Phytomedicine 23 (2016) 1119–1126 Contents lists available at ScienceDirect Phytomedicine journal homepage: www.elsevier.com/locate/phymed Inflammaging and cardiovascular disease: Management by medicinal plants Erfaneh Shayganni a , Mahmoud Bahmani b , Sedigheh Asgary c , Mahmoud Rafieian-Kopaei a,* a Medical Plants Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran b Food and Beverages Safety Research Center, Urmia University of Medical Sciences, Urmia, Iran c Isfahan Cardiovascular Research Center, Isfahan University of Medical Sciences, Isfahan, Iran a r t i c l e i n f o Article history: Received 23 August 2015 Revised 6 November 2015 Accepted 10 November 2015 Keywords: Aging Anti-inflammatory drugs Cardiovascular disease Inflammation Inflammaging Medicinal plants a b s t r a c t Background: In aging, a host of molecular and cellular changes occur which accelerate alteration and progres- sion of inflammatory diseases. These conditions in the elderly people cause appearance of a phenomenon which has been denoted as “inflammaging”. Understanding the pathogenesis and finding new methods for management of inflammaging are essential. Purpose: In this paper we tried not only to explain inflammaging and its treatments with concentrating on medical plants but to collect a sufficient collection of anti-inflammatory plants with focusing on their mechanism of action. Method: In this review paper, by searching in indexing cites, desired articles were obtained since 1995 by us- ing keywords of inflammation, inflammaging, inflammation pathophysiology, free radicals and inflammation, aging inflammation, inflammatory disease, and plants or herbal medicine in inflammation. Sections: In advanced age the generation of free radicals increases in cardiovascular system. Pathological in- flammation is also associated with production of excess free radicals More importantly, chronic inflammation makes aged people susceptible to age-related diseases. Some medicinal plants have been shown promising results in inhibition of inflammaging. Some other sections such as inflammation and inflammaging in cardio- vascular diseases, oxidative stress in cardiovascular complications, prevention and treatment strategies are presented. Conclusion: The results of published papers show that the symptoms of several inflammatory diseases can be inhibited or treated by active ingredients from medicinal plants. © 2015 Elsevier GmbH. All rights reserved. Introduction The world’s population age is increasing and the aging popula- tion is a risk factor for cardiovascular diseases (CVD). Aging generally causes some changes which, even in absence of usual risk factors, ren- der the cardiovascular system prone to some diseases (Lakatta 2000). The progressive degeneration of the heart in elderly makes it more vulnerable to stress and causes an increase in cardiovascu- lar morbidity and mortality (Brodsky et al. 2004). Cardiovascular diseases are also fuelled by some other risk factors such as di- abetes (Baradaran et al. 2013; Behradmanesh et al. 2013), hyper- tension (Asgary et al. 2013; Ghorbani et al. 2013), and obesity Abbreviations: CVD, Cardiovascular diseases; NOS, Nitric oxide synthase; eNOS, En- dothelial nitric oxide synthase; LDLox, Oxidized low density lipoprotein; NSAIDs, Non- steroidal anti-inflammatory drugs; DMARDs, Disease-modifying agents of rheumatoid diseases; NF-kβ, Nuclear factor- kb. * Corresponding author. Tel./fax: +98 383 3330709. E-mail address: rafieian@yahoo.com (M. Rafieian-Kopaei). (Nasri and rafieian-kopaei 2013; Rabiei et al. 2013a; Favarato et al. 2014). Aging is a phenomenon resulted from genetic, epigenetic stochastic, and environmental events in different cells and tissues. In fact in aging, a host of molecular and cellular changes occur which accelerate these alterations and implicate in the progression of arte- rial diseases (Rabiei et al. 2013b; Favarato et al. 2014). Pathological inflammation is also associated with production of excess free radi- cals arising predominantly from mitochondria (Beller 2010; Rafieian- kopaei et al. 2012). There are also evidences showing that in advanced age the generation of free radicals increase in cardiovascular system (Judge et al. 2005; Asadbeigi et al. 2014). More importantly, chronic inflammation makes aged people susceptible to age-related diseases (Franceschi et al. 2000). A wide variety of diseases including diabetes (Asadbeigi et al. 2014) cancer (Azadmehr et al. 2011; Nasri and rafieian-kopaei 2014), infection (Bagheri 2013; Bagheri 2013), atherosclerosis (Rafieian- Kopaei et al. 2011; Rafieian-Kopaei et al. 2014a), cardiovascular dis- eases (Khosravi-Boroujeni et al., 2013; Sarrafzadegan et al. 2013), Alzheimer (Rabiei et al. 2013c, 2014) and other degenerative diseases http://dx.doi.org/10.1016/j.phymed.2015.11.004 0944-7113/© 2015 Elsevier GmbH. All rights reserved.