The effectiveness of Hibiscus sabdariffa in the treatment of hypertension: a systematic review.
BACKGROUND
Hypertension is a common global health problem with significant mortality and morbidity. Hibiscus sabdariffa is a plant known in many countries and is consumed as hot and cold drinks In addition to its use in folk medicine; it has been suggested as treatment for many conditions including hypertension.


OBJECTIVE
The objectives of this review were to examine the evidence of effectiveness and safety of hibiscus in the treatment of hypertension.


METHODS
We searched several medical databases (MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, and the specialized register of the Cochrane Hypertension Group and the general engine Google) to January 2009. We included randomized controlled trials that had examined Hibiscus's effectiveness and safety in the treatment of primary hypertension in adults. Two authors independently selected the trials for the review, extracted the data, and critically appraised the included studies.


RESULTS
Four trials, with a total of 390 patients, met our inclusion criteria. Two studies compared Hibiscus sabdariffa to black tea; one study compared it to captopril and one to lisinopril. The studies found that Hibiscus had greater blood pressure reduction than tea but less than the ACE-inhibitors. However, all studies, except one, were short term and of poor quality with a Jadad scoring of <3 and did not meet international standards.


CONCLUSIONS
The four randomized controlled studies identified in this review do not provide reliable evidence to support recommending Hibiscus sabdariffa for the treatment of primary hypertension in adults.
College of Medicine, King Saud University, Shaikh Bahamdan Research Chair for Evidence-Based Health Care and Knowledge Translation, P.O. Box 2925, Riyadh 11246, Kingdom of Saudi Arabia. Chattanooga, TN 37403
H A
HA
Wahabi
L A
LA
Alansary
A H
AH
Al-Sabban
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Glasziuo
D000328:Adult; D031584:Hibiscus; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008517:Phytotherapy; D010936:Plant Extracts / Q000627:therapeutic use*; D013810:Therapeutic Equivalency
D010936:Plant Extracts