Gokshuradi Kwatha in Ayurvedic Practice: A Critical Narrative Review of Its Classical Basis, Phytochemistry, Pharmacological Activities and Antihypertensive Potential

Abstract

Gokshuradi Kwatha denotes a family of Ayurvedic decoctions built around Gokshura, the fruit and root of Tribulus terrestris L., and prescribed principally for disorders of the urinary tract. Interest has widened towards a possible role in blood-pressure regulation, encouraged by experimental work indicating that aqueous preparations of T. terrestris lower arterial pressure and suppress tissue angiotensin-converting enzyme activity. This critical narrative review examines whether that interest is proportionate to the evidence. Literature was identified through PubMed, Europe PMC, PubMed Central, Crossref, the Directory of Open Access Journals, Semantic Scholar and Google Scholar, supplemented by citation chaining and by institutional reporting, with a final search date of 4 July 2026. Sources were appraised for design adequacy, extract characterisation, model relevance and the fidelity of the link between claim and data. Three findings dominate the synthesis. No stable composition is attached to the name Gokshuradi Kwatha in the indexed literature, and formulations sharing the gokshuradi prefix differ in constituent species, plant part and dosage form, so evidence generated on one preparation cannot be transferred to another without explicit argument. The mechanistic case rests on a small number of aqueous-extract studies of the single principal herb, drawn largely from renovascular hypertension and diuresis models, whereas the larger phytochemical literature characterises hydroalcoholic saponin-enriched fractions whose relationship to a domestic decoction remains unquantified. Direct clinical evidence for the decoction is absent, and the only meta-analysis of Ayurvedic interventions in essential hypertension reports non-significant pooled effects with severe statistical heterogeneity. Mechanistic plausibility is therefore real but modest, and it has been repeatedly overstated in secondary writing. Progress requires chemically defined decoctions, dose-anchored preclinical work in models of primary rather than secondary hypertension, and adequately powered trials using ambulatory blood-pressure endpoints. Until such work exists, Gokshuradi Kwatha is best described as a candidate for investigation rather than an established antihypertensive intervention.