Abstract
Background:
Atherosclerosis is often associated with inflammation and non-alcoholic liver disease (NAFLD) due to high cholesterol diet and the side effects of conventional treatment.

Aim:
This study aimed to determine the efficacy of Blumea balsamifera extract (BBLE) and Sargassum aquifolium extract (SAE) in controling atherosclerosis, anti-inflammatory, and hepatoprotective in rats induced by a high cholesterol diet.

Methods:
Hypercholesterolemia induction was achieved by oral administration of feed with lard for 21 days in male Wistar rats. Next, the animals were treated with 4 mg/kg BW of BBLE (single dose) and 4 mg/kg BW of BBLE+SAE (combined dose) for 3 months and continued to be given a high cholesterol diet. The negative control (KN) was a high cholesterol diet and the positive control (KP) was simvastatin. Blood samples were taken to determine total cholesterol, Apo-E, IL-6, TNF-α, ALT and AST levels. Meanwhile, the weight of the liver and histopathology preparations were weighed.

Results:
Giving BBLE+SAE was able to reduce body weight, liver weight and cholesterol levels significantly compared to negative controls (p≤0.05). There was a significant increase in Apo-E levels in the BBLE+SAE group, as well as a decrease in pro-inflammatory cytokine levels. A decrease in AST and ALT levels was shown by administering BBLE+SAE and showed a higher mean hepatocyte cell count compared to the other groups.

Conclusion:
Administration of BBLE+SAE acts as an anti-atherosclerotic and hepatoprotective agent for the liver through reducing pro-inflammatory cytokines and its use was promising for clinical studies.

Key words: Anti-inflammation; Atherosclerosis; Herbal medicine; Hepatoprotective; Sub-chronic toxicity.