Effect of Ginseng on Blood Pressure: A Systematic Review and Meta-Analysis

인삼이 혈압에 미치는 영향: 체계적 문헌고찰 및 메타분석

  • Received : 2016.05.12
  • Accepted : 2016.06.18
  • Published : 2016.06.30

Abstract

Objective: A meta-analysis was performed to determine effect of ginseng on blood pressure. Methods: The databases of PubMed, Embase, Cochrane Library, RISS, DBpia, KISS, and Koreamed were searched for all published studies from inception to January 2016. The following terms were used: "ginseng", "hypertension", and "blood pressure". Using the Review Manager 5, mean differences (MDs) were pooled to measure the effect of ginseng on blood pressure compared to that of placebo. Results: Eleven randomized controlled trials were included. In this meta-analysis, ginseng treatment significantly lowered systolic blood pressure (SBP) in a dose-independent way (MD: -1.99, p = 0.04). In subgroup analysis, 8-12 week consumption of ginseng achieved significantly greater reduction in SBP (MD: -3.14, p = 0.03), while single administration of ginseng failed to show BP-lowering effect. When ingested over 8-12 weeks, ginseng significantly lowered diastolic blood pressure (DBP) (MD: -1.96, p = 0.03). No significant association was found between ginseng dose and the magnitude of BP-lowering effect. However, a significant positive relationship was observed between baseline SBP level and the magnitude of SBP reduction (r = 0.848, p = 0.033). Such a relationship was not seen in DBP. Conclusion: Consumption of ginseng for 8-12 weeks achieved significant reductions in SBP and DBP in a dose-independent way. There was a significant positive relationship between baseline SBP level and the magnitude of SBP reduction.

Keywords

References

  1. Baeg IH, So SH. The world ginseng market and the ginseng (Korea). J Ginseng Res 2013;37:1-7. https://doi.org/10.5142/jgr.2013.37.1
  2. Choi KT. Botanical characteristics, pharmacological effects and medicinal components of Korean Panax ginseng C A Meyer. Acta Pharmacol Sin 2008;29:1109-18. https://doi.org/10.1111/j.1745-7254.2008.00869.x
  3. Yuan CS, Wang CZ, Wicks SM, et al. Chemical and pharmacological studies of saponins with a focus on American ginseng. J Ginseng Res 2010;34:160-7. https://doi.org/10.5142/jgr.2010.34.3.160
  4. de Andrade E, de Mesquita AA, Claro Jde A, et al. Study of the efficacy of Korean red ginseng in the treatment of erectile dysfunction. Asian J Androl 2007;9:241-4. https://doi.org/10.1111/j.1745-7262.2007.00210.x
  5. Kim HG, Cho JH, Yoo SR, et al. Antifatigue effects of Panax ginseng C.A. Meyer: a randomised, double-blind, placebo-controlled trial. PLoS One 2013;8:e61271. https://doi.org/10.1371/journal.pone.0061271
  6. Bang H, Kwak JH, Ahn HY, et al. Korean red ginseng improves glucose control in subjects with impaired fasting glucose, impaired glucose tolerance, or newly diagnosed type 2 diabetes mellitus. J Med Food 2014;17:128-34. https://doi.org/10.1089/jmf.2013.2889
  7. Lee ST, Chu K, Sim JY, et al. Panax ginseng enhances cognitive performance in Alzheimer disease. Alzheimer Dis Assoc Disord 2008;22:222-6. https://doi.org/10.1097/WAD.0b013e31816c92e6
  8. Ossoukhova A, Owen L, Savage K, et al. Improved working memory performance following administration of a single dose of American ginseng (Panax quinquefolius L.) to healthy middle-age adults. Hum Psychopharmacol 2015;30:108-22. https://doi.org/10.1002/hup.2463
  9. Yu J, Eto M, Akishita M, et al. 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;353:764-9. https://doi.org/10.1016/j.bbrc.2006.12.119
  10. Hien TT, Kim ND, Pokharel YR, et al. Ginsenoside Rg3 increases nitric oxide production via increases in phosphorylation and expression of endothelial nitric oxide synthase: essential roles of estrogen receptordependent PI3-kinase and AMP-activated protein kinase. Toxicol Appl Pharmacol 2010;246:171-83. https://doi.org/10.1016/j.taap.2010.05.008
  11. Kang YJ, Sohn JT, Chang KC. Relaxation of canine corporal smooth muscle relaxation by ginsenoside saponin Rg3 is independent from eNOS activation. Life Sci 2005;77:74-84. https://doi.org/10.1016/j.lfs.2004.12.016
  12. Guan YY, Zhou JG, Zhang Z, et al. Ginsenoside-Rd from panax notoginseng blocks Ca2+ influx through receptor- and store-operated Ca2+ channels in vascular smooth muscle cells. Eur J Pharmacol 2006;548:129-36. https://doi.org/10.1016/j.ejphar.2006.08.001
  13. Cai BX, Li XY, Chen JH, et al. Ginsenoside-Rd, a new voltage-independent Ca2+ entry blocker, reverses basilar hypertrophic remodeling in stroke-prone renovascular hypertensive rats. Eur J Pharmacol 2009;606:142-9. https://doi.org/10.1016/j.ejphar.2009.01.033
  14. Chung IM, Lim JW, Pyun WB, et al. Korean red ginseng improves vascular stiffness in patients with coronary artery disease. J Ginseng Res 2010;34(3)212-8. https://doi.org/10.5142/jgr.2010.34.3.212
  15. Stavro PM, Woo M, Leiter LA, et al. Long-term intake of North American ginseng has no effect on 24-hour blood pressure and renal function. Hypertension 2006;47(4):791-6. https://doi.org/10.1161/01.HYP.0000205150.43169.2c
  16. Stavro PM, Woo M, Heim TF, et al. North American ginseng exerts a neutral effect on blood pressure in individuals with hypertension. Hypertension 2005;46:406-11. https://doi.org/10.1161/01.HYP.0000173424.77483.1e
  17. Jovanovski E, Peeva V, Sievenpiper JL, et al. Modulation of endothelial function by Korean red ginseng (Panax ginseng C.A. Meyer) and its components in healthy individuals: a randomized controlled trial. Cardiovasc Ther 2014;32:163-9. https://doi.org/10.1111/1755-5922.12077
  18. Higgins J, Green S. Cochrane handbook for systematic reviews of interventions. Version 5.1.0. Chapter 8: Assessing risk of bias in included studies. The Cochrane Collaboration 2011.
  19. Kwon DH. Efficacy of red ginseng by single nucleotide polymorphism (SNP) and oriental medical obesity pattern on obese women : Randomized, Double-blind, Placebo-controlled Trial[dissertation].[Korea]: University of Dongguk; 2011.
  20. Rhee MY, Kim YS, Bae JH, et al. Effect of Korean red ginseng on arterial stiffness in subjects with hypertension. J Altern Complement Med 2011;17:45-9. https://doi.org/10.1089/acm.2010.0065
  21. Lim EJ. Effects of Korean red ginseng supplementation on blood pressure, nitric oxide concentration and renin-angiotensin-aldosterone system in subject with prehypertension and stage 1 hypertension [dissertation].[Korea]: University of Yonsei; 2012.
  22. Park BJ, Lee YJ, Lee HR, et al. Effects of Korean red ginseng on cardiovascular risks in subjects with metabolic syndrome: a double-blind randomized controlled study. Korean J Fam Med 2012;33:190-6. https://doi.org/10.4082/kjfm.2012.33.4.190
  23. Cha TW. Blood pressure-lowering effect of Korean red ginseng associated with decreased circulating Lp-PLA(2) activity and lysophosphatidylcholines and increased dihydrobiopterin level in prehypertensive subjects [dissertation].[Korea]: University of Yonsei; 2015.
  24. Mucalo I, Jovanovski E, Raheli D, et al. Effect of American ginseng (Panax quinquefolius L.) on arterial stiffness in subjects with type-2 diabetes and concomitant hypertension. Journal of Ethnopharmacology 2013;150:148-53. https://doi.org/10.1016/j.jep.2013.08.015
  25. Shishtar E, Jovanovski E, Jenkins A, et al. Effects of Korean white ginseng (Panax Ginseng C.A. Meyer) on vascular and glycemic health in type 2 diabetes: results of a randomized, double blind, placebo-controlled, multiple-crossover, acute dose escalation trial. Clin Nutr Res 2014;3:89-97. https://doi.org/10.7762/cnr.2014.3.2.89
  26. Hur M-H, Lee MS, Yang HJ, et al. Ginseng for reducing the blood pressure in patients with hypertension: a systematic review and meta-analysis. J Ginseng Res 2010;34:342-347. https://doi.org/10.5142/jgr.2010.34.4.342
  27. Sung J, Han KH, Zo JH, et al. 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