A systematic review and meta-analysis of the effects of Hibiscus sabdariffa on blood pressure and cardiometabolic markers

Abstract

Context Hibiscus sabdariffa (hibiscus) has been proposed to affect cardiovascular risk factors. Objective To review the evidence for the effectiveness of hibiscus in modulating cardiovascular disease risk markers, compared with pharmacologic, nutritional, or placebo treatments. Data Sources A systematic search of the Web of Science, Cochrane, Ovid (MEDLINE, Embase, AMED), and Scopus databases identified reports published up to June 2021 on randomized controlled trials using hibiscus as an intervention for lipid profiles, blood pressure (BP), and fasting plasma glucose levels in adult populations. Data Extraction Seventeen chronic trials were included. Quantitative data were examined using a random effects meta-analysis and meta-regression with trial sequential analysis to account for type I and type II errors. Data Analysis Hibiscus exerted stronger effects on systolic BP (−7.10 mmHg [95%CI, −13.00, −1.20]; I2 = 95%; P = 0.02) than placebo, with the magnitude of reduction greatest in those with elevated BP at baseline. Hibiscus induced reductions to BP similar to that resulting from medication (systolic BP reduction, 2.13 mmHg [95%CI, −2.81, 7.06], I2 = 91%, P = 0.40; diastolic BP reduction, 1.10 mmHg [95%CI, −1.55, 3.74], I2 = 91%, P = 0.42). Hibiscus also significantly lowered levels of low-density lipoprotein compared with other teas and placebo (−6.76 mg/dL [95%CI, −13.45, −0.07]; I2 = 64%; P = 0.05). Conclusions Regular consumption of hibiscus could confer reduced cardiovascular disease risk. More studies are warranted to establish an effective dose response and treatment duration. Systematic Review Registration PROSPERO registration no. CRD42020167295

Hibiscus sabdariffa inhibits α-glucosidase activity in vitro and lowers postprandial blood glucose response in humans

“…Hibiscus sabdariffa (HS), also known as Roselle or red tea, is a member of the Malvaceae family, with a unique anthocyanin profile containing delphinidin-and cyanidin-sambubiosides as main anthocyanin compounds. Intake of HS has been associated with lowering of blood pressure and blood cholesterol [12]; indeed, a recent meta-analysis of our group has confirmed the consistent effect of HS on systolic blood pressure reduction [13]. The potential anti-diabetic effects of HS have received much less attention with so far limited research being conducted.…”

“…Importantly, long-term effects on glucose metabolism will need to be established. Our recent systematic review and meta-analysis of chronic HS intervention trials has found no differences in fasting blood glucose among the small number of studies on this topic, however the direct comparison was not possible due to variations in study design and in control groups [13]. Therefore, further studies investigating chronic effects of HS intake on markers of glycaemia are urgently needed.…”

Protocol for the Scientific Opinion on the evaluation of the safety in use of hydroxycitric acid and plant preparations containing hydroxycitric acid

“…An overview of the adverse health effects, which have been associated with HCA and HCA in plant preparations in the scientific literature was prepared based on available risk assessments of dietary HCA from various organizations (FDA, 2009; ANSM, 2012; AESAN, 2019; ANSES, 2022) (Appendix C) and reviews (Soni et al, 2004;Onakpoya et al, 2011;Bakhiya et al, 2017;Maunder et al, 2020;Payab et al, 2020;Andueza et al, 2021;Ellis et al, 2022). Several adverse events were identified from case reports and case series (Actis et al, 2007;Elinav et al, 2007;Jones and Andrews, 2007;Fong et al, 2010;Narasimha et al, 2013;Lopez et al, 2014;Araujo and Worman, 2015;Mancano, 2015;Beecheno et al, 2016;Corey et al, 2016;Hendrickson et al, 2016;Lunsford et al, 2016;Wong et al, 2016;Cotovio and Oliveira-Maia, 2017;Crescioli et al, 2018;Kothadia et al, 2018;Nguyen et al, 2019;Nilsson and Duan, 2019;Ferreira et al, 2020;Khetpal et al, 2020).…”

“…Meta-analysis of five studies (n = 285) of G. cambogia as a single herb produced a non-significant effect on weight, with an Standardized mean difference (SMD) +0.04(95% CI-0.33, +0.41; P= 0.82) compared to placebo (I²=56%). Preparations containing G. cambogia did not have a significant effect on weight (I²=87%) Blood pressure, Hypotension (Ellis et al, 2022) Meta-analysis of randomized controlled trials Search was conducted until June 2021 on randomized controlled trials using Hibiscus sabdariffa as an intervention for lipid profiles, blood pressure (BP), and fasting plasma glucose levels in adult populations. Hibiscus exerted stronger effects on systolic BP (−7.10 mmHg [95%CI, −13.00, −1.20]; I2 = 95%; P = 0.02) (n=12 studies) than placebo, with the magnitude of reduction greatest in those with elevated BP at baseline.…”

Gynostemma pentaphyllum for dyslipidemia: A systematic review of randomized controlled trials

“…RYR extracts have been proven beneficial for lipid modification (Lu et al, 2008;Cicero et al, 2019). Hibiscus sabdariffa was also helpful for dyslipidemia (Sabzghabaee et al, 2013;Ellis et al, 2021).…”