Treating hypertension with local products
Combretum micranthum (known as Kinkeliba) and Hibiscus sabdariffa (known as Bissap or Karkadé) are two plants used in the preparation of popular drinks in West Africa.
Two randomized controlled clinical trials were conducted in health centres around Saint-Louis du Senegal. The research team consisted of medical doctors and pharmacists, professors and doctoral students from the University of Saint-Louis, trainees and Swiss volunteers from the Antenna Foundation.
Combretum and Hibiscus were compared with the standard imported reference treatment for mild to moderate hypertension, with a 6 months follow-up. The plants were prepared in the form of compressed powder (tablets) or tea (decoction). Five groups were compared: 2 groups of each plant, and reference treatment as control group. It was found that the use of either plant, in either form, was associated with a reduction in blood pressure similar to that achieved with the reference treatment.
The studies were published in the highly respected Journal of Human Hypertension (see the Publications section at the bottom of this page).
Combretum is widespread in West Africa; Hibiscus also, as well as in the Middle East and in Mexico. The adequate use of either of these plants for hypertension could help improve health in many countries. The reason why hypertension should be taken seriously is its complications, particularly cardiovascular disorders and kidney failure, which require expensive, complicated and often inaccessible treatments such as dialysis and heart surgery. When patients with high blood pressure are treated with the standard, imported drugs, they often stop their treatment, discouraged by the price or side effects. Validated plants could remedy this situation if their use is widely disseminated. Treating hypertension means better health for large populations.
Clinical trial
This clinical trial is an essential step before the results can be published and the public health impact assessed. A new multicentric randomised controlled clinical trial has just been completed in Senegal, this time to ensure that the health benefit is maintained over a long period of time, and also to compare the efficacy of the tablets to that of herbal tea: 219 patients have been followed for 6 months, at the end of which hibiscus and kinkeliba proved to be as effective as the synthetic drug used as standard. In terms of the galenic formulation, it was observed that the herbal tea tends to be slightly more effective than tablets.
A clinical trial conducted in a refugee community in Jordan in partnership with the Red Crescent showed that, after 1 month of daily consumption of hibiscus tea, 38% of people had reached optimal blood pressure. The same improvement has been observed with patients who were unable to control their blood pressure with standard remedies, showing the value of hibiscus as a supplement. This percentage is similar to what is observed with synthetic antihypertensive drugs when used alone.
A multicentric comparative pilot intervention was conducted in Iraq in partnership with the Iraq Health Access Organization (IHAO) with 121 participants. Hibiscus decoction was given to participants of the intervention group (with or without standard medication). After 6 weeks of hibiscus tea consumption, 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). The chemical analysis led to the discovery of a new active substance, hibiscus acid. The study shows the feasibility of using HS decoction in IDP’s problematic framework, also for patients under standard medication not reaching target blood pressure values, as hibiscus is a safe, local, affordable, and culturally accepted food product.
In Haiti, Hibiscus is taken in the form of capsules that are manufactured locally by a local NGO, the Cosmos Foundation. Check https://antenna.ch/fr/activites/medecines/recherches-diabete/ for more details.
This product is available in the form of capsules, and the income will help in the conduction of additional studies. If you are interested please visit this page
Publications
- Al-Anbaki, M., Cavin, A., Nogueira, R., Taslimi, J., Ali, H., Najem, M., Shukur Mahmood, M., Abdullah Khaleel, I., Saad Mohammed, A., Ramadhan Hasan, H., Marcourt, L., Félix, F., Vinh Tri Low-Der’s, N., Ferreira Queiroz, E., Wolfender, J., Watissée, M. and Graz, B., 2021. Hibiscus sabdariffa, a Treatment for Uncontrolled Hypertension. Pilot Comparative Intervention. Plants, 10(5), p.1018. Hibiscus sabdariffa, a Treatment for Uncontrolled Hypertension. Pilot Comparative Intervention
- Bourqui A, Niang EAB, Graz B, Diop EA, Dahaba M, Thiaw I, Soumare K, Valmaggia P, Nogueira RC, Cavin AL, Al-Anbaki M, Seck SM. Hypertension treatment with Combretum micranthum or Hibiscus sabdariffa, as decoction or tablet: a randomized clinical trial. J Hum Hypertens. 2020 Sep 18. doi: 10.1038/s41371-020-00415-1.
- Al-Anbaki M, Nogueira RC, Cavin AL, Al-Hadid M, Al-Ajlouni I, Shuhaiber L and Graz B. (2019). Treating uncontrolled hypertension with Hibiscus sabdariffa when standard treatment is insufficient: pilot intervention. J Altern Complement Med. 25(12):1200-1205.
- Seck SM, Doupa D, Dia DG, Diop EA, Ardiet DL, Nogueira RC, Graz B and Diouf B. (2017). Efficacité clinique des médicaments traditionnels africains dans l’hypertension. J Hum Hypertens. 32(1):75-81.
- Seck SM, Diop AE, Ka FE, Doupa D, Diouf B and Gueye L. (2016). Antihypertensive efficacy of Combretum micranthum and Hibiscus sabdariffa : A randomized controlled trial versus Ramipril. Nephrol Dial Transplant. 31(1):120.