title: Chinese herbal medicine for resistant hypertension: a systematic review.
abstract: OBJECTIVE
  This study aimed to summarise the current evidence from randomised control trials (RCTs) concerning treatment of patients with resistant hypertension with Chinese herbal medicine (CHM).
  
  
  METHODS
  Seven databases, including the Cochrane Library, PubMed, EMBASE, CNKI, VIP, CBM and Wanfang, were systematically searched from their inception to March 2014 for RCTs investigating treatment of resistant hypertension in which CHM was used either as a monotherapy or in combination with conventional medicine versus placebo, no intervention or conventional medicine.
  
  
  RESULTS
  Five trials containing 446 hypertensive patients were identified. The methodological quality of most trials was evaluated as generally low. All included trials compared CHM plus antihypertensive drugs with antihypertensive drugs alone for resistant hypertension. Formulations of CHM included tablet, decoction and injection. It was found that, compared with antihypertensive drugs alone, CHM (tablet) plus antihypertensive drugs resulted in clinically, but not statistically, significant reductions in systolic blood pressure (SBP; weighted mean difference (WMD)=-10.32 mm Hg; 95% CI -21.10 to 0.46; p=0.06) and diastolic blood pressure (DBP; WMD=-3.30 mm Hg; 95% CI -7.66 to 1.06; p=0.14). CHM (decoction) plus antihypertensive drugs also produced a clinically meaningful, but not statistically significant, reduction in SBP (WMD=-12.56 mm Hg; 95% CI -26.83 to 1.71; p=0.08), and did significantly decrease DBP (WMD=-7.89 mm Hg; 95% CI -11.74 to -4.04; p<0.0001). There were no significant differences in SBP (WMD=-3.50 mm Hg; 95% CI -8.95 to 1.95; p=0.21) and DBP (WMD=1.00 mm Hg; 95% CI -1.39 to 3.39; p=0.41) between CHM (injection) plus the antihypertensive drugs group and antihypertensive drugs alone. The safety of CHM remained uncertain.
  
  
  CONCLUSIONS
  No definite conclusions about the effectiveness and safety of CHM for resistant hypertension could be drawn. More rigorously designed trials are warranted.
authors: Department of Cardiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
authors: Xingjiang
authors: X
authors: Xiong
authors: Bio-organic and Natural Products Laboratory, McLean Hospital, Harvard Medical School, Belmont, California, USA.
authors: Xiaoke
authors: X
authors: Li
authors: Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.
authors: Yuqing
authors: Y
authors: Zhang
authors: Department of Cardiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
authors: Jie
authors: J
authors: Wang
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents; D004365:Drugs, Chinese Herbal
keywords: Chinese herbal medicine; resistant hypertension; systematic review
references: J Am Coll Cardiol. 2010 Feb 9;55(6):515-25
references: 20152556
references: Curr Hypertens Rep. 2005 Aug;7(4):275-80
references: 16061046
references: J Am Coll Cardiol. 2002 Apr 3;39(7):1083-95
references: 11923030
references: Evid Based Complement Alternat Med. 2012;2012:268542
references: 22550539
references: Evid Based Complement Alternat Med. 2013;2013:275279
references: 23878594
references: Eur Heart J. 2013 Jul;34(28):2159-219
references: 23771844
references: Circulation. 2007 Jun 19;115(24):3121-9
references: 17548730
references: Evid Based Complement Alternat Med. 2013;2013:215254
references: 23986780
references: Nat Rev Cardiol. 2013 May;10(5):293-6
references: 23459606
references: Phytomedicine. 2014 Sep 15;21(10):1131-6
references: 24877716
references: Nat Rev Nephrol. 2013 Jan;9(1):51-8
references: 23165303
references: J Altern Complement Med. 2008 Jan-Feb;14(1):3-7
references: 18199020
references: Complement Ther Med. 2014 Jun;22(3):511-22
references: 24906591
references: Sleep Med Rev. 2012 Dec;16(6):493-5
references: 22884461
references: Evid Based Complement Alternat Med. 2012;2012:714805
references: 23258998
references: Trends Pharmacol Sci. 2014 Mar;35(3):111-2
references: 24559937
references: BMJ. 1999 Jul 17;319(7203):160-1
references: 10406751
references: Hypertension. 2013 Jun;61(6):1360-83
references: 23608661
references: J Hum Hypertens. 2015 Mar;29(3):143-51
references: 24990417
references: Evid Based Complement Alternat Med. 2012;2012:697237
references: 23346210
references: J Clin Epidemiol. 2010 Aug;63(8):e1-37
references: 20346624
references: Evid Based Complement Alternat Med. 2012;2012:284847
references: 22194771
references: Evid Based Complement Alternat Med. 2013;2013:706125
references: 23710230
references: Clin Exp Hypertens. 2010;32(7):423-5
references: 20828224
references: Circulation. 2008 Jun 24;117(25):e510-26
references: 18574054
references: Hypertension. 2012 Sep;60(3):653-8
references: 22802220
references: Evid Based Complement Alternat Med. 2013;2013:540613
references: 23533493
references: Arch Intern Med. 1998 Nov 9;158(20):2225-34
references: 9818802
references: Am J Hypertens. 2001 Sep;14(9 Pt 1):971-5
references: 11587167
references: Trends Pharmacol Sci. 2007 Feb;28(2):48-50
references: 17222917
references: Hypertension. 2011 Dec;58(6):1008-13
references: 22042809
references: Complement Ther Med. 2014 Feb;22(1):187-95
references: 24559834
references: J Hypertens. 2007 Aug;25(8):1525-32
references: 17620944
references: Cochrane Database Syst Rev. 2005;(4):CD003444
references: 16235320
references: JAMA. 2014 Feb 5;311(5):507-20
references: 24352797
references: Lancet. 2008 Dec 6;372(9654):1938-40
references: 18930523
references: PLoS One. 2011;6(12):e28093
references: 22164232
references: Hypertens Res. 2013 Jul;36(7):570-9
references: 23552514
references: Hypertension. 2009 Sep;54(3):475-81
references: 19620517
references: Evid Based Complement Alternat Med. 2013;2013:982380
references: 23573163
references: Zhong Xi Yi Jie He Xue Bao. 2008 Jul;6(7):695-9
references: 18601850
references: Circulation. 2012 Apr 3;125(13):1635-42
references: 22379110
references: Nat Rev Cardiol. 2012 May;9(5):267-75
references: 22027655
references: Evid Based Complement Alternat Med. 2013;2013:978398
references: 23861720
references: Annu Rev Pharmacol Toxicol. 2003;43:463-84
references: 12540748