Hibiscus May Be An Effective Tool for CVD Risk Mitigation

by | Oct 6, 2023 | 2022, Blood Pressure, Botanicals, Cardiovascular Health

Written by Chrystal Moulton, Staff Writer. Hibiscus demonstrated lowering effects on blood pressure similar to pharmaceuticals with no significant difference between the two treatments.

heart healthCardiovascular disease is the number one cause of death worldwide. There was an estimated 17.7 million people who die of cardiovascular related conditions each year1,2. Hibiscus sabdariffa, an annual bushy plant widely grown in Africa and Asian countries, is typically consumed for medicinal purposes3. Some studies demonstrate hibiscus induced reduction of blood pressure4, lipid modulation5, and anti-diabetic effects6. Whether a specific route of administration influences absorption and peak concentration of the bioactive components in hibiscus is still unknown. In this meta-analysis, researchers conducted a critical evaluation of current evidence investigating the effect of hibiscus supplementation on blood glucose, blood pressure, and lipids7.

Researchers conducted an electronic search of articles limited to randomized trials of adults >18 years old published up until June 2021. Only human studies published in English were included in this meta-analysis. Studies were included only if pre and post intervention were included. Diastolic blood pressure, systolic blood pressure, high density level protein, pulse pressure, triglyceride, total cholesterol, and fasting plasma glucose (FPG) levels were the primary outcomes of interest as it relates to CVD risk factors. Studies containing participants receiving medication were not included unless the medicine was included as the control group treatment. Researchers utilized the Cochrane risk of bias tool to detect any potential bias from the studies included in this trial. Type I and type II errors due to heterogeneity were analyzed through the trial sequential analysis method.

Seventeen randomized controlled human studies were included in this review. Six studies compared the effects of hibiscus to placebo. Five studies compared hibiscus to other teas. Two studies compared hibiscus to a preventative diet. Four studies compared hibiscus to a known pharmaceutical drug. Analysis of the data showed a significant reduction in systolic blood pressure in participants supplemented with hibiscus (P= 0.02). No significant effect on systolic blood pressure was observed when comparing hibiscus with other teas (P= 0.16) or a preventative diet (P= 0.80). Also, compared to other teas hibiscus had a statistically significant effect on diastolic blood pressure (P= 0.05). This however was not observed when compared to volunteers receiving placebo or dietary interventions. No significant difference was observed for pulse pressure. Significant reduction in LDL was observed following hibiscus supplementation (P= 0.05). However, no significant effect was found for total cholesterol, triglyceride, or HDL. Analysis of fasting plasma glucose results revealed no significant effect of hibiscus. Compared to pharmaceutical drugs, hibiscus demonstrated lowering effects on blood pressure similar to pharmaceuticals with no significant difference between the two treatments for systolic and diastolic blood pressure. Analysis of hibiscus dose and duration effects showed that for studies in which systolic and diastolic blood pressure were examined, a dose ≤1 gram/day did not produce significant results. However, a study duration >4 weeks showed significant effects (SBP: P = 0.001, DBP: P = 0.04). For total cholesterol and LDL, a study duration >4 weeks with a dose of >500mg showed significant results following hibiscus supplementation (P < 0.05). No effective dose or duration was found for fasting plasma glucose levels. Studies comparing hibiscus to pharmaceutical medicines were omitted from the dose and duration analysis. According to the Cochrane risk of bias analysis, all studies included in this meta-analysis had a low risk of selective outcome reporting. Furthermore, quantitative evaluation showed no publication bias. The studies included in this meta-analysis did not reach the required information size to rule out type I and type II errors assessed through the trial sequential analysis method.

Overall, this meta-analysis demonstrated that hibiscus supplementation for >4 weeks between 500 -1000 mg/day could significantly lower LDL and total cholesterol while a dose >1 g/day could significantly lower BP. Additional retrospective analyses will be needed to verify these findings.

Source: Ellis, Lucy R., Sadia Zulfiqar, Mel Holmes, Lisa Marshall, Louise Dye, and Christine Boesch. “A systematic review and meta-analysis of the effects of Hibiscus sabdariffa on blood pressure and cardiometabolic markers.” Nutrition reviews 80, no. 6 (2022): 1723-1737.

The Author(s) 2021. Published by Oxford University Press on behalf of the International Life Sciences Institute. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited.

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Posted October 5, 2023.

Chrystal Moulton BA, PMP, is a 2008 graduate of the University of Illinois at Chicago. She graduated with a bachelor’s in psychology with a focus on premedical studies and is a licensed project manager. She currently resides in Indianapolis, IN.

References:

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  5. Sabzghabaee AM, Ataei E, Kelishadi R, et al. Effect of Hibiscus sabdariffa calices on dyslipidemia in obese adolescents: a triple-masked randomized controlled trial. Materia socio-medica. 2013;25(2):76.
  6. Mardiah M, Zakaria F, Prangdimurti E, Damanik R. The effect of roselle extract (Hibiscus sabdariffa Linn.) on blood glucose level and total antioxidant level on diabetic rat induced by streptozotocin. IOSR Journal of pharmacy. 2014;4(10):08-16.
  7. Ellis LR, Zulfiqar S, Holmes M, Marshall L, Dye L, Boesch C. A systematic review and meta-analysis of the effects of Hibiscus sabdariffa on blood pressure and cardiometabolic markers. Nutr Rev. May 9 2022;80(6):1723-1737. doi:10.1093/nutrit/nuab104