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Meta-Analysis
. 2022 May 9;80(6):1723-1737.
doi: 10.1093/nutrit/nuab104.

A systematic review and meta-analysis of the effects of Hibiscus sabdariffa on blood pressure and cardiometabolic markers

Lucy R Ellis  1 , Sadia Zulfiqar  2 , Mel Holmes  2 , Lisa Marshall  2 , Louise Dye  1 , Christine Boesch  2
Affiliations
Meta-Analysis

A systematic review and meta-analysis of the effects of Hibiscus sabdariffa on blood pressure and cardiometabolic markers

Lucy R Ellis et al. Nutr Rev. .

Abstract

Context: Hibiscus sabdariffa (hibiscus) has been proposed to affect cardiovascular risk factors.

Objective: To review the evidence for the effectiveness of hibiscus in modulating cardiovascular disease risk markers, compared with pharmacologic, nutritional, or placebo treatments.

Data sources: A systematic search of the Web of Science, Cochrane, Ovid (MEDLINE, Embase, AMED), and Scopus databases identified reports published up to June 2021 on randomized controlled trials using hibiscus as an intervention for lipid profiles, blood pressure (BP), and fasting plasma glucose levels in adult populations.

Data extraction: Seventeen chronic trials were included. Quantitative data were examined using a random effects meta-analysis and meta-regression with trial sequential analysis to account for type I and type II errors.

Data analysis: Hibiscus exerted stronger effects on systolic BP (-7.10 mmHg [95%CI, -13.00, -1.20]; I2 = 95%; P = 0.02) than placebo, with the magnitude of reduction greatest in those with elevated BP at baseline. Hibiscus induced reductions to BP similar to that resulting from medication (systolic BP reduction, 2.13 mmHg [95%CI, -2.81, 7.06], I2 = 91%, P = 0.40; diastolic BP reduction, 1.10 mmHg [95%CI, -1.55, 3.74], I2 = 91%, P = 0.42). Hibiscus also significantly lowered levels of low-density lipoprotein compared with other teas and placebo (-6.76 mg/dL [95%CI, -13.45, -0.07]; I2 = 64%; P = 0.05).

Conclusions: Regular consumption of hibiscus could confer reduced cardiovascular disease risk. More studies are warranted to establish an effective dose response and treatment duration.

Systematic review registration: PROSPERO registration no. CRD42020167295.

Keywords: Hibiscus sabdariffa; blood pressure; cardiovascular disease; lipidemia; meta-analysis; roselle.

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Figures

Figure 1
Figure 1
PRISMA flow diagram of the literature search process
Figure 2
Figure 2
Meta-analysis of the effects of hibiscus supplementation on A) systolic blood pressure and B) diastolic blood pressure. Superscript denotes population of the Gurrola-Diaz study (a, healthy; b, metabolic syndrome) and the Nwachukwu study comparing hibiscus and placebo
Figure 3
Figure 3
Meta-analysis on the effects of hibiscus supplementation on lipid profiles. A) low-density lipoprotein; B) high-density lipoprotein (HDL); C) total cholesterol; and D) triglycerides. Superscript denotes population of the Gurrola-Diaz study (a, healthy; b, metabolic syndrome). Note in A, C and D the left side of the figure shows effects which favour hibiscus and are beneficial for health. In 3B the right side of the figure favours hibiscus because an increase in HDL is deemed beneficial.
Figure 4
Figure 4
Meta-analysis on the effects of hibiscus supplementation on A) systolic blood pressure and B) diastolic blood pressure compared with pharmaceutical medications
Figure 5
Figure 5
Outcomes from random effects trial sequential analysis of A) systolic blood pressure (SBP) and B) diastolic blood pressure (DBP). Both SBP and DBP achieved the required information size (246 and 242) and crossed the conventional test boundary for significance. TSA, trial sequential analysis
See this image and copyright information in PMC

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