Clinical efficacy of African traditional medicines in hypertension: A randomized controlled trial with Combretum micranthum and Hibiscus sabdariffa

Abstract

Medicinal plants are widely used as a first-line therapy for hypertension, often without comparative clinical data. A prospective, randomized controlled trial was conducted to assess efficacy of Combretum micranthum (kinkeliba) and Hibiscus sabdariffa (bissap), in the galenic form of capsules of plant powder, on blood pressure in adult patients with non-complicated hypertension ( > 140/90 mm Hg). One hundred and twenty five patients were randomly allocated into group 1 (kinkeliba leaves 190 mg × 2/day), or group 2 (bissap calyx 320 mg × 2/day), or group 3 (ramipril 5 mg /day) during four consecutive weeks. Blood and urinary samples were collected on day 0 and 28 while patients' blood pressure was measured weekly. In all three groups SBP and DBP decreased over 3 weeks of treatment (P < 0.001). For SBP, mean decrease was higher with ramipril (-16.7 ± 8.4 mm Hg) than with kinkeliba (-12.2 ± 6.6 mm Hg, P = 0.016) and bissap (-11.2 ± 3.3 mm Hg, P = 0.001). For DBP, mean decrease with ramipril (-6.7 ± 3.6 mm Hg) was more important than with kinkeliba (-5.0 ± 3.0 mm Hg, P = 0.011) but not statistically different to bissap group (-6.0 ± 4.7 mm Hg, P = 0.271). A significant natriuretic effect was observed in the kinkeliba and bissap groups but not in patients under ramipril treatment. At the end of the four weeks, 39% [95% CI: 25.7-54.3] of patients in the ramipril group, 37% [95% CI: 23.6-51.9] of patients in the kinkeliba group and 21% [95% CI: 11.7-35.9] of those taking bissap had normalized their BP.

Effect of sieved fractionation on the physical, flow and hydration properties of Boscia senegalensis Lam., Dichostachys glomerata Forssk. and Hibiscus sabdariffa L. powders

“…Health benefits associated with H. sabdariffa calyxes include antihypertensive, anti-inflammatory, antidiabetic, hepatoprotective, antioxidant and antibacterial activities (Peng et al, 2011;Nyamukuru et al, 2017). It has also proved its efficacy in reducing blood pressure of adult patients with non-complicated hypertension when administered in the galenic form of capsules of H. sabdariffa powder (Seck et al, 2017).…”

The efficacy of sour tea (Hibiscus sabdariffa L.) on selected cardiovascular disease risk factors: A systematic review and meta‐analysis of randomized clinical trials

“…This study included only studies that investigated sour tea effect by comparing with inactive control intervention. However, the question remains, “Is the blood pressure lowering effect of sour tea comparable to conventional anti‐hypertensive pharmacological agents?” A casual analysis was run on six studies (A Herrera‐Arellano et al, ; Armando Herrera‐Arellano et al, ; Nwachukwu, Aneke, Nwachukwu, et al, ; Nwachukwu, Aneke, Obika, & Nwachukwu, ; Seck et al, ; Soleimani, Akbari, Soleimani, Mousavi, & Tamadon, ), which were not included in this review (because of nonsuitability of their control groups) to answer this question. The forest plot showed that, in general, the effect of sour tea on blood pressure is remarkably lower than antihypertensive drugs (Figure S1).…”

Antihypertensive efficacy and safety of a standardized herbal medicinal product of Hibiscus sabdariffa and Olea europaea extracts (NW Roselle): A phase‐II, randomized, double‐blind, captopril‐controlled clinical trial

“…Note: p = .687 for the comparison of mean change in SBP among the three arms (Kruskal Wallis one-way ANOVA test); and p = .948 for the comparison of mean change in DBP among the three arms (Kruskal Wallis one-way ANOVA test mm Hg, respectively; compared with 16.7 (8.4) and 6.7 (3.6) mm Hg reductions with once daily 5 mg ramipril (Seck et al, 2018). Since NW Roselle contains extracts of both Roselle and Olive (both of which exhibit antihypertensive properties), one would expect that the antihypertensive effect of our product would be higher than that found by Herrera-Arellano et al, 2004.…”