The bark of Arjuna is useful as an anti-ischemic and cardioprotective agent in hypertension and in ischemic heart disease, especially in disturbed cardiac rhythm, angina or myocardial infarction. The bark powder possesses diuretic and a general tonic effect in cases of cirrhosis of the liver, in addition to prostaglandin enhancing and coronary risk factor modulating properties. It induces a drug-dependent decrease in blood pressure and heart rate.

Recent studies have investigated the mechanism of this activity and have shown a dose-dependent regulation of blood pressure and heart rate.There was also a slight increase in the HDL-to-total cholesterol ratio and an overall improvement in the cardiovascular profile. The bark of Arjuna inhibits the oxidation of LDL and accelerates the turnover of LDL-cholesterol in liver. This enhances the elimination of cholesterol from the body. The suppression of hepatic cholesterol biosynthesis by Terminalia arjuna is the mechanism responsible for a significant lowering of beta-lipoprotein lipids and the recovery of HDL components in hyperlipidemia. In a study on the efficacy of the bark powder in treating congestive cardiac failure (CCF), over 40% of the cases showed marked improvement. CCF due to congenital anomaly of heart and valve disease was also brought under control. 4 out of 9 cases of CCF due to chronic bronchitis were also relieved by the treatment. Arjuna is also known to relieve symptomatic complaints of essential hypertension viz. giddiness, insomnia, lassitude, headache and the inability to concentrate. Oral administration of an aqueous suspension of the bark powder reduces coagulation, bleeding and prothrombin time.