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. 2021 May 19;10(5):1018.
doi: 10.3390/plants10051018.

Hibiscus sabdariffa, a Treatment for Uncontrolled Hypertension. Pilot Comparative Intervention

Marwah Al-Anbaki  1 , Anne-Laure Cavin  1 , Renata Campos Nogueira  1 , Jaafar Taslimi  2 , Hayder Ali  2 , Mohammed Najem  2 , Mustafa Shukur Mahmood  2 , Ibrahim Abdullah Khaleel  2 , Abdulqader Saad Mohammed  2 , Hasan Ramadhan Hasan  2 , Laurence Marcourt  3   4 , Fabien Félix  3   4 , Nicolas Vinh Tri Low-Der's  3   4 , Emerson Ferreira Queiroz  3   4 , Jean-Luc Wolfender  3   4 , Marie Watissée  5 , Bertrand Graz  1
Affiliations

Hibiscus sabdariffa, a Treatment for Uncontrolled Hypertension. Pilot Comparative Intervention

Marwah Al-Anbaki et al. Plants (Basel). .

Abstract

In Iraq, in 2019, there were about 1.4 million Internally Displaced Persons (IDP); medical treatments were often interrupted. The feasibility of using Hibiscus sabdariffa (HS) decoction to curb hypertension was evaluated. A multicentric comparative pilot intervention for 121 participants with high blood pressure (BP) (≥140/90 mmHg) was conducted. Participants of the intervention group (with or without conventional medication) received HS decoction on a dose regimen starting from 10 grams per day. BP was measured five times over six weeks. The major active substances were chemically quantified. Results: After 6 weeks, 61.8% of participants from the intervention group (n = 76) reached the target BP < 140/90 mmHg, compared to 6.7% in the control group (n = 45). In the intervention group, a mean (±SD) reduction of 23.1 (±11.8) mmHg and 12.0 (±11.2) for systolic and diastolic BP, respectively, was observed, while in the control group the reduction was 4.4 (±10.2)/3.6 (±8.7). The chemical analysis of the starting dose indicated a content of 36 mg of total anthocyanins and 2.13 g of hibiscus acid. The study shows the feasibility of using HS decoction in IDP's problematic framework, as hibiscus is a safe, local, affordable, and culturally accepted food product.

Keywords: Hibiscus sabdariffa; IDP; Iraq; hypertension; refugees.

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Conflict of interest statement

Antenna Foundation has commercialized HS capsules in Switzerland to fund future research projects in the humanitarian sector.

Figures

Figure 1
Figure 1
Participant’s flow.
Figure 2
Figure 2
Boxplots of Systolic BP overtime. Median values are black lines in the middle of the box, interquartile range (IQR) is the height of the box; minimum and maximum values (1.5 × IQR) are represented by the lines extending out of the box. The outliers are pinpoints.
Figure 3
Figure 3
HPLC-PDA-ELSD analysis of HS decoction: (a) PDA detection at 320 nm; (b) PDA detection at 520 nm; (c) ELSD detection. UHPLC-PDA-MS analysis (d); MS and UV spectrum of compounds 1–3; (e) 1H-NMR analysis of HS decoction in a deuterated phosphate buffer (pH 7) containing 0.9 mM of TSP (sodium trimethylsilyl propionate). The signals of hibiscus acid (4) are highlighted.
Figure 4
Figure 4
Refugee IDP settlements in Iraq and study sites. Source: Adapted from [11]. IDP—internally displaced persons. January 2020.
See this image and copyright information in PMC

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