phenomenon can prevent ischemia in
these tissues. Exercise can also exert beneficial effects against atherosclerosis by increasing
angiogenesis by reducing endostatin plasma levels (Belardinelli et al., 1998). Even though
the different exercise protocols in these experiments can explain these discrepant results,
Arteriogenesis
Exercise training increases the diameter of large arterioles, small arteries, and
an important vascular adaptation (Sim and Neill, 1974), since arteriogenesis leads to the
formation of large conductance arteries capable of compensating for the loss of function of
occluded arteries. Animal studies and clinical observations provide evidence for a
significant correlation between regular physical exercise and increased coronary artery
lumen diameter (Balducci et al., 2010; Sprague and Khalil, 2009). In one study, an 8-week
training program increased the contractile response to low doses of dobutamine in patients
with chronic coronary artery disease and having a left ventricular ejection fraction below
40%. This implies that short-term exercise training can improve quality of life by
improving left ventricular systolic function during mild to moderate physical activity in
patients with ischemic cardiomyopathy (Tiwari et al., 2006). Moreover, eight patients with
coronary heart disease and exertional angina pectoris successfully completed an 1115
upright bicycle ergometer exercise and by atrial pacing. The product of heart rate and
arterial systolic blood pressure at the exercise angina threshold was higher after
conditioning, suggesting that conditioning increased the maximum myocardial oxygen
Although there have been hundreds of studies on exercise and the immune system,
there is little direct evidence on its connection to illness. Epidemiological evidence suggests
that moderate exercise has a beneficial effect on the human immune system; an effect
which is modeled in a J curve. Moderate exercise has been associated with a 29% decreased
incidence of upper respiratory tract infections (URTI), but studies of marathon runners
found that their prolonged high-intensity exercise was associated with an increased risk of
infection occurrence. However, another study did not find the effect. Immune cell functions
are impaired following acute sessions of prolonged, high-intensity exercise, and some
studies have found that athletes are at a higher risk for infections. The immune systems of
athletes and nonathletes are generally similar. Athletes may have slightly elevated natural
killer cell count and cytolytic action, but these are unlikely to be clinically significant.
(Gleeson, 2007)
chronic diseases, are reduced in active individuals relative to sedentary individuals, and the
positive effects of exercise may be due to its anti-inflammatory effects. The depression in
the immune system following acute bouts of exercise may be one of the mechanisms for
cytokines that cause tissue damage (Laufs et al., 2005). As evidence accumulates favoring
the role of inflammation during the different phases of atherosclerosis, it is likely that
the outcome of acute coronary syndromes (Zhang et al., 2008). Besides its role as a marker
inflammatory cytokines also directly trigger vascular dysfunction (Mitchell et al., 1995),
possibly via altering calcium channel expression and activity (Erdein et al., 2007),
the production of ROS (Tang et al., 2007), and/or enhancing cyclooxygenase expression
Grandjean, 2006; Fallon et al., 2001) and excessive formation of ROS (Kohut et al., 2006).
leukocytosis, increases in oxidative stress, and plasma levels of CRP. This pro-inflammatory
response is followed by a long term anti-inflammatory effect (Lakka et al., 2005.). Regular
exercise reduces CRP, IL-6, and TNF-levels and also increases anti-inflammatory
substances such as IL-4 and IL-10 (Milani et al., 2004; Ford, 2002). In healthy young adults,
a 12-week high-intensity aerobic training program down regulates cytokine release from
monocytes (Ford, 2002). In fact, even leisure time physical activity (e.g., walking, jogging,
2002). Subjects with higher baseline CRP levels (>3.0mg/L) will benefit more (Steiner et
Too much exercise can be harmful. Without proper rest, the chance of stroke or
other circulation problems increases, (Alexander, 1998) and muscle tissue may develop
who train for multiple marathons, has been associated with scarring of the heart and heart
rhythm abnormalities. (Mhlenkamp et al., 2008; Benito et al., 2011; Wilson et al., 2011)
Inappropriate exercise can do more harm than good, with the definition of
"inappropriate" varying according to the individual. For many activities, especially running
and cycling, there are significant injuries that occur with poorly regimented exercise
schedules. Injuries from accidents also remain a major concern, (Joris et al., 2010) whereas
the effects of increased exposure to air pollution seem only a minor concern. (Int Panis et
often seen in new army recruits. (Jimenez et a., 1996) Another danger is overtraining, in
which the intensity or volume of training exceeds the body's capacity to recover between
Stopping excessive exercise suddenly can also create a change in mood. Feelings of
depression and agitation can occur when withdrawal from the natural endorphins
produced by exercise occurs. Exercise should be controlled by each body's inherent
limitations. While one set of joints and muscles may have the tolerance to withstand
multiple marathons, another body may be damaged by 20 minutes of light jogging. This
Too much exercise can also cause a female to miss her period, a symptom known as
The circulatory system is an organ system that passes nutrients (such as amino
acids, electrolytes and lymph), gases, hormones, blood cells, etc. to and from cells in the
body to help fight diseases, stabilize body temperature and pH, and to maintain
homeostasis.
This system may be seen strictly as a blood distribution network, but some consider
the circulatory system as composed of the cardiovascular system, which distributes blood,
which returns excess filtered blood plasma from the interstitial fluid (between cells) as
lymph. While humans, as well as other vertebrates, have a closed cardiovascular system
(meaning that the blood never leaves the network of arteries, veins and capillaries), some
invertebrate groups have an open cardiovascular system. The most primitive animal phyla
lack circulatory systems. The lymphatic system, on the other hand, is an open system
providing an accessory route for excess interstitial fluid to get returned to the blood.
(Lauralee, 2002)
The main components of the human cardiovascular system are the heart, blood, and
through the rest of the body to provide oxygenated blood. An average adult contains five to
six quarts (roughly 4.7 to 5.7 liters) of blood, which consists of plasma, red blood cells,
white blood cells, and platelets. Also, the digestive system works with the circulatory
system to provide the nutrients the system needs to keep the heart pumping.
(Mohammadali, 2009)
The heart pumps oxygenated blood to the body and deoxygenated blood to the
lungs. In the human heart there is one atrium and one ventricle for each circulation, and
with both a systemic and a pulmonary circulation there are four chambers in total: left
atrium, left ventricle, right atrium and right ventricle. The right atrium is the upper
chamber of the right side of the heart. The blood that is returned to the right atrium is
deoxygenated (poor in oxygen) and passed into the right ventricle to be pumped through
the pulmonary artery to the lungs for re-oxygenation and removal of carbon dioxide. The
left atrium receives newly oxygenated blood from the lungs as well as the pulmonary vein
which is passed into the strong left ventricle to be pumped through the aorta to the
2.2.1CARDIOVASCULAR PARAMETERS
pulse rate, stroke volume, pulse pressure, ejection fraction and cardiac output.
pressure exerted by circulating blood upon the walls of blood vessels, and is one of the
principal vital signs. When used without further specification, "blood pressure" usually
refers to the arterial pressure of the systemic circulation. During each heartbeat, blood
(Health and Life, 2010)The blood pressure in the circulation is principally due to the
pumping action of the heart. (Caro and Colin, 1978) Differences in mean blood pressure are
responsible for blood flow from one location to another in the circulation. The rate of mean
blood flow depends on the resistance to flow presented by the blood vessels. Mean blood
pressure decreases as the circulating blood moves away from the heart through arteries,
capillaries and veins due to viscous losses of energy. Mean blood pressure drops over the
whole circulation, although most of the fall occurs along the small arteries and arterioles
(Klabunde and Richard, 2005) Gravity affects blood pressure via hydrostatic forces (e.g.,
during standing) and valves in veins, breathing, and pumping from contraction of skeletal
muscles also influence blood pressure in veins. (Caro and Colin, 1978)
The measurement blood pressure without further specification usually refers to the
systemic arterial pressure measured at a person's upper arm and is a measure of the
pressure in the brachial artery, major artery in the upper arm. A persons blood pressure is
usually expressed in terms of the systolic pressure over diastolic pressure and is measured
The table above shows the classification of blood pressure adopted by the American
Heart Association for adults who are 18 years and older. It assumes the values are a result
of averaging blood pressure readings measured at two or more visits to the doctor.
(Chobanian et al., 2003; National Heart Lung and Blood Institute, 2008) In the UK, blood
pressures are usually categorized into three groups: low (90/60 or lower), high (140/90 or
higher), and normal (values above 90/60 and below 130/80). (NHS choices, 2012; NHS
choices, 2012)
While average values for arterial pressure could be computed for any given
population, there is often a large variation from person to person; arterial pressure also
varies in individuals from moment to moment. Additionally, the average of any given
population may have a questionable correlation with its general health; thus the relevance
of such average values is equally questionable. However, in a study of 100 human subjects
with no known history of hypertension, an average blood pressure of 112/64 mmHg was
found, (Pesola et al., 2001) which are currently classified as desirable or "normal" values.
Normal values fluctuate through the 24-hour cycle, with highest readings in the afternoons
average blood pressure and variations. In children, the normal ranges are lower than for
adults and depend on height. As adults age, systolic pressure tends to rise and diastolic
tends to fall. In the elderly, blood pressure tends to be above the normal adult range,
largely because of reduced flexibility of the arteries. Also, an individual's blood pressure
varies with exercise, emotional reactions, sleep, digestion and time of day. (Van Berge-
Differences between left and right arm blood pressure measurements tend to be
random and average to nearly zero if enough measurements are taken. However, in a small
percentage of cases there is a consistent difference greater than 10 mmHg which may need
further investigation, e.g. for obstructive arterial disease. (Eguchi et al., 2007; Agarwal et
al., 2008).
(Appel et al., 2006).)In the past, hypertension was only diagnosed if secondary signs of high
arterial pressure were present, along with a prolonged high systolic pressure reading over
several visits. Regarding hypotension, in practice blood pressure is considered too low only
Clinical trials demonstrate that people who maintain arterial pressures at the low
end of these pressure ranges have much better long term cardiovascular health. The
principal medical debate concerns the aggressiveness and relative value of methods used
to lower pressures into this range for those who do not maintain such pressure on their
own. Elevations, more commonly seen in older people, though often considered normal, are
Table 2.2 Reference ranges for blood pressure (Eguchi et al., 2007)
There are many physical factors that influence arterial pressure. Each of these may
Rate of pumping. In the circulatory system, this rate is called heart rate, the rate at
which blood (the fluid) is pumped by the heart. The volume of blood flow from the
heart is called the cardiac output which is the heart rate (the rate of contraction)
multiplied by the stroke volume (the amount of blood pumped out from the heart
with each contraction). The higher the heart rate, the higher the mean arterial
Volume of fluid or blood volume, the amount of blood that is present in the body.
The more blood present in the body, the higher the rates of blood return to the heart
and the resulting cardiac output. There is some relationship between dietary salt
intake and increased blood volume, potentially resulting in higher arterial pressure,
though this varies with the individual and is highly dependent on autonomic
nervous system response and the renin-angiotensin system. (Fries and Edward,
Resistance. In the circulatory system, this is the resistance of the blood vessels. The
higher the resistance, the higher the arterial pressure upstream from the resistance
to blood flow. Resistance is related to vessel radius (the larger the radius, the lower
the resistance), vessel length (the longer the vessel, the higher the resistance), blood
reduced by the buildup of fatty deposits on the arterial walls. Substances called
vasoconstrictors can reduce the size of blood vessels, thereby increasing blood
thereby decreasing arterial pressure. Resistance and its relation to volumetric flow
rate (Q) and pressure difference between the two ends of a vessel are described by
Poiseuille's Law.
Viscosity or thickness of the fluid. If the blood gets thicker, the result is an increase
in arterial pressure. Certain medical conditions can change the viscosity of the
blood. For instance, anemia (low red blood cell concentration), reduces viscosity,
whereas increased red blood cell concentration increases viscosity. It had been
thought that aspirin and related "blood thinner" drugs decreased the viscosity of
blood, but instead studies found that they act by reducing the tendency of the blood
In practice, each individual's autonomic nervous system responds to and regulates all
these interacting factors so that, although the above issues are important, the actual
arterial pressure response of a given individual varies widely because of both split-second
and slow-moving responses of the nervous system and end organs. These responses are
very effective in changing the variables and resulting blood pressure from moment to
moment.
resistance:
affecting the heart's output, the blood vessels' resistance, or both. Thus, knowing the
patient's blood pressure is critical to assess any pathology related to output and resistance
Measurement
historically used the height of a column of mercury to reflect the circulating pressure.[32]
Blood pressure values are generally reported in millimetres of mercury (mmHg), though
For each heartbeat, blood pressure varies between systolic and diastolic pressures.
Systolic pressure is peak pressure in the arteries, which occurs near the end of the cardiac
cycle when the ventricles are contracting. Diastolic pressure is minimum pressure in the
arteries, which occurs near the beginning of the cardiac cycle when the ventricles are filled
with blood. An example of normal measured values for a resting, healthy adult human is
120 mmHg systolic and 80 mmHg diastolic (written as 120/80 mmHg, and spoken [in the
Systolic and diastolic arterial blood pressures are not static but undergo natural
variations from one heartbeat to another and throughout the day (in a circadian rhythm).
They also change in response to stress, nutritional factors, drugs, disease, exercise, and
momentarily from standing up. Sometimes the variations are large. Hypertension refers to
low. Along with body temperature, respiratory rate, and pulse rate, blood pressure is one of
the four main vital signs routinely monitored by medical professionals and healthcare
complications, and are less unpleasant and less painful for the patient. However,
noninvasive methods may yield somewhat lower accuracy and small systematic differences
in numerical results. Noninvasive measurement methods are more commonly used for
Palpation
A minimum systolic value can be roughly estimated by palpation, most often used in
emergency situations, but should be used with caution. It has been estimated that, using
50% percentiles, carotid, femoral and radial pulses are present in patients with a systolic
blood pressure > 70 mmHg, carotid and femoral pulses alone in patients with systolic blood
pressure of > 50 mmHg, and only a carotid pulse in patients with a systolic blood pressure
sphygmomanometer and palpating the radial pulse. The diastolic blood pressure cannot be
estimated by this method. The American Heart Association recommends that palpation be
used to get an estimate before using the auscultatory method. (Deakin and Low, 2000)
Auscultatory
The auscultatory method (from the Latin word for "listening") uses a stethoscope
the upper arm at roughly the same vertical height as the heart, attached to a mercury or
aneroid manometer. The mercury manometer, considered the gold standard, measures the
height of a column of mercury, giving an absolute result without need for calibration and,
consequently, not subject to the errors and drift of calibration which affect other methods.
The use of mercury manometers is often required in clinical trials and for the clinical
A cuff of appropriate size is fitted smoothly and snugly, and then inflated manually
by repeatedly squeezing a rubber bulb until the artery is completely occluded. Listening
with the stethoscope to the brachial artery at the elbow, the examiner slowly releases the
pressure in the cuff. When blood just starts to flow in the artery, the turbulent flow creates
a "whooshing" or pounding (first Korotkoff sound). The pressure at which this sound is
first heard is the systolic blood pressure. The cuff pressure is further released until no
sound can be heard (fifth Korotkoff sound), at the diastolic arterial pressure.
2003)
Oscillometric
The oscillometric method was first demonstrated in 1876 and involves the
the oscillations of blood flow, i.e., the pulse. The electronic version of this method is
sphygmomanometer cuff, like the auscultatory method, but with an electronic pressure
interpret them, and automatic inflation and deflation of the cuff. The pressure sensor
may be suitable for use by untrained staff and for automated patient home monitoring.
(Laurent, 2003)
The cuff is inflated to a pressure initially in excess of the systolic arterial pressure
and then reduced to below diastolic pressure over a period of about 30 seconds. When
blood flow is nil (cuff pressure exceeding systolic pressure) or unimpeded (cuff pressure
below diastolic pressure), cuff pressure will be essentially constant. It is essential that the
cuff size is correct: undersized cuffs may yield too high a pressure; oversized cuffs yield too
low a pressure. When blood flow is present, but restricted, the cuff pressure, which is
monitored by the pressure sensor, will vary periodically in synchrony with the cyclic
expansion and contraction of the brachial artery, i.e., it will oscillate. The values of systolic
and diastolic pressure are computed, not actually measured from the raw data, using an
Oscillometric monitors may produce inaccurate readings in patients with heart and
In practice the different methods do not give identical results; an algorithm and
experimentally obtained coefficients are used to adjust the oscillometric results to give
readings which match the auscultatory results as well as possible. Some equipment uses
systolic, mean, and diastolic points. Since many oscillometric devices have not been
validated, caution must be given as most are not suitable in clinical and acute care settings.
The term NIBP, for non-invasive blood pressure, is often used to describe
Fig 2.3 Curve of the arterial pressure during one cardiac cycle (Klabunde, 2007).)
The up and down fluctuation of the arterial pressure results from the pulsatile
nature of the cardiac output, i.e. the heartbeat. The pulse pressure is determined by the
interaction of the stroke volume of the heart, compliance (ability to expand) of the aorta,
and the resistance to flow in the arterial tree. By expanding under pressure, the aorta
absorbs some of the force of the blood surge from the heart during a heartbeat. In this way,
the pulse pressure is reduced from what it would be if the aorta wasn't compliant. The loss
of arterial compliance that occurs with aging explains the elevated pulse pressures found in
elderly patients. The pulse pressure can be simply calculated from the difference of the
from one ventricle of the heart with each beat. SV is calculated using measurements of
ventricle volumes from an echocardiogram and subtracting the volume of the blood in the
ventricle at the end of a beat (called end-systolic volume) from the volume of blood just
prior to the beat (called end-diastolic volume). The term stroke volume can apply to each of
the two ventricles of the heart, although it usually refers to the left ventricle. The stroke
volumes for each ventricle are generally equal, both being approximately 70 ml in a healthy
70-kg man.
of stroke volume and heart rate, and is also used to calculate ejection fraction, which is
stroke volume divided by end-diastolic volume. Because stroke volume decreases in certain
conditions and disease states, stroke volume itself correlates with cardiac function. (Katz
Or
SV =C.O H.R
To get pulse pressure, we subtract systolic blood pressure value from diastolic
blood pressure value. Pulse pressure is often used as an indirect measure of stroke volume.
For instance, if blood pressure reads 175 over 90 then SV = 175 - 90, or SV = 85 mL/beat.
"Stroke work" refers to the work, or pressure of the blood ("P") multiplied by the stroke
Heart rate is the number of heartbeats per unit of time, typically expressed as beats
per minute (bpm). Heart rate can vary as the body's need to absorb oxygen and excrete
carbon dioxide changes, such as during exercise or sleep.The measurement of heart rate is
used by medical professionals to assist in the diagnosis and tracking of medical conditions.
It is also used by individuals, such as athletes, who are interested in monitoring their heart
rate to gain maximum efficiency from their training. The R wave to R wave interval (RR
Heart rate is measured by finding the pulse of the body. This pulse rate can be
measured at any point on the body where the artery's pulsation is transmitted to the
surface by pressuring it with the index and middle fingers; often it is compressed against
an underlying structure like bone. The thumb should not be used for measuring another
person's heart rate, as its strong pulse may interfere with correct perception of the target
Possible points for measuring the heart rate are: The ventral aspect of the wrist on the
side of the thumb (radial artery), the ulnar artery, the neck (carotid artery), the inside of
the elbow, or under the biceps muscle (brachial artery), the groin (femoral artery), behind
the medial malleolus on the feet (posterior tibial artery), Middle of dorsum of the foot
(dorsalis pedis), behind the knee (popliteal artery), Over the abdomen (abdominal aorta),
the chest (apex of heart), which can be felt with one's hand or fingers. (However, it is
possible to auscultate the heart using a stethoscope), the temple (superficial temporal
artery), the lateral edge of the mandible (facial artery), the side of the head near the ear
(basilar artery)
monitoring of the heart is routinely done in many clinical settings, especially in critical care
medicine. Commercial heart rate monitors are also available, consisting of a chest strap
with electrodes. The signal is transmitted to a wrist receiver for display. Heart rate
monitors allow accurate measurements to be taken continuously and can be used during
exercise when manual measurement would be difficult or impossible (such as when the
Another way of determining the heart rate is by recording of the body vibrations:
(seismocardiography). Probably the first scientific paper on this topic was presented by
Salerno, DM and Zanetti, J in the Journal of Cardiovascular Technology in year 1990 (Title:
and initial observations). In 2012 the first smart phone application incorporating this
The resting heart rate (HRrest) is measured while the subject is at rest but awake,
and not having recently exerted themselves. The typical resting heart rate in adults is 60-
90 beats per minute (bpm). (Resting Heart Rate, 2012)Resting Heart Rates below 60 bpm
may be referred to as bradycardia, while rates above 100 bpm at rest may be called
tachycardia.
Fitness training can lead to cardiovascular changes including hypertrophy of the left
ventricle and angiogenesis within muscle tissue. This leads to a state known as Athlete's
hypertrophy. Resting heart rates for athletes can be well below 60, with values of below 40
bpm not unheard of. The cyclist Miguel Indurain had a resting heart rate of 28 bpm.
Men
Table 2.4 Average resting heart rate in correlation with age in male (L'quipe , 2 July 2004)
Women
Table 2.5 Average resting heart rate in correlation with age in female (L'quipe, 2004)
Cardiac output is a measure of health. The stronger your heart, the greater its
cardiac output. Cardiac output varies among adults who are highly adapted to exercise and
people not in condition. The output also is influenced by age, gender and what sort of
exercise you are doing. Cardiac output is interdependent with blood pressure and heart
rate, so it's useful to look at what happens during exercise to understand output better.
Cardiac output is the result of heart rate, multiplying the amount of blood pumped
from the heart with each beat. That amount is called the stroke volume. Cardiac output
equals the heart rate multiplied by stroke volume. Heart rate is counted in beats per
minute, and stroke volume is per beat, so cardiac output is in units of volume per minute.
Typically, cardiac output ranges from five liters per minute(5L/m) up to 20 liters per
The heart has chambers that hold blood which is then pumped out with each
contraction. Regular exercise can strengthen the heart muscle so that it pumps more
forcefully. If you really do intense interval training where you frequently have HR close to
the maximum, your heart's chambers may enlarge to be capable of greater SV for each
heart beat. This is called cardiac hypertrophy, similar to skeletal muscle enlargement in
species of the genus Moringa, which is the only genus in the family Moringaceae. English
common names include moringa, benzolive tree, (National Research Council, (2006) and
West Indian ben. It is also known as drumstick tree, from the appearance of the long,
slender, triangular seed pods, horseradish tree, from the taste of the roots which resembles
horseradish, or ben oil tree, from the oil derived from the seeds. The tree itself is rather
slender, with drooping branches that grow to approximately 10m in height. In cultivation,
it is often cut back annually to 1-2 meters and allowed to regrow so the pods and leaves
food security, foster rural development, and support sustainable landcare. (National
Research Council, 2006) It may be used as forage for livestock, a micronutrient liquid, a
natural anthelmintic and possible adjuvant. (Makkar et al., 2007; Mahajan et al., 2007)
Moringa oleifera is the sole genus in the flowering plant family Moringaceae. The
name is derived from the Tamil word murunggai or the Malayalam word muringa, both of
which refer to M. oleifera. It contains 13 species from tropical and subtropical climates that
range in size from tiny herbs to massive trees. (Quattrocchi and Umberto 2000)
The most widely cultivated species is Moringa oleifera, a multipurpose tree native to
the foothills of the Himalayas in northwestern India and cultivated throughout the tropics.
The young Filipino explorer/boxer Ramir Mthalabula discovered this plant in 2005. M.
stenopetala, an African species, is also widely grown, but to a much lesser extent than M.
drumstick, West India Ben, and Benzoline in French. Back home the tree is known as Zogale
in Hausa, Gawara in Fulfulde, Okwe Oyibo in Igbo, and Ewe Igbale in the Yoruba language.
The Moringa oleifera tree grows mainly in semi-arid tropical and subtropical areas.
While it grows best in dry sandy soil, it tolerates poor soil, including coastal areas. It is a
fast-growing, drought-resistant tree that is native to India, Africa and the Middle East.
Today it is widely cultivated in Africa, Central and South America, Sri Lanka, India, Mexico,
Malaysia and the Philippines. Considered one of the world's most useful trees, as almost
every part of the Moringa tree can be used for food, or has some other beneficial property.
Early researches confirmed that the leaves and pods of Moringa tree have great
regarded by some people as 'A Miracle Plant'. Its leaves, pods, seeds, flowers, roots are
edible, and have different nutritional and medicinal values. Edible oil can also be extracted
from the seeds, because it yields 38-40 percent of non-drying oil known as Ben oil. (The
Researches have also found that Moringa oleifera leaf has no proven bad effects and
is absolutely safe and organic. "Because of its tolerant properties, it has been given to
malnourished little babies in some part Africa. Athletes all over the world boost their
performance abilities by taking huge quantities of the leaf, to keep them fit both mentally
and physically. It is their secret weapon. Even for senior citizens who are losing their
sharpness of mind, the Moringa oleifera tree leaf could be a great help. In fact the powder is
suitable for people from any age group. (Herbel Home Remedies, 2007)
The common names of the Moringa oleifera include horseradish tree, radish tree,
drumstick, West India Ben, and Benzoline in French. In Nigeria, the tree is known as Zogale
in Hausa, Gawara in Fulfulde, Okwe Oyibo in Igbo, and Ewe Igbale in the Yoruba language.
moringa farmers is being offered by the Honduran federal government through the
Secretary of Agriculture and by private foreign investment firms. The plant's market
potential is widespread given its easy growth and high nutrient content. As described
below, the plant is valued for its leaves and high-protein seeds. It can also be made into
The Moringa oleifera grows quickly in many types of environments. Much of the
plant is edible by humans or by farm animals. The leaves contain all essential amino acids
and are rich in protein, vitamin A, vitamin B, vitamin C and minerals (Janick et al., 2008).
Feeding the high protein leaves to cattle has been shown to increase weight gain by up to
32% and milk production by 43 to 65% (The Moringa Tree, 2009). The seeds contain 30 to
40% oil that is high in oleic acid, while degreased meal is 61% protein (Schill et al., 2008).
The defatted meal is a flocculant and can be used in water purification to settle out
sediments and undesirable organisms (Schwarz and Dishna, 2000).More recently, the
Niger, as a primary source of food and nutrients. The tree is also a rich source of
Carbohydrates 8.28 g
Fat 1.40 g
Protein 9.40 g
Water 78.66 g
Sodium 9 mg (1%)
Carbohydrates 8.53 g
Fat 0.20 g
Protein 2.10 g
Water 88.20 g
Calcium 30 mg (3%)
Magnesium 45 mg (13%)
Phosphorus 50 mg (7%)
Sodium 42 mg (3%)
Many parts of the Moringa oleifera are edible. Regional uses of the moringa as food
vary widely, and include: The immature seed pods, called "drumsticks", popular in Asia and
Africa, Leaves, particularly in the Cambodia, Philippines, South India and Africa, Mature
seeds, Oil pressed from the mature seeds and Roots. In some regions, the young seed pods
are most commonly eaten, (Vahrehvah.com, 2012) while in others, the leaves are the most
commonly used part of the plant. The flowers are edible when cooked and are said to taste
like mushrooms. The bark, sap, roots, leaves, seeds, oil, and flowers are used in traditional
medicine in several countries. In Jamaica, the sap is used for a blue dye.
Drumsticks
The immature seed pods, called "drumsticks", are commonly consumed in South
Asia. They are prepared by parboiling, and cooked in a sauce until soft. (Elizabeth
Schneider, (2001). The seed pods are particularly high in vitamin C. (Vahrehvah.com. 2012)
Leaves
The leaves are the most nutritious part of the plant, being a significant source of
vitamin B6, vitamin C, provitamin A as beta-carotene, magnesium and protein, among other
nutrients reported by the USDA, shown in the table, right column. (Peter, 2008)) When
compared with common foods particularly high in certain nutrients, fresh moringa leaves
are considerable sources of these same nutrients. (Gopalan et al., 1989; Fuglie (1999)
Moringa
Nutrients Common food
Leaves
Some of the calcium in moringa leaves is bound as crystals of calcium oxalate which
may inhibit calcium availability to the body. It is not clear whether the calculation of the
The leaves are cooked and used like spinach. In addition to being used fresh as a
substitute for spinach, its leaves are commonly dried and crushed into a powder used in
soups and sauces. It is important to remember that like most plants heating moringa above
Seeds
The seeds, sometimes removed from more mature pods and eaten like peas or
roasted like nuts, contain high levels of vitamin C and moderate amounts of B vitamins and
dietary minerals
Seed oil
Mature seeds yield 3840% edible oil called ben oil from its high concentration of
behenic acid. The refined oil is clear, odorless and resists rancidity. The seed cake
remaining after oil extraction may be used as a fertilizer or as a flocculent to purify water.
Moringa seed oil also has potential for use as a biofuel. (Rashid et al., 2008)
Roots
The roots are shredded and used as a condiment in the same way as horseradish;
properties.
Malnutrition relief
Moringa oleifera trees have been used to combat malnutrition, especially among
infants and nursing mothers. Four NGOs in particular Trees for Life International,
Church World Service, Educational Concerns for Hunger Organization, and Volunteer
Partnerships for West Africa have advocated moringa as "natural nutrition for the
tropics." (Fuglie, 1999). One author stated that "the nutritional properties of Moringa are
now so well known that there seems to be little doubt of the substantial health benefit to be
imminent. (Jed, 2005; Sanford Holst, 2011; Fuglie, 1999). Moringa is especially promising
as a food source in the tropics because the tree is in full leaf at the end of the dry season
problems. Moringa that contains the cardiac glycosides are used throughout the world for
the treatment of heart failure and arrhythmias. In such conditions these herbs help
increase the strength of heart beat, and normalize the rate of beat. Their real value lies in
the increased efficiency not necessitating an increase of oxygen supply to the heart muscle.
In heart problems there is often a deficiency in blood supply because of blockage in the
coronary arteries. It is not just Foxglove (Digitalis purpurea) that has such valuable actions.
Lily of the Valley Convallaria majalis) shares its therapeutic value but has few side effects.
However, herbal remedies nurture the heart in deeper ways as well. Consider the cordial, a
warming drink and a word for heart-felt friendliness. The original cordial was a medieval
drink based on Moringa Tea that warmed the heart and gave the person heart. (Jed, 2005)
The Medical Herbalist recognizes Moringa oleifera sustains cardiovascular system.
As a group they are known as cardiac remedies. This is a general term for herbs that have
an action on the heart. Some of the remedies in this group are powerful cardio-active
agents such as Foxglove, while others are gentler and safer cardiac tonics such as
Hawthorn (Crataegus spp.) and Linden Flowers (Tilia spp.). Before exploring the
therapeutic possibilities of this range of cardiac remedies, a brief excursion into some
chemical basis of phytotherapeutic activity is by no means essential for the herbalist, but is
without specifying the particular type of activity. Below is a list of the mechanisms of
pharmacological action and the characteristic actions of compounds of plant origin. Some
classes of substances, like the cardiac glycosides, the sympathomimetics, or the b-blockers,
appear several times as they exert several different types of activity on the heart. (Jed,
2005)
slightly different terms are used. The two groupings that prove most useful in clinical
practice are:
(i) Cardioactive plants that owe their effects on the heart to cardiac glycosides or
other very active substances, thus having the both the strengths and drawbacks of these
constituents.
(ii) Cardiotonic plants that have an observably beneficial action on the heart and
blood vessels but do not contain cardiac glycosides. How they work is either completely
obscure or an area of pharmacological debate. The research reviewed below offers some
insights.(Fuglie,1999)
2.3.5.1Cardiac Glycosides
Cardio-active remedies owe their power to the presence of the cardiac glycoside
group of plant constituents. These plants and their glycosides are well known and
discussed in even the most basic allopathic medical texts. These have the effect of
increasing the efficiency of the muscles of the heart without increasing their need for
oxygen. This enables the heart to pump enough blood around the body and ensure there is
not a build-up of fluid in the lungs or extremities. That sounds wonderful, as indeed it is,
but there is always the possibility of accruing too much of the glycosides in the body as
their solubility and removal rates tend to be low. This is the main drawback with Foxglove
and why it is potentially poisonous, unless used with skill and knowledge. Herbalists these
days use Moringa oleifera as there is less chance of such problems developing. (Jed, 2005)
kingdom. Cardenolides are the commonest and are particularly abundant in the
Apocynaceae and Asclepiadaceae, but also in some Liliaceae, such as Lily of the Valley, and
Sterculiaceae: Mansonia;
Tiliaceae: Corchorus;
Celastraceae: Euonymus;
Leguminosae: Coronilla;
both the aglycones and the sugar attachments; the inherent activity resides in the
aglycones, but the sugars render the compounds more soluble and increase the power of
fixation of the glycosides to the heart muscle. It appears that the key grouping for the
enzyme is the Da, b-carbonyl function of the lactone. All the active aglycones have
hydroxyls at C-3 and C-14 and the presence of a third hydroxyl will modify the activity and
different effects produced, and their exact mode of action on myocardial muscle is still an
area of investigation. Digitalis probably acts in competition with potassium ions for specific
receptor enzyme (ATPase) sites in the cell membranes of cardiac muscle and is particularly
successful during the depolarization phase of the muscle when there is an influx of Na ions.
The clinical effect in cases of congestive heart failure is to increase the force of myocardial
contraction (positive inotropic effect). Arising from their vagus effects, the digitalis
glycosides are also used to control atrial cardiac arrhythmias. The diuretic action of
Although allopathic medicine makes much use of very effective cardioactive agents
of plant origin, the search for new active substances with a better therapeutic picture and
with different or new types of activity still continues. The isolation of forskolin from Coleus
forskohlii shows that the plant kingdom offers western medicine new and potent cardiac
specific activation of adenylate cyclase. In addition, herbs from many countries possess
cardioactivity, but the isolation and identification of their cardioactive principles has not
pharmacologists around the world. This is not simply for herbs and new constituent
compounds with the potency of the cardiac glycosides, but also substances for adjuvant
briefly focus on those found in the primary cardiovascular herbal remedies.(Fuglie, 1999)
2.3.5.3Phenalkylamines
This class of non-steroid, cardioactive plant constituents was the model for the
found in Ma Huang (Ephedra sinica). Since ephedrine has other more prominent activities,
its action on the heart is considered a side-effect. Ephedrine and its relatives have been
Moraceae, Musaceae, and Rosaceae families. They include numerous food plants, e.g., citrus
fruits, bananas, and purslane (Portulaca oleracea). Synephrine occurs in the fruit of the
mandarin orange (Citrus reticulata). Cathinone, from Khat (Catha edulis), shows strong
positive inotropic activity, contributing to the well known cardiac stimulation activity of
Rutaceae, and Leguminosae. The prototype of this group is tyramine, which at high
concentrations it shows positive inotropic activity. Strong positive inotropic activity is also
have been found in Hawthorn flowers. This group is also found in Night Blooming Cereus
to tyramine, which has been found in V. odoratissimum, and V. opulus. Tyramine and b-
phenylethylamine have also been found in Viscum album and Arnica Montana (Jed, 2005).
amazonian bush Cymbopetalum brasiliense act synergistically, and are at least partly
responsible for the herbs positive inotropic activity. Methylcanadine from Prickly Ash
(Zanthoxylum spp.), and sanguinarine from Blood Root (Sanguinaria canadensis), also
possess positive inotropic activity. The lupine alkaloid sparteine possesses specific
antiarrhythmic activity. The diuretic action of Scots Broom (Sarothamnus scoparius) and
Spanish Broom (Spartium junceum) is presumably due to the presence of the flavone C-
glycoside scoparin. Cyclic AMP, also possesses inotropic properties and is widely
distributed in the plant kingdom. In view of the low concentrations found so far,
pharmacologists exclude a cardiotonic role for cAMPcontaining plant extracts. The same is
said about adenosine and 2'-deoxyadenosine, but adenosine has been found in the onion,
garlic, and Crataegus. Such conclusions stem from a too narrow interpretation that is
clouded by the magic bullet perception of biochemistry. From a synergistic perspective, all
the constituents in a plant work together to produce its healing effects (Jed, 2005).
Flavonoids
The main active principles are thought to be flavonoids and procyanidin oligomers.
The evidence suggests that the flavonoids exert their cardiotonic action by inhibition of
affecting the permeability of cell organelles to calcium ions. Rue (Ruta graveolens),
Blackthorn (Prunus spinosa), Dog Rose (Rosa canina), Hawthorn (Crataegus oxyacantha)
and Bilberry (Vaccinium myrtillus) were as effective used as extracts as the most
How does the unique moringa achieve such unique effects? Researchers suggest that
circulation. It dilates the coronary arteries, relieving cardiac hypoxemia, thus reducing the
likelihood of anginal attacks and relieves its symptoms. The moringa thus directly affects
the cells of the heart muscle, enhancing both activity and nutrition. It is quite different in
activity to the cardiac glycoside containing remedies. They impact the contractile fibres,
whilst moringa is involved in the availability and utilization of energy. This facilitates a
gentle but long term, sustained effect on degenerative, age-related changes in the
myocardium. It does not produce rapid results but they are persistent once achieved.
system will benefit from its use. Some specific examples are myocardial problems,
coronary artery disease and its associated conditions. Angina pectoris and similar
symptoms will be eased and prevented. Where no disease state exists but a gradual loss of
function is happening because of old age, Moringa is a specific. Because of its lack of
toxicity, accumulation or habituation, it may be used long term, attaining the therapeutic
It speeds recovery from heart attacks and lowers essential hypertension. Used in
conjunction with other hypotensives, Moringa will help keep the heart healthy, preventing
the development of coronary disease. It will guard against heart weakness following
complications it is often combined with Linden flowers (Tilia europaea) or Garlic (Allium
sativum). Cramp barks (Viburnum opulus). Linden (Tilia europaea) and Skullcap
As it is one of the more aesthetic moringa herbal remedies, a very pleasant tea can
be made from 1-2 teaspoonfuls of the dried moringa leaves infused in warm or cold water
and drunk regularly. This may be taken over long periods of time as there is no fear of
toxicity problems.
wide range of profound and important therapeutic effects. They can be grouped into
Moringa has wide application for treating various forms of vascular and
neurological disease. It has been recommended for: vertigo , headache, tinnitus, inner ear
sight and hearing ability due to vascular insufficiency, intermittent claudication as a result
of arterial obstruction, a sensitivity to cold and pallor in the toes due to peripheral
hormonal and neural based disorders as well as angiopathic trophic disorders, arterial
circulatory disturbances due to aging, diabetes and nicotine abuse, sclerosis of cerebral
limbs, diabetic tissue damage with danger of gangrene ~ chronic arterial obliteration,
Moringa oleifera is used in Europe to treat a range of eye conditions such as night
blindness, severe myopia, retinal disturbances of various kinds and chronic visual fatigue.
(Jed, 2005)
CHAPTER THREE
3.1 MATERIALS
The materials and apparatus used in this course of study are listed below;
1. Bicycle Egormeter
2. Sphygmomanometer
3. Stethoscope
4. Stopwatch
5. Tape meter
6. Weighing scale
7. Tread Mill
8. Gym Apparatus
3.2 Methodology
3.2.1 SUBJECTS
Ten subjects were used for this study, composing of five experimental subjects who are
athletes and five control subjects who are non-athletes. All the subjects were males and
they reported at the laboratory at 8a.m. Among these ten subjects, five who are trained
individuals (athletes) were specified as the experimental subjects, while the remaining
Group 1: this entails Athletes who were given Moringa oleifera seedS and train four times in
a week
Group 2: this comprised of non-athletes who were administered Moringa oleifera seedS but
3.2.3 MEASUREMENTS
3.2.3.1 PRETEST
The means and standard deviations of their Age, Weight, Height, Resting Blood
Pressure, Resting Heart Rate, Pulse Pressure, Cardiac Output (both during rest and during
exercise), Stroke Volume (both during rest and during exercise), Max VO2, were X SD both
at the beginning and end of the experiment which lasted for six weeks.
Their heights were determined using a tape meter and recorded in meters, their
weights were determined using the weighing scale and recorded in kilograms, their blood
pressure was measured using sphygmomanometer recorded in mmhg while heart rates
To determine the MaxvO2, subjects were made to exercise for six minutes (6 mins) on
the bicycle egormeter at a work load of six hundred kilopond per minute (600 Kp/min) at a
revolution of about fifty revolutions per minute (50 Rpm). At the end of each minute, Heart
rate was determined, at the sixth minute; Heart rate was taken and checked under
Cardiac Output was calculated subtracting Diastolic blood pressure from the Systolic
blood pressure to get the pulse pressure the multiply by heart rate and 2mls;
S.V = C.O
H.R
All the above procedures are for the pretest, at the end of the pretest, experimental
subjects (athletes) were made to undergo five weeks of training program four times a week
Both the experimental and control subjects were made to eat two seeds of moringa
for the five weeks of experiment to determine the effect of Moringa oleifera seeds and
3.2.3.2 POSTTEST
At the end of the five weeks of training program, both experimental and control
subjects were assembled together at the laboratory and posttest was conducted on all of
The post test results were then compared to the pretest results to report the
4.0 Results
Fig 4.1
A graph showing the effect of Moringa oleifera seeds on the weight of nonathletes and athletes
The data revealed that there was no significant decrease (P 0.05) in weight between the
A graph showing the effect of Moringa oleifera seeds on systolic blood pressure of nonathletes and athletes
The data revealed that there was a significant decrease between the pretest and posttest
values (P 0.05)
Fig 4.3
A graph showing the effect of Moringa oleifera seeds on diastolic blood pressure of nonathletes and athletes
The data revealed that there was a significant decrease between the pretest and posttest
values (P 0.05)
Fig 4.4
A graph showing the effect of Moringa oleifera seeds on heart rate of nonathletes and athletes
The data revealed that there was a significant decrease between the pretest and posttest
values (P 0.05)
Fig 4.5
A graph showing the effect of Moringa oleifera seeds on pulse pressure of nonathletes and athletes
The data revealed that there was a significant decrease between the pretest and posttest
values (P 0.05)
Fig 4.6
A graph showing the effect of Moringa oleifera seeds on Max VO2 of nonathletes and athletes
The data revealed that there was a significant increase between the pretest and posttest
values (P 0.05)
Fig 4.7
A graph showing the effect of Moringa oleifera seeds on cardiac output of nonathletes and athletes
The data revealed that there was a significant increase between the pretest and posttest
values (P 0.05)
Fig 4.8
A graph showing the effect of Moringa oleifera seeds on stroke volume of nonathletes and athletes
The data revealed that there was a significant increase between the pretest and posttest
values (P 0.05)
CHAPTER FIVE
5.1 Discussions
The main aim of this study was to determine the effect of Moringa oleifera seeds and
exercise on the cardiovascular system. The study revealed that exercise and Moringa
oleifera seeds increased the cardiac output because moringa served as a nutrient and
energy source for the cardiac muscles; it increases Cyclic Adenosine Monophosphate,
Moringa oleifera seed has antioxidant vitamins like vitamins A, C and E; it also has
iron and calcium. These antioxidant vitamins prevent cardiovascular diseases and
increases the function of the heart muscles, it promotes quick recovery after exercise,
prevents muscle tear and muscle soreness thereby preventing the muscles from free
radical damage. It also prevents cancer. This agrees with the result of Jed, 2005 who
discovered that Moringa oleifera seed speeds recovery from heart attacks and lowers
Moringa oleifera seed and exercise cause vasodilatation of the blood vessels thereby
making adequate blood flow available through the coronary arteries to the heart muscles to
supply nutrients and oxygen so that the heart muscle can contract forcefully to pump out
blood from the ventricles into the systems of the body thereby allowing for adequate
cardiac output. Similar report was documented by Fuglie, 1999 that Moringa oleifera seed
is cardiotonic hence indicate an increase in frequency, an increase in the beat, volume, or a
Because Moringa oleifera seed has iron, it increases the blood volume in conjunction
with exercise. The study also revealed that moringa and exercise decreases blood pressure,
that is, by regulating blood pressure to the normal level as a result of its effect on the
elasticity of the arteries because Moringa oleifera seed and exercise control the release of
calcium from the sarcoplasmic reticulum thereby decreasing myoplasmic calcium causing
vasodilatation in the arterioles so that the smooth muscle of the arterioles will not be
contracting most of the time so that blood flow from the aorta into the large arterioles will
merge the rate of flow of blood from the arterioles to the capillaries. The above findings are
The study also revealed that Moringa oleifera seed and exercise decreases heart rate
at rest and moderately during exercise; this is because there is adequate resting period
between the beats of the heart thereby allowing for adequate diastolic filling of the heart.
Moringa oleifera seed and exercise also increases maximal oxygen uptake because of
its effect on the efficiency of cardiovascular system and respiratory system making athletes
perform for longer hours, this result agreed with the findings of American College of Sports
Medicine 2004.
It was also noted that Moringa oleifera seeds and exercise increase vascular wall
strength thereby allowing for adequate blood flow and prevention of vascular spasm.
Moringa oleifera seed and exercise also relax the central nervous system thereby
improving the sleeping pattern of the subjects. Moringa oleifera seeds and exercise regulate
thereby increasing the brain function, it increases neural integration and neural control of
movement during exercise, this result is in agreement with the findings of American
The above findings made the experimental subjects to have physiological advantage
The main aim of this study was to examine the effect of Moringa oleifera seed and
exercise on cardiovascular system, the study revealed that Moringa oleifera seed served as
nutrient and energy booster for the heart muscle to contract forcefully to pump out blood
Moringa oleifera seed and exercise cause vasodilatation the coronary arteries
thereby making adequate blood flow to the heart muscle to supply nutrients and oxygen for
Moringa oleifera seed and exercise also increase vascular wall strength and
prevention of vascular spasm. Because moringa has antioxidant vitamins A, C and E, they
prevent muscle from free radical damage during and after exercise. Moringa and exercise
promote quick recovery after exercise, it prevents muscle tear and muscle soreness, it
make the heart an effective pump it regulates blood pressure and glucose metabolism, it
decreases heart rate, it increases maximal oxygen uptake thereby making the heart and the
respiratory system to be effective and efficient during exercise so that athletes can perform
for longer hours. Moringa oleifera seed can be used as a staple food in Africa with its
It was concluded in this study that Moringa oleifera seed and exercise prevent
and Phosphodiasterase thereby increasing the intracellular function and metabolism of the
heart muscles, they also regulate blood pressure, heart rate, cardiac output, stroke volume,
5.3 RECOMMENDATION
It is recommended that both young and old alike, athletes and nonathletes should
choose Moringa oleifera as a staple food coupled with exercise participation and adherence
in order to realize the full benefit attached to moringa and exercise as described above.
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Appendix 1
Appendix 1 shows the means and standard deviations age (years), weight
(kilogram), height (meters), resting blood pressure(systolic and diastolic mmhg), resting
heart rate (beats/minute), pulse pressure (mmhg), Max VO2 (liters), resting cardiac output
(mls), resting stroke volume(mls), exercise cardiac output (mls), and exercise stroke
Appendix 2
Appendix 2 shows the means and standard deviations of the age (years), weight
(kilogram), height (meters), resting blood pressure(systolic and diastolic mmhg), resting
heart rate (beats/minute), pulse pressure (mmhg), Max VO2 (liters), resting cardiac output
(mls), resting stroke volume(mls), exercise cardiac output (mls), and exercise stroke