Effect of Combination of Purple Sweet Potato (Ipomoea batatas L.) Ethanolic Extract and Ramipril Administration on Myocardial C-Reactive Protein Expression and Aortic Intima-Media Thickness in Hypertensive Rat Model

Abstract

Purposes: To determine the effect of giving a combination of purple sweet potato (Ipomoea batatas L.) ethanolic extract and ramipril in a rat model of hypertension. Methods: This is an experimental study with a post-test-only control group design and is a collaborative study of the effect of giving a combination of purple sweet potato (Ipomoea batatas L.) ethanolic extract and ramipril in a rat model of hypertension. Thirty male Wistar rats were given 2 mL/day of a 4% NaCl diet to induce hypertension. The rats were divided into three treatment groups, consists of NaCl 4% 2 mL/day + combination therapy with purple sweet potato (Ipomoea batatas L.) ethanolic extract 400 mg/kgBW/day and ramipril 1 mg/day (P1), NaCl 4% 2 mL/day + purple sweet potato (Ipomoea batatas L.) ethanolic extract 400 mg/kgBW/day (P2) and NaCl 4% 2 mL/day + ramipril 1 mg/day (P3). At week 5, the rat was executed to examine myocardial CRP expression and measure aortic IMT. All the data obtained were analyzed statistically. Results: There was a significant difference in myocardial CRP expression between the three treatment groups (p value<0.05). The combination of purple sweet potato (Ipomoea batatas L.) ethanolic extract 400 mg/kgBW/day + ramipril 1 mg/day (P1) showed a better effect on reducing myocardial CRP expression than administration of purple sweet potato (Ipomoea batatas L.) ethanolic extract 400 mg/kgBW/day (P2) (mean difference 216.44 ng/ml; 95% CI 133.56 – 299.32; p value<0.001) or Ramipril 1 mg/day (P3) (mean difference 144.44 ng/ml; 95% CI 29 .40 – 199.47; p value=0.010). Administration of Ramipril 1 mg/day (P3) showed a better effect on reducing myocardial CRP expression than the group given purple sweet potato (Ipomoea batatas L.) ethanolic extract 400 mg/kg/day (P2) (mean difference 102.00 ng/ml; CI 95% 19 .11 – 184.88; p value=0.018). There was a significant difference in aortic IMT between the three treatment groups (p value<0.05). The combination of purple sweet potato (Ipomoea batatas L.) ethanolic extract 400 mg/kgBW/day + ramipril 1 mg/day (P1) showed a better effect on reducing aortic IMT than administration of purple sweet potato (Ipomoea batatas L.) ethanolic extract 400 mg/kgBW/day (P2) (mean difference 10,16 μm; 95% CI 6,63 – 13,69; p value<0.001) or Ramipril 1 mg/day (P3) (mean difference 5,10 μm; 95% CI 1,40 – 8,70; p value=0.008). Administration of Ramipril 1 mg/day (P3) showed a better effect on reducing aortic IMT than the group given purple sweet potato (Ipomoea batatas L.) ethanolic extract 400 mg/kg/day (P2) (mean difference 5,05 μm; CI 95% 1,50 – 8,50; p value=0.007). Combination of purple sweet potato (Ipomoea batatas L.) ethanolic extract and ramipril showed a higher potential effect on reducing myocardial CRP expression and aortic IMT compared to single therapy. Conclusion: The combination of purple sweet potato (Ipomoea batatas L.) ethanolic extract 400 mg/kgBW/day + ramipril 1 mg/day can provide the best decrease in the expression of myocardial CRP and aortic IMT compared to the administration of purple sweet potato (Ipomoea batatas L.) ethanolic extract 400 mg/kg/day or ramipril 1 mg/day.