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  <front>
    <journal-meta id="journal-meta-5a30ef6cbc844b51b93a7c20cb758cfb">
      <journal-id journal-id-type="nlm-ta">Sciresol</journal-id>
      <journal-id journal-id-type="publisher-id">Sciresol</journal-id>
      <journal-id journal-id-type="journal_submission_guidelines"/>
      <journal-title-group>
        <journal-title>Journal of Pharmaceutical Research</journal-title>
      </journal-title-group>
      <issn publication-format="electronic">2454-8405</issn>
      <issn publication-format="print"/>
    </journal-meta>
    <article-meta id="article-meta-09adaa01621b4131b5892ca0cadecd9d">
      <article-id pub-id-type="doi">10.18579/jopcr/v22.1.23.2</article-id>
      <article-categories>
        <subj-group>
          <subject>Research Article</subject>
        </subj-group>
      </article-categories>
      <title-group>
        <article-title id="article-title-894241986bd64ab394e64a17621d8ca0">
          <bold id="strong-e70a6a10fb1741e59df4c8551daed732">A Study of the Antihyperlipidemic and Antioxidant Activities of Ethanolic Extracts of Leaves of </bold>
          <bold id="strong-bfbc9f9f65074b4ba05f7e52b1562170">
            <italic id="e-0861ddbbf1c0">Houttuynia cordata</italic>
          </bold>
          <italic id="e-0861ddbbf1c0-6bb34068-2274-4f11-8787-75573bc37ed3">
            <bold id="strong-a2f02de3e6f7489597b310b1620751ee"> </bold>
          </italic>
          <bold id="strong-85d612a6cedd48dba47aad8ffe84add1">Thunb</bold>
          <bold id="strong-07f54e9f883f4469ae060ab5f8fe3d36">. (EELHC) in Albino Rats </bold>
        </article-title>
        <alt-title alt-title-type="right-running-head">antihyperlipidemic and antioxidant activities</alt-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <name id="name-dc79bf16ffb44d5990f596724bc2a481">
            <surname>Dutta Tassa</surname>
            <given-names>Bikram</given-names>
          </name>
          <xref id="xref-67fa1e015eb44a8aa1326798d0636489" rid="aff-df9478a60a614b3585e7a3181643e79f" ref-type="aff">1</xref>
        </contrib>
        <contrib contrib-type="author" corresp="yes">
          <name id="name-16ea98faeb624dada1ad51368d71f85b">
            <surname>Sahu</surname>
            <given-names>Navajit</given-names>
          </name>
          <email>navasahu@gmail.com</email>
          <xref id="xref-2b8712586dab4571aa4fc0698aaa76c2" rid="aff-40c47e14a8474c06b99636a606d49714" ref-type="aff">2</xref>
        </contrib>
        <contrib contrib-type="author">
          <name id="name-644f7004862e49d1a211089c770adbd8">
            <surname>Pathak</surname>
            <given-names>Pradumna</given-names>
          </name>
          <xref id="xref-62a04b20cecc483b94ec468f31aee0f9" rid="aff-116ef662ed804edeb4427613179ece9f" ref-type="aff">3</xref>
        </contrib>
        <aff id="aff-df9478a60a614b3585e7a3181643e79f">
          <institution>Associate Professor, Department of Pharmacology, Assam Medical College</institution>
          <addr-line>Dibrugarh, Assam</addr-line>
          <country country="IN">India</country>
        </aff>
        <aff id="aff-40c47e14a8474c06b99636a606d49714">
          <institution>Assistant Professor, Department of Pharmacology, Assam Medical College</institution>
          <addr-line>Dibrugarh, Assam</addr-line>
          <country country="IN">India</country>
        </aff>
        <aff id="aff-116ef662ed804edeb4427613179ece9f">
          <institution>Assistant Professor, Department of Pharmacology, Fakhruddin Ali Ahmed Medical College</institution>
          <addr-line>Barpeta, Assam</addr-line>
          <country country="IN">India</country>
        </aff>
      </contrib-group>
      <volume>22</volume>
      <issue>1</issue>
      <fpage>21</fpage>
      <permissions>
        <copyright-year>2023</copyright-year>
      </permissions>
      <abstract id="abstract-abstract-title-29863d0ad8b4412291cabb53588b6686">
        <title id="abstract-title-29863d0ad8b4412291cabb53588b6686">Abstract</title>
        <p id="t-7d21a09ab168">The present study was designed to evaluate the antihyperlipidemic and antioxidant activities of leaves of <italic id="e-4451f5e7a5e5">Houttuynia cordata </italic>Thunb. The ethanolic extract was obtained by percolation method and acute oral toxicity tests were performed according to OECD (Organization for Economic Cooperation and Development) guidelines. Hyperlipidaemia was induced by feeding the rats with a high-fat diet consisting of coconut oil and vanaspati ghee, in a ratio of 2:3 v/v at a dose of 10 ml/Kg body weight. The extract was given at a dose of 500mg/kg body weight. Lipid profile, Malondialdehyde (MDA), Catalase (CAT), and Superoxide Dismutase (SOD) were measured using standard methods. The extract showed a significant decrease in total cholesterol, triglycerides, LDL, and MDA in the blood. On the other hand, HDL, CAT, and SOD increased significantly. The study demonstrates that the ethanolic extract of leaves of Houttuynia <italic id="e-ea4bf0fa0638">cordata Thunb</italic>., decreases blood lipid levels and lipid peroxidation. </p>
        <p id="p-d2cfe1ee993d"/>
      </abstract>
      <kwd-group id="kwd-group-6fc582ba27eb4e68bd5bc81680497d9f">
        <title>Keywords</title>
        <kwd>Antihyperlipidemic</kwd>
        <kwd>Antioxidant</kwd>
        <kwd>Houttuynia cordata Thunb</kwd>
        <kwd>EELHC</kwd>
      </kwd-group>
    </article-meta>
  </front>
  <body>
    <sec>
      <title id="title-64f931d3f558417d815d24fbaa75b228">Introduction</title>
      <p id="paragraph-83d40e61629e4e1599117a55cec38d59">Raised serum lipid profile, particularly of cholesterol along with the generation of reactive oxygen species (ROS), plays a key role in the development of coronary artery disease (CAD) and atherosclerosis. <xref id="xref-d56444c6c2bd4065a2ce7584f5ecd51d" rid="R185819127716462" ref-type="bibr">1</xref>  Clinical trials showed conclusively that lowering serum cholesterol reduces morbidity and mortality from coronary artery disease in patients with established coronary artery disease and also reduces new coronary artery disease events and mortality in patients without established coronary artery disease. <xref id="xref-285999e96ede4d25aab1e09935577b89" rid="R185819127716469" ref-type="bibr">2</xref><sup id="superscript-31860c8bbdca4d96885565e16d4f2bfc"> </sup>CAD is a serious medical problem that affects millions of people annually throughout the world. People who are predisposed to a combination of risk factors (dietary habits, genetic susceptibility, etc.) are more prone to develop atherosclerosis and CAD. <xref id="xref-5a2e94028be44516849e269487ae1f6f" rid="R185819127716473" ref-type="bibr">3</xref></p>
      <p id="paragraph-900f5f20b29743488b08f7ee527681e1"> The main aim of treatment in patients with hyperlipidemia is to reduce the risk of developing ischemic heart disease or the occurrence of further cardiovascular disease or cerebrovascular disease. <xref id="xref-258aafaf0e8b41d5a52eb6b9faf97d81" rid="R185819127716467" ref-type="bibr">4</xref><sup id="superscript-6107ddfdb03f47e187a72db8d35a292f"> </sup> A significant number of patients with hypercholesterolemia do not achieve adequate cholesterol reduction with statins and other lipid-lowering drugs. <xref id="xref-a0d73f6bd459432682aab640b5584d1a" rid="R185819127716476" ref-type="bibr">5</xref></p>
      <p id="paragraph-63fd0bdf64f8462cba8ad7f292c781a9">Although various drugs like HMG-CoA reductase inhibitors, Nicotinic acid, Fibrate derivatives, and bile acid sequestrants are available to combat the situation, they are not always free from side effects. Myopathy, hyperuricemia, peripheral neuropathy, impotence, gynaecomastia, hepatitis, impotence, skin rashes, etc. are noted. <xref id="xref-b0800f2b20be4423bef930609c290a36" rid="R185819127716463" ref-type="bibr">6</xref>  For ages, there has been always a search for an alternative to synthetic drugs with maximal efficacy, and safety at a minimal cost. </p>
      <p id="paragraph-832029f689eb4173b463abe10b1b7211">Phytosterols and natural antioxidants have also been shown to be effective in reducing lipid profiles and also mitigate peroxidative modification of lipoproteins and atherosclerosis. <xref id="xref-e14925038aa5481eab5c47814d0286a3" rid="R185819127716472" ref-type="bibr">7</xref> In this context, the present study is designed to carry out evaluation of hypolipidemic effect of leaves of <italic id="e-b41d8be08fbf">Houttuynia cordata </italic>Thunb. in hyperlipidaemic rats.</p>
      <p id="paragraph-a86827ef0caf4e4585ebacb14c93c64f"><italic id="e-c5d637024724">Houttuynia cordata</italic> Thunb. is one of the important plants of the family Saururaceae. <xref id="xref-e5c98dd427644b56bb060b9ab1c85010" rid="R185819127716478" ref-type="bibr">8</xref><sup id="superscript-b79b7f8d452a460a9e27157dbebe5806"> </sup>This plant is grown widely in South-East Asian region. It’s natural habitat extends up to the Assam region in India on one side and to the Java region of Indonesia on the other.<italic id="e-7c1f4b982d05"> Houttuynia cordata</italic>  has different common names : Chameleon plant, Chinese lizard tail, fish mint, fishwort, heart leaf, Himalayan spinach etc. It grows naturally in moist loamy soils, shallow water and low light intensity. The leaf of this plant has an unusual taste that is often described as fishy. <xref id="xref-e909c21f552d41e187298d79849bd912" rid="R185819127716464" ref-type="bibr">9</xref> The herb is used as a folk medicine as it has antiviral, antibacterial, immune-stimulant, diuretic, anti-cancer, and anti-inflammatory effects. <xref rid="R185819127716479" ref-type="bibr">10</xref>, <xref rid="R185819127716477" ref-type="bibr">11</xref>  It is considered a good blood purifier. Leaves are used to cure stomach ulcers and boiled extract of rhizomes for muscular pains. The brew made of dried herbs is considered very effective for detoxification, hypertension, constipation, pulmonary tuberculosis, and diuretics. <xref id="xref-ecce84b5d7404c74b5888d7365f78e1a" rid="R185819127716471" ref-type="bibr">12</xref></p>
    </sec>
    <sec>
      <title id="title-2f5cbee72ca74919b4f653fc21026a3f">MATERIAL AND METHODS</title>
      <sec>
        <title id="t-c81754212ce6">
          <bold id="strong-22eb662d0e9a49b596dd6a24d12c0568">Plant material</bold>
        </title>
        <p id="paragraph-aab3ea0e4b1142098cd5308a13b63f91"><italic id="e-1afc34cac8f2">Houttuynia cordata</italic> Thunb. leaves were collected from Assam Medical College and Hospital campus, Dibrugarh in the month from April to August 2012, and plant materials were authenticated by Dr. L.R. Saikia, Reader, Department of Life Sciences, Dibrugarh University, Dibrugarh, Assam, India. </p>
      </sec>
      <sec>
        <title id="t-ff8ab73be448">
          <bold id="strong-8e4b37f806414888a3ab952ecc0efefd">Preparation of the extract</bold>
        </title>
        <p id="paragraph-f94a7682ebdf4de481d8b452bb173813"><italic id="e-fcce6729053a">Houttuynia cordata</italic> Thunb. leaves were collected and washed thoroughly and dried at room temperature separately. The dried leaves were ground into powder. A sufficient number of powdered leaves were moistened with 95% ethyl alcohol and allowed to remain for 6 hours in a percolator. When the liquid began to drop from the percolator, the orifice was closed and the content was allowed to macerate for 24 hours. After 24 hours, it was allowed to percolate slowly at a rate not exceeding 1 ml/ min and the solution was collected in Petri dishes. Alcohol was allowed to evaporate at room temperature. When the extract got completely dried, it was scrapped out, weighed, and stored. <xref id="xref-4130cdc1d64e48b2addba33e76ae0d24" rid="R185819127716461" ref-type="bibr">13</xref> </p>
      </sec>
      <sec>
        <title id="t-73061c42ff77">
          <bold id="strong-c2f4afa116664f82a574feca619b574f">Animals</bold>
        </title>
        <p id="paragraph-0e7234ec8a5741f5912d754c48a2ccca">The study was carried out in healthy albino rats (6-8 months aged) of Wistar strain (<italic id="e-f200b013abee">Rattus norvegicus</italic>) of either sex of body weight between 150-200 g. Animals were procured from the Central Animal House (Committee for the Purpose of Control and Supervision on Experiments on Animals (CPCSEA) registration number: 634/GO/Re/S/02/CPCSEA), Assam Medical College and Hospital, Dibrugarh, Assam. They were given a standard animal diet consisting of Bengal gram, wheat, maize, and carrot in sufficient quantity, and water was given ad libitum during the entire period of the experiment. The animals were housed in standard conditions with natural light and dark cycles and adequate ventilation. The study was permitted by the Institutional Animal Ethics Committee (IAEC), Assam Medical College, Dibrugarh, Assam, with approval number IAEC/AMC/02 dated 07/08/11 and conducted in accordance with the CPCSEA guidelines. </p>
      </sec>
      <sec>
        <title id="t-2cc27b7f2ca2"><bold id="strong-0e1535a331b64b45ba897c895f56fff0">Sample collection</bold> </title>
        <p id="paragraph-e60b4058f0244ce39e3c3104e9d6e979">Under all aseptic and antiseptic measures and under ether inhalation anaesthesia, blood samples were collected from the retro-orbital sinus with the help of a capillary tube. The capillary tube was inserted at the medial canthus into the retro-orbital plexus with gentle rotation so that blood flowed into it by capillary action. <xref id="xref-a853d40ad90a4fc382b325c037aacfb5" rid="R185819127716466" ref-type="bibr">14</xref></p>
      </sec>
      <sec>
        <title id="t-9e5ac4238b44">
          <bold id="strong-8de9f93e92774e5c87eae1509b7ef08f">Acute Toxicity Tests </bold>
        </title>
        <p id="paragraph-d80fdf8b9a1645efa0b5f9cf5af4fede">The acute toxicity of Ethanolic Extract of leaves of <italic id="e-894580fc16e5">Houttuynia cordata</italic> Thumb. (EELHC) was determined on female albino rats of Wistar Strain weighing 150-200g. After administration of different doses of the extract, the mortality with each dose was noted as per OECD (Organization for Economic Cooperation and Development, 2006) guidelines 425. <xref id="xref-dcd0ea9f6ebf459c95c0cbb189476abc" rid="R185819127716474" ref-type="bibr">15</xref></p>
      </sec>
      <sec>
        <title id="t-49d2afe6e21d">
          <bold id="strong-ab7baa13b6364294a0ce5082e6b328cf">Induction of </bold>
          <bold id="strong-40e24ae4e0304f6889aa089fd7ab6d5e">hyperlipidemia</bold>
        </title>
        <p id="paragraph-481263b8518247f89b7066a5a9ba7468">A high-fat diet, consisting of coconut oil and vanaspati ghee, in a ratio of 2:3 v/v at a dose of 10 ml/Kg body weight, was fed to the animals, orally, daily, in addition to the normal diet for a period of 8 weeks. <xref rid="R185819127716482" ref-type="bibr">16</xref>, <xref rid="R185819127716480" ref-type="bibr">17</xref></p>
      </sec>
      <sec>
        <title id="t-349a8c564666">Experimental design</title>
        <p id="paragraph-97ce106304f345c895fa7289278f8c91">A total of 20 animals of either sex weighing 150-200g were divided into four groups of five animals each and were treated as follows:</p>
        <p id="paragraph-e46002efb8e74ce1b8a80b9d22dd1940">Group I (Normal Control): Received normal diet and normal saline at a dose of 10 ml/Kg/day.</p>
        <p id="paragraph-09400cd0dffb4d0ba35ae7dbf323c1d3">Group II (Hyperlipidaemic Control): Received high-fat diet at a dose of 10 ml/Kg/day. </p>
        <p id="paragraph-0f9429fb333645f9b44873557d792af2">Group III (Hyperlipidaemic Test): Received high-fat diet at a dose of 10 ml/Kg/day and EELHC at a dose of 500 mg/Kg/day. </p>
        <p id="paragraph-d98aa79cdd954ba6bc6424f93692a7a7">Group IV (Hyperlipidaemic Standard): Received high-fat diet at a dose of 10 ml/Kg/day and Simvastatin at a dose of 1.8 mg/Kg/day.</p>
        <p id="paragraph-7d0e030029414c41940845e7d9120c35">The drugs were administered once daily orally for a period of 8 weeks by intragastric feeding tube. At the end of 8 weeks, all the animals were kept fasting for 12 hours and blood samples were collected from each rat to assess the various parameters of lipid profile and antioxidant status. This fasting may hold true due to two main reasons – </p>
        <list list-type="order">
          <list-item id="li-5546607eba61">
            <p>Postprandial triglycerides remain elevated for several hours, <xref id="xref-9c312014e89948d68ba48402e616977c" rid="R185819127716481" ref-type="bibr">18</xref> </p>
          </list-item>
          <list-item id="li-05709c855e4b">
            <p>Most reference values for serum lipids are established on fasting blood specimens <xref id="xref-ce6cee759a7a4f198bf50e676581447d" rid="R185819127716465" ref-type="bibr">19</xref> </p>
          </list-item>
        </list>
      </sec>
      <sec>
        <title id="t-678d3ca38ff6">
          <bold id="strong-fe64d0b7dee04fb7abb5b9517860bc7b">Estimation of the biochemical parameters</bold>
        </title>
        <p id="paragraph-7a99a4ec238f4c3fae39114686ce3e6b">Serum was separated from the blood after clotting and centrifuged for 5 minutes at 3000 rpm. The serum thus obtained was used for biochemical estimations.</p>
        <p id="paragraph-3e993447fd404896b27ffaa9a1039f6c"> The total serum cholesterol estimation was done by the method described by Allain CC <italic id="e-e3d75e5e791c">et al.</italic> (1974) <xref id="xref-42dac088e2814f24968af983bcf1dc06" rid="R185819127716475" ref-type="bibr">20</xref> using Qualigens-Diagnostics Cholesterol Kit manufactured by Sigma Diagnostics (India) Pvt. Ltd., Baroda. </p>
        <p id="paragraph-f72630f1a78044c5b177415c3f22add9">Triglycerides were measured by enzyme colorimetric method as described by Fossati P <italic id="e-d8f73ebb6209">et al</italic>. (1982) <xref id="xref-d144f22c34bc421b9acc7e3dbce0769b" rid="R185819127716468" ref-type="bibr">21</xref><sup id="superscript-b2c75c386f8f4d068e3f7c94efd9f175"> </sup>using Qualigens-Diagnostics Triglyceride Reagent GPO manufactured by Sigma Diagnostics (India) Pvt. Ltd., Baroda.</p>
        <p id="paragraph-8608a73e869d4d62af7916cae13d4802"> HDL–Cholesterol was assayed by the method of Izzo C <italic id="e-539bc6ec0e25">et al.</italic> (1981) <xref id="xref-9f9438967f624d3abf0f3b72c6141e5a" rid="R185819127716470" ref-type="bibr">22</xref><sup id="superscript-2aace7ea47d9495faffa09a8e0981eec"> </sup>using Qualigens-Diagnostics HDL-cholesterol Kit manufactured by Sigma Diagnostics (India) Pvt. Ltd., Baroda. </p>
        <p id="paragraph-f2f4aa288e704d60906efc605087c530">LDL–Cholesterol was measured by using the formula of Friedewald WT<italic id="e-d0a1c3b82a3f"> et al.</italic> (1972).<xref id="x-3286f3826e34" rid="R185819127718180" ref-type="bibr">23</xref> </p>
        <p id="p-3b0aae8bc685"/>
        <fig id="f-f638d13f95ba" orientation="portrait" fig-type="graphic" position="anchor">
          <label>Figure 0 </label>
          <graphic id="g-ec6c3ff6dc37" xlink:href="https://typeset-prod-media-server.s3.amazonaws.com/article_uploads/d6aca902-8230-42f2-b0f9-1f6076761f1c/image/ac957eb0-e56b-45cb-8b20-0a00b9909b5b-uimage.png"/>
        </fig>
        <p id="p-253a9945eaaf"/>
        <p id="p-07807e1b4c67"/>
        <p id="p-024fca44cd32"/>
        <p id="p-4cb354097e96"/>
        <p id="p-22219da8a47b"/>
        <p id="paragraph-330f46707a8b4224a6bad6e0dc96ce4f">The Atherogenic Index (AI) and Percent Protection were calculated using the following formulae:<sup id="superscript-246c9724d76643e180d13ed4f0bcb42a"> <xref id="x-d10616e4cef3" rid="R185819127718178" ref-type="bibr">24</xref> </sup></p>
        <p id="p-295f2cd62a08"/>
        <fig id="f-8ce007092cb8" orientation="portrait" fig-type="graphic" position="anchor">
          <label>Figure 0 </label>
          <graphic id="g-919150a0c5ea" xlink:href="https://typeset-prod-media-server.s3.amazonaws.com/article_uploads/d6aca902-8230-42f2-b0f9-1f6076761f1c/image/a3e9f597-7951-4bc8-8262-7d5ea4552bbc-uimage.png"/>
        </fig>
        <p id="p-301c7b3334d9"/>
        <p id="p-06962b2064cd"/>
        <p id="p-6b4c653c9ace"/>
        <p id="p-ccfee112e917"/>
        <fig id="f-4216cdcc14d6" orientation="portrait" fig-type="graphic" position="anchor">
          <label>Figure 0 </label>
          <graphic id="g-0e192d6e694a" xlink:href="https://typeset-prod-media-server.s3.amazonaws.com/article_uploads/d6aca902-8230-42f2-b0f9-1f6076761f1c/image/cbbe7b58-24a9-4511-bbd6-09512d7f346d-uimage.png"/>
        </fig>
        <p id="p-2ac4dd949a48"/>
        <p id="p-1313ff619d1f"/>
      </sec>
      <sec>
        <title id="t-cb94ea728126">
          <bold id="strong-bff2aa041b7e494abee0e13f965df548">Estimation of antioxidant status </bold>
        </title>
        <p id="paragraph-32ebb6833be0425b9fee29ec3ee5502d">Malondialdehyde (MDA) was measured in plasma while Catalase (CAT) and Superoxide Dismutase (SOD) were measured in the erythrocytes. MDA level was estimated by the method described by Satoh K, <xref id="x-5f3b7d952881" rid="R185819127718181" ref-type="bibr">25</xref> the CAT level was estimated by the method described by Beers and Sizer <xref id="x-1bfc1f2aa786" rid="R185819127718184" ref-type="bibr">26</xref> and the SOD level was estimated by the method described by Kakkar <italic id="e-4af5f770809d">et al.</italic> <xref id="x-53732240ce51" rid="R185819127718187" ref-type="bibr">27</xref> </p>
      </sec>
      <sec>
        <title id="t-de735f4cbea6">
          <bold id="strong-3a83c488cc6b4f7085b8fd9e63ead154">Statistical analysis</bold>
        </title>
        <p id="paragraph-1f124f1f46324be3bdcd06d7d1bd7549">Statistical Analysis was done using the software Graph pad Prism version 5. All the values were expressed as mean ± SEM. The results were analyzed for statistical significance by using one-way ANOVA, followed by Dunnett’s test. P values that were &lt; 0.05 were considered significant.</p>
      </sec>
    </sec>
    <sec>
      <title id="title-22745cb218b24baabce73297d1c9a955">RESULTS</title>
      <sec>
        <title id="t-837b7408018a">Result of Acute Toxicity Test</title>
        <p id="paragraph-6e7acb0805b040a583b88ee5639e6d8e">There was no mortality recorded for the extracts of the leaves of <italic id="e-36e848d721ee">Houttuynia cordata </italic>Thunb. among the rats up to the maximum dose of 2000 mg/Kg when administered orally. Hence, the LD50 can be said to be above 2000mg/kg. </p>
      </sec>
      <sec>
        <title id="t-e3531741ffd1">
          <bold id="strong-1ae353a733514c3586d3a595f269cd31">Changes in blood lipid profile </bold>
        </title>
        <p id="paragraph-2ab72ff1918a4aec96d0c680ca12a5cd">At the end of the experiment, the hyperlipidaemic control group showed a significant (p&lt;0.05) elevation of total cholesterol, triglycerides, and LDL cholesterol together with a significant (p&lt;0.05) decrease in HDL Cholesterol when compared with the normal control group.<bold id="strong-a0e299c9f3484de2981571965d8a442f"> </bold>Results are presented in <xref id="x-7aa43b20051b" rid="table-wrap-1799163b7121490fb446cd7d0927da66" ref-type="table">Table 1</xref>.</p>
        <p id="paragraph-47d718a1429644078f7851bd1d28e074">In the hyperlipidaemic test group as well as in the hyperlipidaemic standard group there was a significant (p&lt;0.05) reduction in total cholesterol, triglycerides, and LDL Cholesterol. HDL cholesterol was also increased significantly (p&lt;0.05) in both groups. </p>
        <p id="paragraph-e0ef0e1511f24afa801ccb5eeaa21148">This indicates that EELHC is effective in reducing total cholesterol, triglycerides, and LDL cholesterol and increasing HDL cholesterol. The results are presented in <xref id="x-3f59b0ccbdd1" rid="table-wrap-1799163b7121490fb446cd7d0927da66" ref-type="table">Table 1</xref>. </p>
        <table-wrap id="table-wrap-1799163b7121490fb446cd7d0927da66" orientation="portrait">
          <label>Table 1</label>
          <caption id="caption-ff35dcbde8984fde903b86eddb1bc105">
            <title id="title-caae3d7718744be2abe250bfc9a63c04">
              <bold id="strong-5b88fa45ed81473dbd2a80b654e56ed7">Changes in Serum Lipid Profile</bold>
            </title>
          </caption>
          <table id="table-04eebb38f2b04c13995f1a1c55cd38bd" rules="rows">
            <colgroup>
              <col width="15.899999999999999"/>
              <col width="15.100000000000001"/>
              <col width="15.09"/>
              <col width="13.46"/>
              <col width="13.86"/>
              <col width="13.86"/>
              <col width="12.73"/>
            </colgroup>
            <tbody id="table-section-4adca3d94c6740d3ad9e0ce96e916a51">
              <tr id="table-row-cac59f0efea144f2af32b70a1acacdb7">
                <td id="table-cell-95916b77fb5d46f3881448540f05a3e0" align="left">
                  <p id="paragraph-343e119e5ce44feb81fd27a659c675dc"> <bold id="strong-b05cb4ad23dd4f348adf30f601bd9a00">Groups</bold></p>
                </td>
                <td id="table-cell-1eb9094798584f368c53178228aca056" align="left">
                  <p id="paragraph-65d6b81407d14b8bb8f82b43c306dcc4"> <bold id="strong-f9b020a2244f4cacabfba24c29b766a9">Total </bold><bold id="strong-8adbfb2e84ce4409ad9b2f176c36145c">Cholesterol (mg/dl)</bold></p>
                </td>
                <td id="table-cell-35600421b0d04229b0b6d0786d386522" align="left">
                  <p id="paragraph-a32db570f2b2456882d64309c79c6297"> <bold id="strong-dadf6b0e014842779cb014e70cbcd2dc">Triglyceride (mg/dl)</bold></p>
                </td>
                <td id="table-cell-db30ae36cfb8447aa66106fc79a32c7a" align="left">
                  <p id="paragraph-3fd9f64d834342f2908531fe5356aea6"> <bold id="strong-950069e22e484f229159a1b4d9bd8a48">HDL (mg/dl)</bold></p>
                </td>
                <td id="table-cell-9897e4ff8b664d29bfea1213f4630151" align="left">
                  <p id="paragraph-6c6a767a41f3403586b224516ce18507"> <bold id="strong-5f65f99adf484ce794ad175937f23a2a">LDL (mg/dl)</bold></p>
                </td>
                <td id="table-cell-3be6c030a98a42e6ab851912517af700" align="left">
                  <p id="paragraph-b422c778b7c84a74b3e2aa9f618d1f49"> <bold id="strong-21aa34eea0b04fe28f6b584b75e8e36a">Athero</bold> <bold id="strong-ab74fecca7ce41518e8d4f3d724c70c5">genic</bold> <bold id="strong-e84c98f498394f8d8ad1b2445f0d5784">index</bold></p>
                </td>
                <td id="table-cell-543863797cdc426bb8a45b6f9e949c64" align="left">
                  <p id="paragraph-cdeb873dc6b84853b40f691b12f2a160"> <bold id="strong-c5ad857d65f54ee2bd1943929b29234f">%</bold> <bold id="strong-fb76953f964b41118b114d585f49a429">protection</bold></p>
                </td>
              </tr>
              <tr id="table-row-0cc1fb58743f4af195bdb3c208abbac9">
                <td id="table-cell-b88a0b58413a4fe0897e4f287de4d84f" align="left">
                  <p id="paragraph-3e3ffbd8874d462c977175524b27cf88"> Normal control</p>
                </td>
                <td id="table-cell-88767c8cd0db4f379c49041485725224" align="left">
                  <p id="paragraph-62e45c91f12a4e148a428e76e5e8c2e3"> 72.44 + 1.98</p>
                </td>
                <td id="table-cell-4ebe2f162ec04d42882c5698722b8bd1" align="left">
                  <p id="paragraph-c79647e2f18b4d6ba2e9a6f7751bd6e6"> 68.28 + 1.73</p>
                </td>
                <td id="table-cell-e7edf2a2becf4b79a3e07712b87b2fee" align="left">
                  <p id="paragraph-9585199f77e6478abb42dac81d81561d"> 23.91 + 1.77</p>
                </td>
                <td id="table-cell-4049fc1f148c4c22bea3e1f7c44c91f0" align="left">
                  <p id="paragraph-06538eeadd5c4dfb9b744ba33683d717"> 36.07 + 1.57</p>
                </td>
                <td id="table-cell-0a06b099ff064d4fa1ce113a783d35eb" align="left">
                  <p id="paragraph-faba69a54233410db6f76a2489284504"> 3.03</p>
                </td>
                <td id="table-cell-8d0ef37740c74589aec28e948a627430" align="left">
                  <p id="paragraph-2764f0b32de44c5e85f7cbd758f8a16e"> -</p>
                </td>
              </tr>
              <tr id="table-row-89af19a180234fe8b261c8638d0cd02d">
                <td id="table-cell-e7f813bbc0154b028ef529cace2f4701" align="left">
                  <p id="paragraph-54930638d9fa435eb43890efa9a4e821"> Hyperlipidaemic Control</p>
                </td>
                <td id="table-cell-93647b1319764372aaf15bbfdb9f3182" align="left">
                  <p id="paragraph-f106ff6c8c8f4de3be67f263a8c722c7"> 239.38 + 2.05<sup id="superscript-704dba670e794c65a81da0d5ec233714">a</sup></p>
                </td>
                <td id="table-cell-ab948f8391b94a6a873f02aa0f3ac245" align="left">
                  <p id="paragraph-6306522d94d646558469c951b4f1c47b"> 217.10 + 1.86<sup id="superscript-e31b381b13c042f4b86e8e22fd02c36c">a</sup></p>
                </td>
                <td id="table-cell-842eca9b01e440148663456965f6f778" align="left">
                  <p id="paragraph-7bc66675235c4501b9c50f87fe0a00ba"> 11.44 + 2.03<sup id="superscript-bce318473ea54e9689f876f3d4bce29a">a</sup></p>
                </td>
                <td id="table-cell-8074a2b1fe3f49ee845171c103d54dc8" align="left">
                  <p id="paragraph-fca534facdfc4f8fb5ab97a10498da51"> 184.52 + 1.75<sup id="superscript-07ae467f1ff642638cc33dec8f4360d4">a</sup></p>
                </td>
                <td id="table-cell-4efbb5b9fc4d48b7b49003a9ef04c641" align="left">
                  <p id="paragraph-a686659d6f4c4b4c8e02b479c660b31a"> 20.92 </p>
                </td>
                <td id="table-cell-7b8e76e7fb4e4835b5b57377278ec50a" align="left">
                  <p id="paragraph-d57388a019cf42f48584b0acb9fef730"> -</p>
                </td>
              </tr>
              <tr id="table-row-d69a98b2ab0c49058a5f5b4ef0ff7635">
                <td id="table-cell-e01ee4769000441d8a8889b94d655cd3" align="left">
                  <p id="paragraph-27c9e2c8d73c4ec69e617d39b80ea718"> Hyperlipidaemic test (EELHC)</p>
                </td>
                <td id="table-cell-e40d7a61aa9f48cba05f9c17f9bd75c1" align="left">
                  <p id="paragraph-c1e34f609fbc44408f84ab4f68bf68f8"> 114.71 +2.01<sup id="superscript-65fdee2141ca486e8e797b744d1f6267">b</sup></p>
                </td>
                <td id="table-cell-b7a06d8356df4bb793977638b520e336" align="left">
                  <p id="paragraph-439713c8f7e94922ba73e7486a8f7e7a"> 74.07 +1.92<sup id="superscript-81f3e9e6b21d41d2800109f67e06b718">b</sup></p>
                </td>
                <td id="table-cell-1efe0f8679ac40d5bd46f3b5bdb5ef13" align="left">
                  <p id="paragraph-f93c9f22c56c41dea1cb71ddfc3b09f4"> 39.29 +2.01<sup id="superscript-3919036b48184790a23f25ba11c31382">b</sup></p>
                </td>
                <td id="table-cell-c96d7ab54ee94fb8970d026f8c84f4dc" align="left">
                  <p id="paragraph-ae92e8de6381422ea55fb605fd65b731"> 55.22 +1.98<sup id="superscript-12861279c6624776a5edf33c70533100">b</sup></p>
                </td>
                <td id="table-cell-635b6e39d34b4ed48c00cc007a3db2da" align="left">
                  <p id="paragraph-f1cc6e101270406e9444f8d5a95bb292"> 2.92</p>
                </td>
                <td id="table-cell-e110bc4fe92c45d9b41a308653d5a834" align="left">
                  <p id="paragraph-a2b771066be747cd8b556d1388cf4779"> 86.04</p>
                </td>
              </tr>
              <tr id="table-row-bbff5147cb6e48fd97c48263f2ac6f2f">
                <td id="table-cell-82125fd6ff434f9593bf246b68c55457" align="left">
                  <p id="paragraph-058e0535e56343288a7c3a062bbd075c"> Hyperlipidaemic standard</p>
                </td>
                <td id="table-cell-14cd0e237bac490294cdc390864dc94f" align="left">
                  <p id="paragraph-93f743b73df94fdb8ce394ee16efd359"> 75.36 + 2.30<sup id="superscript-6860ca41584c4c569a8acb924ca6a844">b</sup></p>
                </td>
                <td id="table-cell-018ab1704af440f2bf08056bad3d2fe2" align="left">
                  <p id="paragraph-508c183ac86b497097470e0625e877e8"> 59.82 + 1.79<sup id="superscript-deb68fbc863f49f883f10b89dca5721f">b</sup></p>
                </td>
                <td id="table-cell-7773f1057f2b4c9b8c133b823230cd02" align="left">
                  <p id="paragraph-fd3c224d946f49a29d1f60cc2e37fb73"> 34.71 + 1.88<sup id="superscript-30c545c571ee4ca6996f8f7b7ead4dac">b</sup></p>
                </td>
                <td id="table-cell-31a3596492d84078974168f8087cf444" align="left">
                  <p id="paragraph-1152c0ff64e84be7aacd05f58cc29b27"> 28.69 + 1.63<sup id="superscript-293a6452d0364b49a8b0bd686275e8de">b</sup></p>
                </td>
                <td id="table-cell-5c78265d0fe3449e90279c5d839229a2" align="left">
                  <p id="paragraph-ec129f85692e4d049f8cf700e16119a3"> 2.17</p>
                </td>
                <td id="table-cell-7ee1f1d892414668889e4a55bd83948e" align="left">
                  <p id="paragraph-e215d06197414763994547f942aa1421"> 89.63</p>
                </td>
              </tr>
            </tbody>
          </table>
          <table-wrap-foot>
            <fn-group>
              <fn id="f-820f7cc52bcf">
                <p id="p-ddcd6c541778">Values are expressed as MEAN ± SEM; (n=5). </p>
              </fn>
              <fn id="f-c2173e97248b">
                <p id="p-9ab812475e75">One Way ANOVA followed by Dunnett’s multiple comparison tests is done. </p>
              </fn>
              <fn id="f-110602298b1c">
                <p id="p-073943006c97"><sup id="s-097adccc3dc8">a</sup>P&lt;0.05 when compared to the normal control group</p>
              </fn>
              <fn id="f-ed093826aca5">
                <p id="p-e4bdb8045fe2"><sup id="s-11419519e594">b</sup>P&lt;0.05 when compared to the hyperlipidaemic control group.</p>
              </fn>
            </fn-group>
          </table-wrap-foot>
        </table-wrap>
      </sec>
      <sec>
        <title id="t-137b12aa93d4">
          <bold id="strong-eb28bf050c704e32b0311165ab9486bf">Changes in lipid peroxidation and blood antioxidant levels</bold>
        </title>
        <p id="paragraph-ffee955c7d9147e094ecddc81592a943">At the end of the experiment, there was a significant increase (p&lt;0.05) in the serum MDA level and a significant decrease (p&lt;0.05) in blood CAT and SOD levels in the hyperlipidaemic control group when compared to the normal control group.</p>
        <p id="paragraph-dd73f24bb68a4f83902b60cde4aa46b0">There was a significant (p&lt;0.05) decrease in serum MDA levels in the hyperlipidaemic test group and Hyperlipidaemic standard group when compared to the hyperlipidaemic control group. Blood CAT and SOD levels were increased significantly in the hyperlipidaemic test group and hyperlipidaemic standard group when compared to the hyperlipidaemic control group. This indicates that EELHC decreases lipid peroxidation and increases the antioxidant enzymes in the blood. The results are presented in <xref id="x-8eb75ff3a9a8" rid="table-wrap-43d18ad225954aba8e409e6e90ca2961" ref-type="table">Table 2</xref>.</p>
        <table-wrap id="table-wrap-43d18ad225954aba8e409e6e90ca2961" orientation="portrait">
          <label>Table 2</label>
          <caption id="caption-ee259e0be27d458c9e43662d1699ec01">
            <title id="title-32703bd2448b4c2aa94c7f582eb36f8a">
              <bold id="strong-d6e8a4b694044823bc04b0c022c6781b">Changes in lipid peroxidation and blood antioxidant levels</bold>
            </title>
          </caption>
          <table id="table-94df77462ba0423aa074fef2c61ff464" rules="rows">
            <colgroup>
              <col width="33.11"/>
              <col width="23.57"/>
              <col width="21.42"/>
              <col width="21.9"/>
            </colgroup>
            <tbody id="table-section-215cbcaee04c498996054c7b3a15354d">
              <tr id="table-row-0e15b7bca13b4ab18fc315430904c13d">
                <td id="table-cell-a7be8a1f89f84dda86bc807db598b108" align="left">
                  <p id="paragraph-450c4859641145cca025479860258dad"> <bold id="strong-aad31e60a6f945409ec1c1d1bdf76308">Groups</bold></p>
                </td>
                <td id="table-cell-c24837288c0e452b8fce1f9c4c5a273a" align="left">
                  <p id="paragraph-4b8f665f0a6c43bd974517fcf15de08e"> <bold id="strong-2e39ec77ef2d4bed92ae59e6618d300e">MDA</bold> <bold id="strong-6314464655de464ca66797bf3c6a072e">(nmol/ml blood)</bold></p>
                </td>
                <td id="table-cell-a9f303e8d7a44e8aa4e0b6f7cb6a9b50" align="left">
                  <p id="paragraph-3a9c6e04531b47eb87cd53f65e87ce9d"> <bold id="strong-9a1965d9b3ff411fbef4cad8fd3bb42e">CAT</bold> <bold id="strong-30dd78b23488482bbaa1cec4831f1700">(u/mg protein)</bold></p>
                </td>
                <td id="table-cell-620b9845e840408eb85843a6ad0a9481" align="left">
                  <p id="paragraph-c87047d4e02f48a895a86c51109ac341"> <bold id="strong-276e3c4646724a9b8056a3b7ef931190">SOD</bold> <bold id="strong-bb5dbf30c8334432b020fe6cb84b3000">(u/mg protein)</bold></p>
                </td>
              </tr>
              <tr id="table-row-836fb84ac44c4a03b477f1eb06d3f682">
                <td id="table-cell-c0eb37e57ae24880a873a5bc00605067" align="left">
                  <p id="paragraph-ddd7a4188d7a4d3a9b046ce45fc45548"> Normal Control</p>
                </td>
                <td id="table-cell-a367a68fe2304ecc8024e44659b5e6e6" align="left">
                  <p id="paragraph-7f3fb83c2e224f0d9fac437e5df3f239"> 1.52+0.72</p>
                </td>
                <td id="table-cell-ac305460015e4b0887fe9a84bc997ff0" align="left">
                  <p id="paragraph-0087c77e80d64b16af33692b687878e9"> 396.2+0.86</p>
                </td>
                <td id="table-cell-5bcdbdc6c52d4832b6f1ec7dae6d0cd8" align="left">
                  <p id="paragraph-52db3b9944324c5faa97be8e5cda1bf6"> 7.2+0.21</p>
                </td>
              </tr>
              <tr id="table-row-742ab181ebb64fa4a85766303875e504">
                <td id="table-cell-56e9d226611d43cdb87d27f836381b2c" align="left">
                  <p id="paragraph-b6868ffaec8d41f28629035e6b754037"> Hyperlipidaemic Control</p>
                </td>
                <td id="table-cell-9391d4c316e24ff0a720e68435e2c85a" align="left">
                  <p id="paragraph-e42af6634fa941718bb13b1a02a5a328"> 4.34+0.04<sup id="superscript-c141d7d47b14436283bb51c06b3245ee">a</sup></p>
                </td>
                <td id="table-cell-12c0d0cff6684cf6a14135646702d1f7" align="left">
                  <p id="paragraph-511c7bcc08704ceba2aaa399e30f30e5"> 143.8+0.37<sup id="superscript-4777bac9f67841f6aa0423d3fc145b5e">a</sup></p>
                </td>
                <td id="table-cell-3df638316a134f0e8bd56c63ca9cb81b" align="left">
                  <p id="paragraph-8aad95e7c5684adf88bfb24a1878563a"> 4.1+0.61<sup id="superscript-6e3041cea8d146a49872f6b8b2987462">a</sup></p>
                </td>
              </tr>
              <tr id="table-row-71585a819a44420eb1df3c492162930f">
                <td id="table-cell-aa0746f6daa0430280801930b44e43ec" align="left">
                  <p id="paragraph-c87a282fb0584bd097b623f9cca1501e"> Hyperlipidaemic Test (EELHC)</p>
                </td>
                <td id="table-cell-894d158b58964f07a5dbe0b4df353780" align="left">
                  <p id="paragraph-74700eefcb9148a39f7ef87f7fddd953"> 2.58+0.68<sup id="superscript-f537bc8427624579a232fdc398dd90d1">b</sup></p>
                </td>
                <td id="table-cell-18df4f0d1a1e406f958df3c11b50b570" align="left">
                  <p id="paragraph-c6ef642e46644fb486baa8ce29c9728c"> 190.4+0.19<sup id="superscript-9bc5d5121fc049f284760e1a7ba94c50">b</sup></p>
                </td>
                <td id="table-cell-4f0caba7b6d14a43b7f60d9c99816247" align="left">
                  <p id="paragraph-63cd0f0814d8449590a6f3e6f5ab60f5"> 5.1+0.09<sup id="superscript-20f202c4e3a649c8950e5888c5a8e5ec">b</sup></p>
                </td>
              </tr>
              <tr id="table-row-5162455796304945b74d1dec86301de6">
                <td id="table-cell-7610f9defa144dc594987fe31966fd8f" align="left">
                  <p id="paragraph-390ba5a2b8894939990c06441f40fcd5"> Hyperlipidaemic standard</p>
                </td>
                <td id="table-cell-c2db5e58a36e48d3aebc1baf43c4236b" align="left">
                  <p id="paragraph-48894aa7a3c34cba8dafc6d434fd553f"> 1.82+0.95<sup id="superscript-1b0ac249bd9f4c54bd2641404c45c6ef">b</sup></p>
                </td>
                <td id="table-cell-f9b0f4202fba4d16a47805dbae1840ed" align="left">
                  <p id="paragraph-ed9c3791c8a046fa9ff4fbcc189847bd"> 327.8+3.86<sup id="superscript-8b792f87e22f43ccb17a4db206157c46">b</sup></p>
                </td>
                <td id="table-cell-167e57574b1045198ee43e49fd46e41b" align="left">
                  <p id="paragraph-044a880ce1d04bebafa3f4672783b280"> 6.9+0.17<sup id="superscript-daca53a220734f77b2572bbdab6f30ff">b</sup></p>
                </td>
              </tr>
            </tbody>
          </table>
          <table-wrap-foot>
            <fn-group>
              <fn id="f-f1f35950d46b">
                <p id="p-d865be527e80">Values are expressed as MEAN + SEM; (n= 5)</p>
              </fn>
              <fn id="f-160466d00b77">
                <p id="paragraph-ed062c11e282479e9f8fe386e460aa91">One Way ANOVA followed by Dunnett’s multiple comparison tests is done.</p>
              </fn>
              <fn id="f-e5611f94edad">
                <p id="p-491eed61cf99">P&lt; 0 05 when compared to the normal control group</p>
              </fn>
              <fn id="f-be95b4fe844d">
                <p id="paragraph-475129f347314427b50e66cc14bed4bd"><sup id="superscript-c637e60b59464051ba94836be546f162">b </sup>P &lt; 0.05 when compared to the hyperlipidaemic control group</p>
              </fn>
            </fn-group>
          </table-wrap-foot>
        </table-wrap>
      </sec>
    </sec>
    <sec>
      <title id="title-45bf6fe33fec46a9a1af5cc8761dc7c8">DISCUSSION</title>
      <p id="paragraph-b8d3ac1cceec4da59e7beb9eec2f775d">The present study was undertaken to evaluate the antihyperlipidemic and antioxidant activities of leaves of <italic id="e-bf568d8e8825">Houttuynia cordata</italic> Thunb. </p>
      <p id="paragraph-f2519ee6944d4939bda4f87388d33407"> The elevated level of total cholesterol is one of the major factors for occurrence of coronary heart disease (CHD).<xref id="x-78e321578e9a" rid="R185819127718188" ref-type="bibr">28</xref>  Hyperlipidaemia, high cholesterol diet, and oxidative stress increases serum LDL levels resulting in an increased risk of development of atherosclerosis.<xref id="x-76352a1dbc74" rid="R185819127718185" ref-type="bibr">29</xref> </p>
      <p id="paragraph-06a053e9ab5d4cba812057a73382daa3">In the hyperlipidaemic control group, the total cholesterol triglycerides and LDL cholesterol levels in the blood are significantly (p&lt;0.05) increased together with a decrease in HDL cholesterol level. </p>
      <p id="paragraph-6bec1ac3f88041beb854787469e73ee4">Elevated levels of all lipoproteins except HDL are associated with an increased risk of atherosclerosis.<xref id="x-cc81dc8aa124" rid="R185819127718186" ref-type="bibr">30</xref> </p>
      <p id="paragraph-d3ecb15a308440cb8b3e26673f309ee1">The hyperlipidaemic test group fed with a high-fat diet and EELHC showed significant (p&lt;0.05) decreases in the total cholesterol, triglyceride, and LDL Cholesterol which is almost comparable to the Standard group fed with a high-fat diet and simvastatin. </p>
      <p id="paragraph-9135880e405840588f30c5450517faca">On the other hand, HDL cholesterol level is significantly (p&lt;0.05) increased in the hyperlipidaemic test group as well as in the standard group.</p>
      <p id="paragraph-0d05c80f33a040848ff4a33538fc4c1b"> HDL cholesterol is referred to as the ‘good cholesterol’ because HDL is involved in the transport of cholesterol from peripheral tissues to the liver and thereby reducing the amount stored in the tissue and the possibility of developing atherosclerotic plaques. <xref id="x-bc35818807bf" rid="R185819127718186" ref-type="bibr">30</xref> </p>
      <p id="paragraph-6b4405557bc64b7692436dbb9478f707">Atherogenic index (AI) calculated as the ratio between total cholesterol and HDL cholesterol is used as a marker to assess the susceptibility of atherogenesis. <xref id="x-cb6dbb7cfca3" rid="R185819127718183" ref-type="bibr">31</xref> It is an important indicator of CHD risks at both high and low serum cholesterol levels. <xref id="x-ace522f7b13b" rid="R185819127718189" ref-type="bibr">32</xref> When compared with the hyperlipidaemic control group there is a significant decrease in the atherogenic index in the group fed with EELHC (2.92), which is almost comparable to the standard (2.17).</p>
      <p id="paragraph-12f12616a8034a569d0d67a917f7493e"> The persistence of a hypercholesterolemic state causes enhanced oxidative stress, leading to the development of atherosclerosis, coronary artery disease (CAD), and other complications of obesity. <xref id="x-030538c4c2e5" rid="R185819127718182" ref-type="bibr">33</xref> </p>
      <p id="paragraph-d9654ff170674227a7324934b995064a">Hypercholesterolemia increases the levels of the lipid peroxidation product Malondialdehyde. The increase in Malondialdehyde (MDA) levels in the liver suggests enhanced lipid peroxidation leading to tissue damage and failure of antioxidant defense mechanisms to prevent the formation of excessive free radicals.<xref id="x-12a018a7aa45" rid="R185819127718177" ref-type="bibr">34</xref> Oxygen free radicals have been implicated in the development of hyperlipidaemic atherosclerosis. SOD and catalase mimic the effective detoxification of Oxygen free radical and Hydrogen peroxide among these, SOD convert the highly toxic superoxide (O<sub id="subscript-50ae5b33f32b408fae752eb4d5c3a08a">2</sub><sup id="superscript-13568b4fddb04679abb9ab0bbe3d1897">-</sup>) to less toxic hydrogen peroxide and O<sub id="subscript-ef1870de51bc4b59970f7160b81533be">2,</sub><sub id="subscript-ea6aa3aa37984b4295db9681c87e3f53"> </sub>this is the first line of defense to protect the cells from the injurious effects of superoxide. Hydrogen peroxide produced by superoxidedismutase is further metabolized by catalase. <xref id="x-37f841330952" rid="R185819127718179" ref-type="bibr">35</xref> The hyperlipidaemic test group fed with HFD showed a significant increase in MDA and a decrease in CAT and SOD, indicating increased lipid peroxidation and decreased antioxidant enzyme levels. The hyperlipidaemic test group which was fed with EELHC showed a significant decrease in MDA and an increase in CAT and SOD.</p>
      <p id="paragraph-c014236e8afd41da8abc5727df09a9e9"> It is well known that flavonoids and polyphenols have been shown to have hypolipidemic and antioxidant activity. <xref id="x-90bd416c64b4" rid="R185819127718176" ref-type="bibr">36</xref>  Flavonoids present in medicinal plants protect LDL from oxidation thereby decreasing atherosclerotic plaques. They are reported to significantly increase superoxide dismutase and catalase activity.<xref id="x-96f1e73637b4" rid="R185819127718185" ref-type="bibr">29</xref>  Several naturally occurring active components are found in <italic id="e-478f36dcb85b">Houttuynia cordata</italic> Thumb. Leaves may be the reason behind its antihyperlipidemic and antioxidant activity. </p>
    </sec>
    <sec>
      <title id="title-1f3c253962104f0487fb65ac6bf82d76">CONCLUSION</title>
      <p id="paragraph-8fadcad3359242698884336f79c1df72">The present study suggests that ethanolic extract of leaves of <italic id="e-c879dc18446d">Houttuynia cordata </italic>Thunb. has antihyperlipidemic and antioxidant activities. This was evident from decreased lipid levels with an increase in HDL even with the daily administration of the atherogenic diet and decreased MDA with an increase in CAT and SOD levels respectively.<italic id="e-66d7de5c98c2"> Houttuynia cordata</italic> Thunb. leaves reduce oxidative stress by free radical scavenging and protecting against lipid peroxidation and are also able to manage hyperlipidemia by decreasing serum levels of cholesterol, triglycerides, and LDL. The probable antihyperlipidemic mechanism may be due to decreased absorption of exogenous cholesterol and increased conversion of endogenous cholesterol to bile acids. Further pharmacological and biochemical investigations are needed to determine the precise mechanism and site of action and the active constituents involved so that these herbal drugs can be used as a safer alternative to synthetic drugs. </p>
    </sec>
    <sec>
      <title id="t-57c812a4dd04">
        <bold id="strong-180e6daddb064dcca56178c2b2309889">CONFLICT OF INTEREST</bold>
      </title>
      <p id="paragraph-81397e1ed03c40a0a7a629fa9b639804">The authors declare no conflict of interests.</p>
    </sec>
  </body>
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