DOI QR코드

DOI QR Code

Ginseng for Reducing the Blood Pressure in Patients with Hypertension: A Systematic Review and Meta-Analysis

  • Received : 2010.08.16
  • Accepted : 2010.10.20
  • Published : 2010.12.29

Abstract

Ginseng is one of the most-widely used herbal remedies. This systematic review evaluates the current evidence for its use in the reducing blood pressure (BP) in patients with hypertension. Systematic searches of 12 electronic databases were conducted without language restrictions. All randomized clinical trials (RCTs) of ginseng as a treatment for hypertension were candidates for inclusion. Methodological quality was assessed using the Cochrane risk of bias. Five RCTs met the inclusion criteria. The risk of bias was low in most of the trials. Four of the included RCTs compared the effectiveness of ginseng to placebo. The meta-analysis of these data failed to show a statistically significant acute effect on systolic BP (SBP) or diastolic BP (DBP). However, subgroup analyses showed beneficial effects of Korean red ginseng (KRG) on both SBP (n=54, mean difference [MD], -6.52; 95% confidence interval [CI], -9.99 to -3.04; p=0.0002) and DBP (n=54, MD, -5.21; 95% CI, -7.90 to -2.51; p=0.0001). Two RCTs tested the long-term effects of ginseng for BP for 24hours. One of these trials failed to show any benefits of KRG compared to no treatment, and the other failed to show superior effects of North American ginseng compared to placebo. Adverse events with ginseng were none in one trial or not assessed. Collectively, these RCTs provide limited evidence for the acute effectiveness of KRG in the treatment of high BP. The total number of RCTs included in the analysis and the total sample size were insufficient to draw definitive conclusions. More rigorous studies are warranted.

Keywords

References

  1. World Health Organization. WHO CVD-risk management package for low- and medium-resource settings. Availble from: http://whqlibdoc.who.int/publications/2002/9241545852.pdf.
  2. Yeh GY, Davis RB, Phillips RS. Use of complementary therapies in patients with cardiovascular disease. Am J Cardiol 2006;98:673-680. https://doi.org/10.1016/j.amjcard.2006.03.051
  3. Nam KY. Clinical applications and efficacy of Korean ginseng (Panax ginseng C.A. Meyer). J Ginseng Res 2002;26:111-131. https://doi.org/10.5142/JGR.2002.26.3.111
  4. Helms S. Cancer prevention and therapeutics: Panax ginseng. Altern Med Rev 2004;9:259-274.
  5. Jang DJ, Lee MS, Shin BC, Lee YC, Ernst E. Red ginseng for treating erectile dysfunction: a systematic review. Br J Clin Pharmacol 2008;66:444-450. https://doi.org/10.1111/j.1365-2125.2008.03236.x
  6. Shim MK, Lee YJ. Ginseng as a complementary and alternative medicine for postmenopausal symptoms. J Ginseng Res 2009;33:89-92. https://doi.org/10.5142/JGR.2009.33.2.089
  7. Stavro PM, Woo M, Leiter LA, Heim TF, Sievenpiper JL, Vuksan V. Long-term intake of North American ginseng has no effect on 24-hour blood pressure and renal function. Hypertension 2006;47:791-796. https://doi.org/10.1161/01.HYP.0000205150.43169.2c
  8. Han KH, Choe SC, Kim HS, Sohn DW, Nam KY, Oh BH, Lee MM, Park YB, Choi YS, Seo JD et al. Effect of red ginseng on blood pressure in patients with essential hypertension and white coat hypertension. Am J Chin Med 1998;26:199-209. https://doi.org/10.1142/S0192415X98000257
  9. Kim ND, Kang SY, Schini VB. Ginsenosides evoke endothelium-dependent vascular relaxation in rat aorta. Gen Pharmacol 1994;25:1071-1077. https://doi.org/10.1016/0306-3623(94)90121-X
  10. Toda N, Ayajiki K, Fujioka H, Okamura T. Ginsenoside potentiates NO-mediated neurogenic vasodilatation of monkey cerebral arteries. J Ethnopharmacol 2001;76:109-113. https://doi.org/10.1016/S0378-8741(01)00217-3
  11. Jeon BH, Kim CS, Kim HS, Park JB, Nam KY, Chang SJ. Effect of Korean red ginseng on blood pressure and nitric oxide production. Acta Pharmacol Sin 2000;21:1095-1100.
  12. Jeon BH, Kim CS, Park KS, Lee JW, Park JB, Kim KJ, Kim SH, Chang SJ, Nam KY. Effect of Korea red ginseng on the blood pressure in conscious hypertensive rats. Gen Pharmacol 2000;35:135-141. https://doi.org/10.1016/S0306-3623(01)00096-9
  13. Akasaka Y, Takahashi E, Miyate Y, Kudo K, Ikeda M, Shimizu C, Tachikawa E, Kashimoto T. Effect of red ginseng on blood pressure, heart rate and sympathetic activity in 5-hydroxydopamine treated rats. Eur J Pharmacol 1990;183:1004. https://doi.org/10.1016/0014-2999(90)92851-9
  14. Stavro PM, Woo M, Heim TF, Leiter LA, Vuksan V. North American ginseng exerts a neutral effect on blood pressure in individuals with hypertension. Hypertension 2005;46:406-411. https://doi.org/10.1161/01.HYP.0000173424.77483.1e
  15. Stavro PM, Woo M, Vuksan V. Korean red ginseng lowers blood pressure in individuals with hypertension. Am J Hypertens 2004;17(Suppl 1):S33.
  16. Stavro PM, Hana AK, Vuksan V. The effect of Korean red ginseng extracts with escalating levels of ginsenoside Rg3 on blood pressure in individuals with high normal blood pressure or hypertension. Am J Hypertens 2002;15(Suppl 1):A34.
  17. Sung J, Han KH, Zo JH, Park HJ, Kim CH, Oh BH. Effects of red ginseng upon vascular endothelial function in patients with essential hypertension. Am J Chin Med 2000;28:205-216. https://doi.org/10.1142/S0192415X00000258
  18. Schulz KF, Chalmers I, Hayes RJ, Altman DG. Empirical evidence of bias. Dimensions of methodological quality associated with estimates of treatment effects in controlled trials. JAMA 1995;273:408-412. https://doi.org/10.1001/jama.273.5.408
  19. Center for Disease Control and Prevention. Heart disease and stroke prevention. Addressing the nation’s leading killers: at a glance 2009. Availble from: http://www.cdc.gov/chronicdisease/resources/publications/AAG/pdf/dhdsp.pdf.
  20. Yu J, Eto M, Akishita M, Kaneko A, Ouchi Y, Okabe T. Signaling pathway of nitric oxide production induced by ginsenoside Rb1 in human aortic endothelial cells: a possible involvement of androgen receptor. Biochem Biophys Res Commun 2007;353:764-769. https://doi.org/10.1016/j.bbrc.2006.12.119
  21. Ernst E, Pittler MH. Alternative therapy bias. Nature 1997;385:480.
  22. Pittler MH, Abbot NC, Harkness EF, Ernst E. Location bias in controlled clinical trials of complementary/alternative therapies. J Clin Epidemiol 2000;53:485-489. https://doi.org/10.1016/S0895-4356(99)00220-6

Cited by

  1. in Randomised Controlled Trials: A Systematic Review vol.27, pp.7, 2013, https://doi.org/10.1002/ptr.4832
  2. Ginseng for Health Care: A Systematic Review of Randomized Controlled Trials in Korean Literature vol.8, pp.4, 2013, https://doi.org/10.1371/journal.pone.0059978
  3. Korean ginseng modulates the ileal microbiota and mucin gene expression in the growing rat vol.5, pp.7, 2014, https://doi.org/10.1039/c4fo00087k
  4. Manic Psychosis Associated With Ginseng: A Report of Two Cases and Discussion of the Literature vol.12, pp.2, 2015, https://doi.org/10.3109/19390211.2014.902001
  5. The effect of ginseng (genus Panax) on blood pressure: a systematic review and meta-analysis of randomized controlled clinical trials vol.30, pp.10, 2016, https://doi.org/10.1038/jhh.2016.18
  6. Gene Level Interactions of Four Commonly Used Herbal Products-A Systematic Literature vol.18, pp.6, 2018, https://doi.org/10.3923/jbs.2018.307.316
  7. Panax ginseng: An Overview of the Clinical Evidence vol.34, pp.4, 2010, https://doi.org/10.5142/jgr.2010.34.4.259
  8. Red Ginseng Saponin Fraction A Isolated from Korean Red Ginseng by Ultrafiltration on the Porcine Coronary Artery vol.35, pp.3, 2010, https://doi.org/10.5142/jgr.2011.35.3.325
  9. Processed Panax ginseng, Sun Ginseng, Decreases Oxidative Damage Induced by tert-butyl Hydroperoxide via Regulation of Antioxidant Enzyme and Anti-apoptotic Molecules in HepG2 Cells vol.36, pp.3, 2010, https://doi.org/10.5142/jgr.2012.36.3.248
  10. The effect of ginseng supplement on heart rate, systolic and diastolic blood pressure to resistance training in trained males vol.15, pp.None, 2010, https://doi.org/10.1016/j.artres.2016.06.001
  11. Beliefs, practices and knowledge of community pharmacists regarding complementary and alternative medicine: national cross-sectional study in Lebanon vol.9, pp.3, 2019, https://doi.org/10.1136/bmjopen-2018-025074
  12. Antihypertensive effects of Korean wild simulated ginseng (Sanyangsam) extracts in spontaneously hypertensive rats vol.28, pp.5, 2010, https://doi.org/10.1007/s10068-019-00617-5
  13. A Systems Biological Approach to Understanding the Mechanisms Underlying the Therapeutic Potential of Red Ginseng Supplements against Metabolic Diseases vol.25, pp.8, 2010, https://doi.org/10.3390/molecules25081967