American Ginseng (Panax quinquefolius L) Reduces Postprandial Glycemia in Nondiabetic Subjects and Subjects With Type 2 Diabetes Mellitus

Vuksan, Vladimir; Sievenpiper, John L.; Koo, Vernon Y. Y.; Fleischer, Thomas; Beljan-Zdravkovic, Uljana; Zheng, Xu; Vidgen, Edward

doi:10.1001/archinte.160.7.1009

Cited by 321 publications

(183 citation statements)

References 35 publications

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“…However, Chung et al [11] reported better hypoglycemic activity of red ginseng, which has a PD/ PT ratio lower than that of white ginseng or American ginseng, in an animal study. These findings contradict the results of clinical trials reported by Vuksan et al [12].…”

contrasting

confidence: 92%

Effect of White, Taegeuk, and Red Ginseng Root Extracts on Insulin-Stimulated Glucose Uptake in Muscle Cells and Proliferation of β-cells

Young¹,

Park²,

Kim³

et al. 2010

Journal of Ginseng Research

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contrasting

confidence: 92%

Effect of White, Taegeuk, and Red Ginseng Root Extracts on Insulin-Stimulated Glucose Uptake in Muscle Cells and Proliferation of β-cells

Young¹,

Park²,

Kim³

et al. 2010

Journal of Ginseng Research

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“…Importantly, NAG contains a 3-to 5-times higher content of ginsenosides and different profile of ginsenosides than both forms of P ginseng. 2,15,16,24,28 As well, KRG is the only marketed ginseng to contain ginsenoside Rg 3 , the most potent vasodilating ginsenoside. 36 To date, 4 clinical interventions have tested the effect of P ginseng root on BP.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Intake of North American Ginseng Has No Effect on 24-Hour Blood Pressure and Renal Function

et al. 2006

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Abstract-Ginseng is consumed by 10% to 20% of adults in Asia and by up to 5% in Western countries. Despite observational evidence suggesting a link between its intake and the development of hypertension, there remains no long-term scrutiny for its effect on blood pressure (BP). We therefore undertook a randomized, placebo-controlled, double-blinded, crossover trial in 52 hypertensive individuals to determine the effect of 12-week North American ginseng intake on 24-hour BP; we also measured serum cystatin C as a marker of renal function. After a 4-week placebo run-in, we randomly assigned 52 participants to 3 g/day of ginseng or placebo for 12 weeks. This was followed by an 8-week washout and a subsequent 12-week period in which the opposite treatment was administered. At run-in and at weeks 0 and 12 of each treatment period, participants were fitted with an ambulatory BP monitor to assess 24-hour BP. The primary outcome was the treatment difference at week 12 in mean 24-hour systolic BP. Secondary outcomes were treatment differences at week 12 in other ambulatory BP parameters and serum cystatin C. Forty participants (77%) completed the trial, with 3 removed from main analysis (nϭ2, antihypertensive drug changes; nϭ1, incomplete ambulatory monitoring). In the remaining 37, 12-week ginseng treatment was associated with a neutral effect on all ambulatory BP parameters compared with placebo; an intention-to-treat analysis supported this. Ginseng did not affect serum cystatin C level. Overall, long-term ginseng use had no effect on 24-hour BP and renal function in hypertensive individuals. It is also shown through randomized, controlled trials (RCTs) to improve glycemic control 2 and cognitive function. 3 In contrast, however, there is repeated mention in the medical literature that ginseng can elevate blood pressure (BP). 4 -6 This stems from an early observational study by Siegel 7 that connected the self-reported use of ginseng to the development of hypertension in 14 individuals after 3 months of use. This possibility could have widespread impact, because ginseng is used by 10% to 20% of adults in Asia 8 -10 and by up to 5% in the United States, 11 Australia,12 and parts of Europe. 13 Furthermore, given that 20% to 40% of adults in these regions are estimated to have hypertension, 14 there is potential for overlap between the prevalence of ginseng use and hypertension. Still, there remains no longterm RCT investigation of the effect of ginseng on BP, and until such evaluations are undertaken, physicians will remain greatly limited in the advice they can provide to hypertensive individuals regarding ginseng use.Although many species of ginseng exist, Panax quinquefolius, or North American ginseng (NAG), and Panax ginseng together account for the majority of ginseng consumed worldwide. Recently, we demonstrated that single 3-g doses of NAG 15 and P ginseng 16 exert neutral and lowering effects on BP, respectively, for 160 minutes after intake. In the former study, 15 the neutral effect on BP was comprehensively ...

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“…Furthermore, our previous studies with P ginseng or NAG used a 3-g dose. 7,[23][24][25] We used an acute study design, similar to the procedure applied to the evaluation of new antihypertensive agents. 26 As well, given the uncertainty of the effect of NAG on BP, and in light of Siegel's observational findings, we opted to use an acute rather than chronic model.…”

Section: Discussionmentioning

confidence: 99%

“…In our studies, we have seen that ginseng has the same adverse event profile as placebo. 10,[23][24][25]34 Considering drug interactions, an RCT by Yuan et al 35 showed that ginseng can interfere with warfarin metabolism, whereas another RCT showed no effect on the metabolism of this drug. 36 Overall, hypertensive individuals who choose to consume NAG should be aware of its neutral effect on BP, its overall safety, and its potential to interact with warfarin.…”

Section: Stavro Et Al North American Ginseng and Blood Pressurementioning

confidence: 99%

North American Ginseng Exerts a Neutral Effect on Blood Pressure in Individuals With Hypertension

et al. 2005

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Abstract-An early observational study suggested that ginseng could elevate blood pressure. This caused concern because 4.5% of American adults use ginseng, with a popular choice being North American ginseng. To date, North American ginseng lacks hemodynamic evaluation; therefore, we conducted a randomized, double-blinded, controlled trial to investigate its effect on blood pressure in 16 hypertensive individuals (meanϮSD age 61.1Ϯ8.1 years; systolic/diastolic blood pressure 132.4Ϯ12.8/83.3Ϯ8.1 mm Hg; 13 on antihypertensives). We used 6 batches of North American ginseng root that varied in quality and ginsenoside content, representing the spectrum of this ginseng on the market. On 8 mornings, each participant was fitted with an ambulatory blood pressure monitor, which measured blood pressure during a 30-minute baseline period. Each participant then consumed in a randomized and double-blind fashion 3 g of encapsulated treatment: placebo (on 2 mornings) or powdered North American ginseng (on 6 mornings). After treatment, blood pressure was measured every 10 minutes for 160 minutes, and its change at each post-treatment time point relative to baseline was determined per individual and averaged, and the mean was obtained for the overall 160-minute period. None of the North American ginsengs or their mean differed from placebo in their effect on overall (160 minutes) mean blood pressure change. None affected blood pressure versus placebo at the 10-minute intervals; but their mean versus placebo increased systolic and diastolic blood pressure at 140 and 160 minutes, respectively, and lowered diastolic blood pressure at 100 minutes. 2,3 This is based on an observational study by Siegel published Ͼ25 years ago, which found that hypertension developed in 14 adults reporting the use of ginseng root. 4 In response, medical commentaries recommend that hypertensive individuals avoid ginseng. 3 More recently, animal studies 5,6 and randomized controlled clinical trials (RCTs) 7,8 show that Panax ginseng, the most consumed species of ginseng in the United States, exerts a neutral or lowering effect on BP. Although these outcomes contrast Siegel's finding, it should be noted that they pertain to a single ginseng species. Another commonly consumed species of ginseng in the United States is P quinquefolius, or North American ginseng (NAG), which ranks second to P ginseng for use. Together, these species comprise most of the ginseng that Ϸ9 million American adults consume annually. 9 However, to date, the effect of NAG on BP is unknown and could be important to address because this herb is used widely and acts biologically different from other ginseng species. 10 The importance of determining the effect of NAG on BP also holds from a phytochemical perspective. All ginsengs contain a group of triterpene glycosides called ginsenosides, which show antihypertensive efficacy in animals. Because the content of NAG and profile of ginsenosides differs from P ginseng, its potential effect on BP cannot be inferred from the latter and requir...

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American Ginseng (Panax quinquefolius L) Reduces Postprandial Glycemia in Nondiabetic Subjects and Subjects With Type 2 Diabetes Mellitus

Cited by 321 publications

References 35 publications

Effect of White, Taegeuk, and Red Ginseng Root Extracts on Insulin-Stimulated Glucose Uptake in Muscle Cells and Proliferation of β-cells

Effect of White, Taegeuk, and Red Ginseng Root Extracts on Insulin-Stimulated Glucose Uptake in Muscle Cells and Proliferation of β-cells

Long-Term Intake of North American Ginseng Has No Effect on 24-Hour Blood Pressure and Renal Function

North American Ginseng Exerts a Neutral Effect on Blood Pressure in Individuals With Hypertension

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