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Netala VR, Teertam SK, Li H, Zhang Z. A Comprehensive Review of Cardiovascular Disease Management: Cardiac Biomarkers, Imaging Modalities, Pharmacotherapy, Surgical Interventions, and Herbal Remedies. Cells 2024; 13:1471. [PMID: 39273041 DOI: 10.3390/cells13171471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2024] [Revised: 08/26/2024] [Accepted: 08/31/2024] [Indexed: 09/15/2024] Open
Abstract
Cardiovascular diseases (CVDs) continue to be a major global health concern, representing a leading cause of morbidity and mortality. This review provides a comprehensive examination of CVDs, encompassing their pathophysiology, diagnostic biomarkers, advanced imaging techniques, pharmacological treatments, surgical interventions, and the emerging role of herbal remedies. The review covers various cardiovascular conditions such as coronary artery disease, atherosclerosis, peripheral artery disease, deep vein thrombosis, pulmonary embolism, cardiomyopathy, rheumatic heart disease, hypertension, ischemic heart disease, heart failure, cerebrovascular diseases, and congenital heart defects. The review presents a wide range of cardiac biomarkers such as troponins, C-reactive protein, CKMB, BNP, NT-proBNP, galectin, adiponectin, IL-6, TNF-α, miRNAs, and oxylipins. Advanced molecular imaging techniques, including chest X-ray, ECG, ultrasound, CT, SPECT, PET, and MRI, have significantly enhanced our ability to visualize myocardial perfusion, plaque characterization, and cardiac function. Various synthetic drugs including statins, ACE inhibitors, ARBs, β-blockers, calcium channel blockers, antihypertensives, anticoagulants, and antiarrhythmics are fundamental in managing CVDs. Nonetheless, their side effects such as hepatic dysfunction, renal impairment, and bleeding risks necessitate careful monitoring and personalized treatment strategies. In addition to conventional therapies, herbal remedies have garnered attention for their potential cardiovascular benefits. Plant extracts and their bioactive compounds, such as flavonoids, phenolic acids, saponins, and alkaloids, offer promising cardioprotective effects and enhanced cardiovascular health. This review underscores the value of combining traditional and modern therapeutic approaches to improve cardiovascular outcomes. This review serves as a vital resource for researchers by integrating a broad spectrum of information on CVDs, diagnostic tools, imaging techniques, pharmacological treatments and their side effects, and the potential of herbal remedies.
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Affiliation(s)
- Vasudeva Reddy Netala
- School of Chemical Engineering and Technology, North University of China, Taiyuan 030051, China
| | - Sireesh Kumar Teertam
- Department of Dermatology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53705, USA
| | - Huizhen Li
- School of Chemical Engineering and Technology, North University of China, Taiyuan 030051, China
| | - Zhijun Zhang
- School of Chemical Engineering and Technology, North University of China, Taiyuan 030051, China
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Caminiti R, Carresi C, Mollace R, Macrì R, Scarano F, Oppedisano F, Maiuolo J, Serra M, Ruga S, Nucera S, Tavernese A, Gliozzi M, Musolino V, Palma E, Muscoli C, Rubattu S, Volterrani M, Federici M, Volpe M, Mollace V. The potential effect of natural antioxidants on endothelial dysfunction associated with arterial hypertension. Front Cardiovasc Med 2024; 11:1345218. [PMID: 38370153 PMCID: PMC10869541 DOI: 10.3389/fcvm.2024.1345218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 01/15/2024] [Indexed: 02/20/2024] Open
Abstract
Arterial hypertension represents a leading cause of cardiovascular morbidity and mortality worldwide, and the identification of effective solutions for treating the early stages of elevated blood pressure (BP) is still a relevant issue for cardiovascular risk prevention. The pathophysiological basis for the occurrence of elevated BP and the onset of arterial hypertension have been widely studied in recent years. In addition, consistent progress in the development of novel, powerful, antihypertensive drugs and their appropriate applications in controlling BP have increased our potential for successfully managing disease states characterized by abnormal blood pressure. However, the mechanisms responsible for the disruption of endogenous mechanisms contributing to the maintenance of BP within a normal range are yet to be fully clarified. Recently, evidence has shown that several natural antioxidants containing active ingredients originating from natural plant extracts, used alone or in combination, may represent a valid solution for counteracting the development of arterial hypertension. In particular, there is evidence to show that natural antioxidants may enhance the viability of endothelial cells undergoing oxidative damage, an effect that could play a crucial role in the pathophysiological events accompanying the early stages of arterial hypertension. The present review aims to reassess the role of oxidative stress on endothelial dysfunction in the onset and progression of arterial hypertension and that of natural antioxidants in covering several unmet needs in the treatment of such diseases.
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Affiliation(s)
- Rosamaria Caminiti
- Department of Health Sciences, Institute of Research for Food Safety and Health (IRC-FSH), University “Magna Graecia” of Catanzaro, Catanzaro, Italy
| | - Cristina Carresi
- Department of Health Sciences, Veterinary Pharmacology Laboratory, Institute of Research for Food Safety and Health (IRC-FSH), University “Magna Graecia” of Catanzaro, Catanzaro, Italy
| | - Rocco Mollace
- Department of Health Sciences, Institute of Research for Food Safety and Health (IRC-FSH), University “Magna Graecia” of Catanzaro, Catanzaro, Italy
- Department of Systems Medicine, University “Tor Vergata” of Rome, Rome, Italy
| | - Roberta Macrì
- Department of Health Sciences, Institute of Research for Food Safety and Health (IRC-FSH), University “Magna Graecia” of Catanzaro, Catanzaro, Italy
| | - Federica Scarano
- Department of Health Sciences, Institute of Research for Food Safety and Health (IRC-FSH), University “Magna Graecia” of Catanzaro, Catanzaro, Italy
| | - Francesca Oppedisano
- Department of Health Sciences, Institute of Research for Food Safety and Health (IRC-FSH), University “Magna Graecia” of Catanzaro, Catanzaro, Italy
| | - Jessica Maiuolo
- Laboratory of Pharmaceutical Biology, Department of Health Sciences, Institute of Research for Food Safety and Health (IRC-FSH), University “Magna Graecia” of Catanzaro, Catanzaro, Italy
| | - Maria Serra
- Department of Health Sciences, Institute of Research for Food Safety and Health (IRC-FSH), University “Magna Graecia” of Catanzaro, Catanzaro, Italy
| | - Stefano Ruga
- Department of Health Sciences, Institute of Research for Food Safety and Health (IRC-FSH), University “Magna Graecia” of Catanzaro, Catanzaro, Italy
| | - Saverio Nucera
- Department of Health Sciences, Institute of Research for Food Safety and Health (IRC-FSH), University “Magna Graecia” of Catanzaro, Catanzaro, Italy
| | - Annamaria Tavernese
- Department of Health Sciences, Institute of Research for Food Safety and Health (IRC-FSH), University “Magna Graecia” of Catanzaro, Catanzaro, Italy
| | - Micaela Gliozzi
- Department of Health Sciences, Institute of Research for Food Safety and Health (IRC-FSH), University “Magna Graecia” of Catanzaro, Catanzaro, Italy
| | - Vincenzo Musolino
- Laboratory of Pharmaceutical Biology, Department of Health Sciences, Institute of Research for Food Safety and Health (IRC-FSH), University “Magna Graecia” of Catanzaro, Catanzaro, Italy
| | - Ernesto Palma
- Department of Health Sciences, Veterinary Pharmacology Laboratory, Institute of Research for Food Safety and Health (IRC-FSH), University “Magna Graecia” of Catanzaro, Catanzaro, Italy
| | - Carolina Muscoli
- Department of Health Sciences, Institute of Research for Food Safety and Health (IRC-FSH), University “Magna Graecia” of Catanzaro, Catanzaro, Italy
- IRCCS San Raffaele Roma, Rome, Italy
| | - Speranza Rubattu
- IRCCS Neuromed, Pozzilli, Italy
- Department of Clinical and Molecular Medicine, School of Medicine and Psychology, Sapienza University, Rome, Italy
| | | | - Massimo Federici
- Department of Systems Medicine, University “Tor Vergata” of Rome, Rome, Italy
| | | | - Vincenzo Mollace
- Department of Health Sciences, Institute of Research for Food Safety and Health (IRC-FSH), University “Magna Graecia” of Catanzaro, Catanzaro, Italy
- Renato Dulbecco Institute, Catanzaro, Italy
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Álvares AA, Garcêz A, Silva LT, Averbuch N, Garavaglia J. Olive leaf extract effect on cardiometabolic risk factors: a systematic review and meta-analysis of randomized clinical trials. Nutr Rev 2024:nuad164. [PMID: 38287654 DOI: 10.1093/nutrit/nuad164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2024] Open
Abstract
CONTEXT Olive leaf extract (OLE) is rich in phenolic compounds, which are known for their health benefits. Cardiovascular diseases, primarily coronary heart disease and stroke, are leading causes of mortality globally. OBJECTIVE This systematic review aimed to assess the impact of OLE on cardiometabolic risk factors in adults. The selection of studies was based on intervention and outcomes, using relevant search descriptors. DATA SOURCES The databases PubMed, EMBASE, and Web of Science were systematically searched for pertinent studies published up to August 2021. DATA EXTRACTION Only randomized clinical trials, either cross-over or parallel, involving adult individuals aged ≥18 years, were considered. Additionally, trials that had a comparative or placebo group and used pure OLEs for oral treatment were included. DATA ANALYSIS Twelve randomized clinical trials (RCTs) met the inclusion criteria. These trials had follow-up periods ranging from 2 days to 12 weeks and involved 703 patients aged 18 years-79 years. The outcomes demonstrated a positive correlation between the intervention group and glucose metabolism (4 RCTs), blood pressure (2 RCTs), lipid profile (2 RCTs), and inflammatory markers (2 RCTs). The RoB2 tool and the GRADE system were used to evaluate the risk of bias and the quality of evidence in the studies. CONCLUSIONS In the meta-analysis, fasting glycemia, as evaluated in studies using a low dose of OLE, showed a significant result favoring the control group. To obtain more consistent results, further clinical studies in humans, using similar methodologies, are required. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42020200877.
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Affiliation(s)
- Andressa Anelo Álvares
- Nutrition Sciences Graduate Program, Department of Nutrition, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, RS, Brasil
| | - Anderson Garcêz
- Nutrition Sciences Graduate Program, Department of Nutrition, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, RS, Brasil
| | - Lucas Tolio Silva
- Gastronomy Undergraduate Course, Department of Nutrition, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, RS, Brasil
| | - Natália Averbuch
- Nutrition Sciences Graduate Program, Department of Nutrition, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, RS, Brasil
| | - Juliano Garavaglia
- Nutrition Sciences Graduate Program, Department of Nutrition, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, RS, Brasil
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Almajid A, Bazroon A, AlAhmed A, Bakhurji O. Exploring the Health Benefits and Therapeutic Potential of Roselle (Hibiscus sabdariffa) in Human Studies: A Comprehensive Review. Cureus 2023; 15:e49309. [PMID: 38024072 PMCID: PMC10676230 DOI: 10.7759/cureus.49309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2023] [Indexed: 12/01/2023] Open
Abstract
Hibiscus sabdariffa (HS), commonly known as Roselle, has a rich history of traditional uses and is recognized for its diverse pharmacological properties, including antihypertensive, anti-inflammatory, antimicrobial, and more. This comprehensive review synthesizes the existing literature on the health benefits associated with the consumption of HS or its ingredients. Key areas of focus include metabolic health, blood sugar, and lipid regulation, wherein studies have reported varying effects on parameters such as fasting blood glucose, insulin sensitivity, and lipid profiles. Furthermore, Roselle exhibits anti-inflammatory properties, as evidenced by its impact on inflammatory markers such as MCP-1 and TNF-α. Additionally, HS extracts have shown notable antibacterial efficacy against various strains, with a potential role in urinary tract infection management. Studies also suggest potential benefits for renal function, with improvements in markers such as blood urea nitrogen and creatinine levels. In this article, we aim to review the existing literature on the health benefits of HS.
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Affiliation(s)
- Ali Almajid
- Internal Medicine, King Fahad Specialist Hospital, Dammam, SAU
| | - Ali Bazroon
- Internal Medicine, King Fahad Specialist Hospital, Dammam, SAU
| | - Alzahraa AlAhmed
- Faculty of Medicine, King Abdulaziz University Hospital, Jeddah, SAU
| | - Omar Bakhurji
- Medicine, Imam Abdulrahman Bin Faisal University, Dammam, SAU
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García-Muñoz AM, García-Guillén AI, Victoria-Montesinos D, Abellán-Ruiz MS, Alburquerque-González B, Cánovas F. Effect of the Combination of Hibiscus sabdariffa in Combination with Other Plant Extracts in the Prevention of Metabolic Syndrome: A Systematic Review and Meta-Analysis. Foods 2023; 12:foods12112269. [PMID: 37297513 DOI: 10.3390/foods12112269] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 05/23/2023] [Accepted: 06/02/2023] [Indexed: 06/12/2023] Open
Abstract
Metabolic syndrome is a complex and multifactorial disorder associated with increased risk of cardiovascular disease and type 2 diabetes, exacerbated by a sedentary lifestyle and situations such as the COVID-19 pandemic. Recent studies have shown that consumption of fruits and vegetables high in polyphenols has a protective effect, reducing cardiovascular risk. Hibiscus sabdariffa (HS) in combination with other plant extracts has recently attracted scientists' attention due to its potential use in the treatment of metabolic syndrome. This systematic review and meta-analysis examines the effects of HS in combination with other plant extracts on the prevention of metabolic syndrome, exploring their synergistic effects and potential as therapeutic agents. For this purpose, a systematic search of randomized clinical trials (RCTs) was conducted in four different databases and the data obtained were then used for a meta-analysis. Initially, the titles and abstracts of 1368 studies were read. From these, 16 studies were examined closely for their eligibility, and finally, seven RCTs with 332 participants were included in both the meta-analysis and the qualitative analysis. Our results show that HS in combination with other plant extracts improved anthropometric parameters, blood pressure, and lipid profile (low density lipoprotein cholesterol and total cholesterol) compared to a placebo control group. It is important to note that although this meta-analysis suggests that HS in combination with other plant extracts may have a beneficial effect on cardiovascular parameters, further research is needed to determine the optimal dose and intake duration.
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Affiliation(s)
- Ana María García-Muñoz
- Faculty of Pharmacy and Nutrition, UCAM Universidad Católica San Antonio de Murcia, 30107 Murcia, Spain
| | - Ana I García-Guillén
- Faculty of Medicine, UCAM Universidad Católica San Antonio de Murcia, 30107 Murcia, Spain
| | | | | | - Begoña Alburquerque-González
- Izpisua Lab, HiTech, Sport and Health Innovation Hub, UCAM Universidad Católica San Antonio de Murcia, 30107 Murcia, Spain
| | - Fernando Cánovas
- Faculty of Medicine, UCAM Universidad Católica San Antonio de Murcia, 30107 Murcia, Spain
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Sapian S, Ibrahim Mze AA, Jubaidi FF, Mohd Nor NA, Taib IS, Abd Hamid Z, Zainalabidin S, Mohamad Anuar NN, Katas H, Latip J, Jalil J, Abu Bakar NF, Budin SB. Therapeutic Potential of Hibiscus sabdariffa Linn. in Attenuating Cardiovascular Risk Factors. Pharmaceuticals (Basel) 2023; 16:807. [PMID: 37375755 DOI: 10.3390/ph16060807] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 05/23/2023] [Accepted: 05/24/2023] [Indexed: 06/29/2023] Open
Abstract
Cardiovascular diseases (CVDs) represent a broad spectrum of diseases afflicting the heart and blood vessels and remain a major cause of death and disability worldwide. CVD progression is strongly associated with risk factors, including hypertension, hyperglycemia, dyslipidemia, oxidative stress, inflammation, fibrosis, and apoptosis. These risk factors lead to oxidative damage that results in various cardiovascular complications including endothelial dysfunctions, alterations in vascular integrity, the formation of atherosclerosis, as well as incorrigible cardiac remodeling. The use of conventional pharmacological therapy is one of the current preventive measures to control the development of CVDs. However, as undesirable side effects from drug use have become a recent issue, alternative treatment from natural products is being sought in medicinal plants and is gaining interest. Roselle (Hibiscus sabdariffa Linn.) has been reported to contain various bioactive compounds that exert anti-hyperlipidemia, anti-hyperglycemia, anti-hypertension, antioxidative, anti-inflammation, and anti-fibrosis effects. These properties of roselle, especially from its calyx, have relevance to its therapeutic and cardiovascular protection effects in humans. This review summarizes the findings of recent preclinical and clinical studies on roselle as a prophylactic and therapeutic agent in attenuating cardiovascular risk factors and associated mechanisms.
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Affiliation(s)
- Syaifuzah Sapian
- Centre for Diagnostic, Therapeutic and Investigative Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia
| | - Asma Ali Ibrahim Mze
- Centre for Diagnostic, Therapeutic and Investigative Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia
| | - Fatin Farhana Jubaidi
- Centre for Diagnostic, Therapeutic and Investigative Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia
| | - Nor Anizah Mohd Nor
- Centre for Diagnostic, Therapeutic and Investigative Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia
| | - Izatus Shima Taib
- Centre for Diagnostic, Therapeutic and Investigative Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia
| | - Zariyantey Abd Hamid
- Centre for Diagnostic, Therapeutic and Investigative Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia
| | - Satirah Zainalabidin
- Center for Toxicology and Health Risk Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia
| | - Nur Najmi Mohamad Anuar
- Center for Toxicology and Health Risk Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia
| | - Haliza Katas
- Centre for Drug Delivery Technology, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia
| | - Jalifah Latip
- Department of Chemical Sciences, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, Selangor 43600, Malaysia
| | - Juriyati Jalil
- Centre for Drug and Herbal Development, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia
| | - Nur Faizah Abu Bakar
- Centre for Diagnostic, Therapeutic and Investigative Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia
| | - Siti Balkis Budin
- Centre for Diagnostic, Therapeutic and Investigative Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia
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BEYAZ S, GÖK Ö, ASLAN A. A research paper on the immunomodulatory and anti-inflammatory activities of olive tree (Olea europaea L.) leaf. INTERNATIONAL JOURNAL OF SECONDARY METABOLITE 2022. [DOI: 10.21448/ijsm.1075283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Olive tree (Olea europaea L.) leaf is known to have a number of bioactive properties being antioxidant, antihypertensive, antiatherogenic, anti-inflammatory, antifungal, antiviral and antimicrobial. In this study, the immunomodulatory roles of Olive tree (Olea europaea L.) leaf against oxidative damage caused by carbon tetrachloride (CCl4) in Saccharomyces cerevisiae were investigated. In the study, four groups were formed; namely, (i) Control Group: Yeast only planted group; (ii) CCl4 Group: Group given CCl4 (15 mM); (iii) Olive Tree Leaf Group: The group given olive tree leaf (10%); and (iv) Olive Tree Leaf + CCl4 Group: Olive tree leaf (10%) + CCl4 (15 mM) given group. Cultures of Saccharomyces cerevisiae were grown at 30 °C for 1, 3, 5, and 24 hours. Malondialdehyde (MDA), glutathione levels (GSH), cell growth and catalase (CAT) activity measurements were determined by spectrophotometer. Total protein concentrations were determined by SDS-PAGE electrophoresis and the Bradford protein method. According to the results obtained; compared to the CCl4 group, cell growth (1, 3, 5 and 24 hours), total protein synthesis, and GSH and CAT activities (24 hours) increased in olive tree leaf groups, while MDA level (24 hours) decreased. Thanks to its strong bioactive properties, olive tree leaf has been found to increase cell growth and total protein synthesis by decreasing CCl4 induced oxidative stress in Saccharomyces cerevisiae culture. It has been concluded that if the olive tree leaf is used regularly, it will be beneficial in eliminating many health problems.
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Hibiscus sabdariffa in Diabetes Prevention and Treatment—Does It Work? An Evidence-Based Review. Foods 2022; 11:foods11142134. [PMID: 35885378 PMCID: PMC9319339 DOI: 10.3390/foods11142134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/13/2022] [Accepted: 07/15/2022] [Indexed: 11/28/2022] Open
Abstract
Diabetes is currently a global health problem that is already reported as an epidemic. This metabolic disease, characterized by a disturbance in the carbohydrate, protein, and lipid metabolism, is often accompanied by disorders of several organs. Its treatment is expensive and often difficult to control. Therefore, it seems necessary to search for new drugs and solutions to facilitate therapy and reduce treatment costs. Herbal medicines are becoming more and more popular. Hibiscus sabdariffa (roselle) is a plant that grows wild in a tropical climate. It has been used in folk medicine for thousands of years. Thanks to the numerous active compounds, including polyphenols, polysaccharides, organic acids, or pectins, it is reported to exhibit hypoglycemic, antioxidant, hypotensive, and anti-lipidemic activities and numerous indirect effects that are related to them. The aim of this review was to update the knowledge about the therapeutic effects of roselle in diabetes and its comorbidities based on in vitro, animal, and human studies. After a careful analysis of the scientific literature, it can be stated that roselle is a promising product that can be used either on its own or as an addition to the conventional treatment regimens to prevent or treat diabetes and its accompanying diseases.
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Montalvo-González E, Villagrán Z, González-Torres S, Iñiguez-Muñoz LE, Isiordia-Espinoza MA, Ruvalcaba-Gómez JM, Arteaga-Garibay RI, Acosta JL, González-Silva N, Anaya-Esparza LM. Physiological Effects and Human Health Benefits of Hibiscus sabdariffa: A Review of Clinical Trials. Pharmaceuticals (Basel) 2022; 15:ph15040464. [PMID: 35455462 PMCID: PMC9033014 DOI: 10.3390/ph15040464] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 04/09/2022] [Accepted: 04/10/2022] [Indexed: 02/04/2023] Open
Abstract
Hibiscus sabdariffa Linn. Malvaceae (HS) is characterized by its edible calyxes. The HS calyxes are widely used for cosmetic, food, and medicinal applications. According to ethnobotanical evidence, decoction, infusion, or maceration extracts from HS calyxes have been used in folk medicine to treat many ailments. Moreover, several in vitro and in vivo studies have demonstrated the pharmacological properties and potential human health benefits of HS consumption. On the other hand, the evaluation of the physiological effects and health benefits of HS in clinical studies is most challenging. Therefore, this narrative review summarizes and discusses the physiological effects and health benefits of HS calyxes reported in clinical trials. Preparations obtained from HS calyxes (extracts, infusions, decoction, teas, beverages, capsules, and pills) are used as non-pharmacological therapies to prevent/control diverse chronic non-communicable diseases. The most-reported HS health benefits are its antihypertensive, antidyslipidemic, hypoglycemic, body fat mass reduction, nephroprotective, antianemic, antioxidant, anti-inflammatory, and anti-xerostomic activities; these effects are associated with the phytochemicals found in HS. Moreover, no adverse effects were reported during the clinical trials. However, clinical studies exhibited some limitations; thus, further studies are required to validate the clinical efficacy of HS in large-scale studies with higher doses and a good experimental design
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Affiliation(s)
- Efigenia Montalvo-González
- Integral Food Research Laboratory, National Technological of Mexico/Technological Institute of Tepic, Av. Tecnologico 2595, Tepic 63175, Mexico;
| | - Zuamí Villagrán
- Department of Health Sciences, Division of Biomedical Science, University Center of Los Altos, University of Guadalajara, Av. Rafael Casillas Aceves 1200, Guadalajara 47600, Mexico; (Z.V.); (S.G.-T.)
| | - Sughey González-Torres
- Department of Health Sciences, Division of Biomedical Science, University Center of Los Altos, University of Guadalajara, Av. Rafael Casillas Aceves 1200, Guadalajara 47600, Mexico; (Z.V.); (S.G.-T.)
| | - Laura Elena Iñiguez-Muñoz
- División of Natural and Technological Exact Sciences, Southern Region University Center, University of Guadalajara, Av. Enrique Arreola Silva 883, Guadalajara 49000, Mexico;
| | - Mario Alberto Isiordia-Espinoza
- Department of Clinics, Division of Biomedical Sciences, Institute of Research in Medical Sciences, Los Altos University Center, University of Guadalajara, Av. Rafael Casillas Aceves 1200, Guadalajara 47600, Mexico;
| | - José Martín Ruvalcaba-Gómez
- National Center for Genetic Resources, National Institute of Forestry, Agriculture and Livestock Research, Boulevard de la Biodiversidad 400, Tepatitlan de Morelos 47600, Mexico; (J.M.R.-G.); (R.I.A.-G.)
| | - Ramón Ignacio Arteaga-Garibay
- National Center for Genetic Resources, National Institute of Forestry, Agriculture and Livestock Research, Boulevard de la Biodiversidad 400, Tepatitlan de Morelos 47600, Mexico; (J.M.R.-G.); (R.I.A.-G.)
| | - José Luis Acosta
- Interdisciplinary Research Centre for Integral Regional Development Sinaloa Unit, National Polytechnic Institute, Boulevard Juan de Dios Bátiz 250, Guasave 81049, Mexico;
| | - Napoleón González-Silva
- Department of Livestock and Agricultural Sciences, University Center of Los Altos, University of Guadalajara, Av. Rafael Casillas Aceves 1200, Guadalajara 47600, Mexico
- Correspondence: (N.G.-S.); (L.M.A.-E.)
| | - Luis Miguel Anaya-Esparza
- Department of Livestock and Agricultural Sciences, University Center of Los Altos, University of Guadalajara, Av. Rafael Casillas Aceves 1200, Guadalajara 47600, Mexico
- Correspondence: (N.G.-S.); (L.M.A.-E.)
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Abstract
BACKGROUND Hypertension is considered to be a serious health problem worldwide. Controlling and lowering blood pressure are of significant benefit to people with hypertension because hypertension is a risk factor for stroke, heart disease, and cardiovascular disease. Roselle, the tropical plant Hibiscus sabdariffa, also commonly called sour tea or red tea, has been used as both a thirst-quenching drink and for medicinal purposes. OBJECTIVES To assess the effect of Roselle on blood pressure in people with primary hypertension. SEARCH METHODS For this update, the Cochrane Hypertension Information Specialist searched the following databases and trials registers for randomised controlled trials (RCTs): the Cochrane Hypertension Specialised Register (to 6 August 2021), Cochrane Central Register of Controlled Trials (CENTRAL; 2021, Issue 7), MEDLINE Ovid (1946 to 5 August 2021), Embase Ovid (1974 to 5 August 2021), ProQuest Dissertations & Theses (to 6 August 2021), Web of Science Clarivate (to 7 August 2021), Food Science and Technology Abstracts Clarivate (to 7 August 2021), the WHO International Clinical Trials Registry Platform (to 6 August 2021), and the US National Institutes of Health Ongoing Trials Register ClinicalTrials.gov (to 6 August 2021). We searched Google Scholar and OpenSIGLE. We also handsearched local and regional Chinese databases: CBM, CMCC, TCMLARS, CNKI, CMAC, and the Index to Chinese Periodical Literature (to 14 September 2020), as well as Thai databases (ThaiJO, CUIR, TDC, CMU e-Theses, TCTR) (to 3 October 2020). There were no language or publication date restrictions. SELECTION CRITERIA We sought RCTs evaluating the use of any forms of Roselle with placebo or no treatment in adults with hypertension. Our primary outcome was change in trough and/or peak systolic and diastolic blood pressure (SBP, DBP). Secondary outcomes were withdrawals due to adverse effects, change in pulse pressure, and change in heart rate. DATA COLLECTION AND ANALYSIS All search results were managed using Covidence and re-checked for the number of records, inclusion and exclusion of studies with Mendeley reference management software. We used standard methodological procedures expected by Cochrane. Two review authors worked independently in parallel for screening (titles and abstracts, and full reports), data extraction, risk of bias assessment, and assessment of the certainty of the evidence using the GRADE approach. Any disagreements were resolved by discussion or by consultation with the third review author if necessary. We presented mean difference (MD) of change in SBP and DBP with their corresponding 95% confidence interval (CI). MAIN RESULTS For this update, only one RCT with a parallel-group design involving 60 participants with type 2 diabetes mellitus fulfilled the inclusion criteria. This study investigated the effect of Roselle extract capsules (total dose of 5600 mg) compared with placebo (lactose) at eight weeks. The study was at low risk of selection bias, performance bias, and detection bias. Conversely, it was at high risk of attrition bias, reporting bias, and other bias (baseline imbalance). We have very little confidence in the effect estimate of Roselle on change-from-baseline in both SBP and DBP between the two groups. The MD of change in SBP was 1.65, 95% CI -7.89 to 11.19 mmHg, 52 participants, very low-certainty evidence. The MD of change in DBP was 4.60, 95% CI -1.38 to 10.58 mmHg, 52 participants, very low-certainty evidence. Our secondary outcomes of withdrawals due to adverse effects, change in pulse pressure, and change in heart rate were not reported. Due to the limited available data, no secondary analyses were performed (subgroup and sensitivity analysis). AUTHORS' CONCLUSIONS The evidence is currently insufficient to determine the effectiveness of Roselle compared to placebo for controlling or lowering blood pressure in people with hypertension. The certainty of evidence was very low due to methodological limitations, imprecision, and indirectness. There is a need for rigorous RCTs that address the review question.
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Affiliation(s)
- Porjai Pattanittum
- Department of Epidemiology and Biostatistics, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand
| | - Chetta Ngamjarus
- Department of Epidemiology and Biostatistics, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand
| | - Fonthip Buttramee
- Department of Disease Control, The office of disease prevention and control 8 Udon Thani, Udon Thani, Thailand
| | - Charoonsak Somboonporn
- Department of Radiology (Division of Nuclear Medicine), Faculty of Medicine, Khon Kaen University, Muang District, Thailand
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Marzouk HM, Teaima MH, El-Desoky AM, Mohamed SO. A cost-effective HPLC-DAD method for quality and stability assessment of antihypertensive herbal extracts in their recently co-formulated nutraceutical product. Microchem J 2021. [DOI: 10.1016/j.microc.2021.106563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
BACKGROUND Hypertension is considered a serious health problem worldwide. Controlling and lowering blood pressure have a significant benefit to the hypertensive patients because hypertension is a risk factor for stroke, heart disease and cardiovascular disease. A tropical plant called Roselle, or Red Sorrel in English-speaking countries, has been used both as a thirst-quenching drink and for medical purposes. OBJECTIVES To explore the effect of Roselle on blood pressure in hypertensive adult patients. SEARCH STRATEGY The following databases were searched (Date of most recent search was September 2009): - Cochrane Database of Systematic Reviews (2nd Quarter 2009) - DARE (2nd Quarter 2009) - Ovid MEDLINE (1950 to Present with Daily Update) - EMBASE (1980 to 2009 Week 22) - AMED (1985 to May 2009) - EBSCO CINAHL - BIOSIS (1969 to 2008) - AGRICOLA (1970 to May 2009) - Food Science and Technology Abstract (1969 to 2009 June Week 1) - International Pharmaceutical Abstracts - International Bibliographic Information on Dietary Supplements - Clinical Trials.gov and Current Controlled Trials - OpenSIGLE - Hand searching of journals - ISI Web of Knowledge SELECTION CRITERIA We sought randomised control trials (RCTs) evaluating use of any forms of Roselle with placebo or no treatment in hypertensive patients. Change in trough and/or peak systolic and diastolic blood pressure were primary outcomes. Secondary outcomes were withdrawals due to adverse effects, change of pulse pressure and change of heart rate. DATA COLLECTION AND ANALYSIS Two review authors (C Ngamjarus, CN and P Pattanittum, PP) independently scanned titles and abstracts, as well as independently screened the full reports of the potentially relevant studies. At each stage, the results were compared and disagreements were solved by discussion. MAIN RESULTS No studies were identified that met the inclusion criteria. However, one abstract of an ongoing study is likely to meet the inclusion criteria, when completed. AUTHORS' CONCLUSIONS There is insufficient evidence to support the benefit of Roselle for either controlling or lowering blood pressure in patients with hypertension. Based on the information of this review, there is a clear need to develop well-designed studies to assess the efficacy of Roselle on hypertensive patients.
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Affiliation(s)
- Chetta Ngamjarus
- Department of Biostatistics and Demography, Faculty of Public Health, Khon Kaen University, 123 Miltraparp Road, Khon Kaen, Thailand, 40002
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