Hypertension treatment with Combretum micranthum or Hibiscus sabdariffa, as decoction or tablet: a randomized clinical trial

Bourqui, Angélique; Niang, ElHadji Atou Boye; Graz, Bertrand; Diop, ElHadji Assane; Dahaba, Mohamed; Thiaw, I.; Soumare, Khady; Valmaggia, Philippe; Nogueira, Renata Campos; Cavin, Anne-Laure; Al-Anbaki, Marwah; Seck, Sidy Mohamed

doi:10.1038/s41371-020-00415-1

Cited by 16 publications

(16 citation statements)

References 22 publications

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“… 60 Notably, 150 mg/kg hibiscus had superior BP-lowering effects compared with 25 mg of hydrochlorothiazide. 57 Bourqui et al 86 recently reported hibiscus to be as effective as captopril in a 6-month study of patients with hypertension, a finding consistent with the results of our meta-analysis. However, Bourqui et al 86 combined the hibiscus tea or capsule treatments with the corresponding kinkeliba ( Combretum micranthum ) treatment if either treatment did not produce a clinical response, rendering this study ineligible for inclusion in this meta-analysis.…”

Section: Discussionsupporting

confidence: 92%

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

et al. 2022

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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

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Section: Discussionsupporting

confidence: 92%

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

et al. 2022

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“…In a randomized controlled trial in Senegal, a similar mean reduction of 21.8 (± 11.1) mmHg of SBP was observed despite some differences in the protocol, including absence of concomitant conventional medication, longer follow-up (6 months), and a maximal dosage of 15 g (versus 20 g in the present study). However, in the Senegal study, only 45.5% of participants reached the target BP [9]. This might be explained by the different BP baseline: While in the present study, participants started with a mean BP of 152/94 mmHg, in the Senegalese study, participants entered the program with a higher mean BP (158/98).…”

Section: Discussioncontrasting

confidence: 59%

“…Regarding the traditional use of HS, although much progress has been made, questions remain concerning the most affordable pharmaceutical form: Aqueous decoction of HS calyces (known as tea/brew). As HS brew is known and accessible even for the poorest patients, we dedicated efforts in researching a practical use of HS decoction and observed a sustained clinical effectiveness for 6 months when used by hypertensive patients without standard (conventional) medication [9]. During the same study, a similar effect was observed in the three treatment groups: Tablets made of the dried powdered calyx, versus decoction, versus standard treatment.…”

Section: Introductionmentioning

confidence: 80%

Hibiscus sabdariffa, a Treatment for Uncontrolled Hypertension. Pilot Comparative Intervention

Al-Anbaki¹,

Cavin²,

Nogueira³

et al. 2021

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In Iraq, in 2019, there were about 1.4 million Internally Displaced Persons (IDP); medical treatments were often interrupted. The feasibility of using Hibiscus sabdariffa (HS) decoction to curb hypertension was evaluated. A multicentric comparative pilot intervention for 121 participants with high blood pressure (BP) (≥140/90 mmHg) was conducted. Participants of the intervention group (with or without conventional medication) received HS decoction on a dose regimen starting from 10 grams per day. BP was measured five times over six weeks. The major active substances were chemically quantified. Results: After 6 weeks, 61.8% of participants from the intervention group (n = 76) reached the target BP < 140/90 mmHg, compared to 6.7% in the control group (n = 45). In the intervention group, a mean (±SD) reduction of 23.1 (±11.8) mmHg and 12.0 (±11.2) for systolic and diastolic BP, respectively, was observed, while in the control group the reduction was 4.4 (±10.2)/3.6 (±8.7). The chemical analysis of the starting dose indicated a content of 36 mg of total anthocyanins and 2.13 g of hibiscus acid. The study shows the feasibility of using HS decoction in IDP’s problematic framework, as hibiscus is a safe, local, affordable, and culturally accepted food product.

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“…Most of the studies did not provide sufficient information about the allocation concealment except 5 studies. 16,17,22,25,27 Almost half of the studies faced difficulties in blinding of participants and personnel and blinding of outcome assessment because of, but not limited to: the distinguished taste of the tea, the insolubility of the comparator. Moreover, 4 studies had a high risk of incomplete outcome data as in Haji Faraji and Haji Tarkhani, 26 patients were excluded because of elevation of blood pressure above the expected range, 19 whereas in the other 2 studies, the exclusion was because of withdrawal (because of nonmedical cause) or failure of compliance.…”

Section: Rob In the Included Studiesmentioning

confidence: 99%

Efficacy of Hibiscus sabdariffa on Reducing Blood Pressure in Patients With Mild-to-Moderate Hypertension: A Systematic Review and Meta-Analysis of Published Randomized Controlled Trials

Abdelmonem

Ebada

Diab

et al. 2022

Journal of Cardiovascular Pharmacology

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We aimed to assess the efficacy of Hibiscus sabdariffa in patients with mild-to-moderate hypertension or metabolic syndrome (MetS) by comparing it against placebo, antihypertensive drugs, or other herbal products. Four databases were searched for randomized clinical trials (RCTs) examining the efficacy of H. sabdariffa in patients with mild-to-moderate hypertension or hypertension associated with MetS. Data on the change in systolic blood pressure (SBP) and diastolic blood pressure (DBP) were extracted and analyzed using Review Manager Version 5.3. A total of 13 RCTs (1205 participants) were analyzed. Hibiscus sabdariffa significantly reduced both SBP and DBP compared with placebo (mean difference 26.67, P = 0.004 and 24.35 mm Hg, P = 0.02). Subgroup analysis showed that change in SBP and DBP was statistically significant in patients with only hypertension, whereas not significant in patients with hypertension associated with MetS. When H. sabdariffa was compared with active controls (antihypertensive drugs or other herbals), the change in SBP and DBP was not statistically significant (all P . 0.05). Hibiscus sabdariffa is effective in reducing the SBP and DBP in patients with mild-to-moderate hypertension, but was neither effective in those with MetS nor superior to antihypertensive drugs. Further RCTs are required to determine the long-term efficacy of H. sabdariffa and to describe patients who would benefit most from this treatment.

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Hypertension treatment with Combretum micranthum or Hibiscus sabdariffa, as decoction or tablet: a randomized clinical trial

Cited by 16 publications

References 22 publications

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

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

Hibiscus sabdariffa, a Treatment for Uncontrolled Hypertension. Pilot Comparative Intervention

Efficacy of Hibiscus sabdariffa on Reducing Blood Pressure in Patients With Mild-to-Moderate Hypertension: A Systematic Review and Meta-Analysis of Published Randomized Controlled Trials

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