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Circula BP

CLINICAL STUDIES ON THE FOLLOWING INGREDIENTS:

Garlic

Potential of garlic (Allium sativum) in lowering high blood pressure: mechanisms of action and clinical relevance

Abstract

Garlic supplements have shown promise in the treatment of uncontrolled hypertension, lowering blood pressure (BP) by about 10 mmHg systolic and 8 mmHg diastolic, similar to standard BP medication. Aged garlic extract, which contains S-allylcysteine as the bioactive sulfur compound, in particular is standardizable and highly tolerable, with little or no known harmful interaction when taken with other BP-reducing or blood-thinning medication. Here we describe biologically plausible mechanisms of garlic’s BP-lowering effect. Garlic-derived polysulfides stimulate the production of the vascular gasotransmitter hydrogen sulfide (H2S) and enhance the regulation of endothelial nitric oxide (NO), which induce smooth muscle cell relaxation, vasodilation, and BP reduction. Several dietary and genetic factors influence the efficiency of the H2S and NO signaling pathways and may contribute to the development of hypertension. Sulfur deficiency might play a part in the etiology of hypertension, and could be alleviated with supplementation of organosulfur compounds derived from garlic.

Source: Karin Ried, Peter Fakler. “Potential of garlic (Allium sativum) in lowering high blood pressure: mechanisms of action and clinical relevance” Integrated Blood Pressure Control (2014): 7: 71–82.

Potential of garlic (Allium sativum) in lowering high blood pressure: mechanisms of action and clinical relevance

Abstract

Garlic supplements have shown promise in the treatment of uncontrolled hypertension, lowering blood pressure (BP) by about 10 mmHg systolic and 8 mmHg diastolic, similar to standard BP medication. Aged garlic extract, which contains S-allylcysteine as the bioactive sulfur compound, in particular is standardizable and highly tolerable, with little or no known harmful interaction when taken with other BP-reducing or blood-thinning medication. Here we describe biologically plausible mechanisms of garlic’s BP-lowering effect. Garlic-derived polysulfides stimulate the production of the vascular gasotransmitter hydrogen sulfide (H2S) and enhance the regulation of endothelial nitric oxide (NO), which induce smooth muscle cell relaxation, vasodilation, and BP reduction. Several dietary and genetic factors influence the efficiency of the H2S and NO signaling pathways and may contribute to the development of hypertension. Sulfur deficiency might play a part in the etiology of hypertension, and could be alleviated with supplementation of organosulfur compounds derived from garlic.

Source: Karin Reid, Peter Fakler. “Potential of garlic (Allium sativum) in lowering high blood pressure: mechanisms of action and clinical relevance” Integrated Blood Pressure Control (2014): 7: 71–82.

Magnesium

Effect of magnesium on blood pressure.

Abstract

Twenty patients receiving long term diuretic treatment for arterial hypertension (18 patients) or congestive heart failure (two patients) received magnesium supplementation as aspartate hydrochloride 15 mmol/day for six months. Both systolic and diastolic pressures decreased significantly, by a mean of 12/8 mm Hg. No significant changes were recorded in plasma or urinary electrolytes except for magnesium, 24 hour urinary volumes, or body weight after treatment. The effect of magnesium on blood pressure may be direct or through influences on the internal balance of potassium, sodium, and calcium.

Source: T Dyckner, T O Wester. “Effect of magnesium on blood pressure.” British Medical Journal (1983): 286(6381): 1847–1849

Magnesium and Vascular Changes in Hypertension

Abstract

Many factors have been implicated in the pathogenesis of hypertension, including changes in intracellular concentrations of calcium, sodium, potassium, and magnesium. There is a significant inverse correlation between serum magnesium and incidence of cardiovascular diseases. Magnesium is a mineral with important functions in the body such as antiarrhythmic effect, actions in vascular tone, contractility, glucose metabolism, and insulin homeostasis. In addition, lower concentrations of magnesium are associated with oxidative stress, proinflammatory state, endothelial dysfunction, platelet aggregation, insulin resistance, and hyperglycemia. The conflicting results of studies evaluating the effects of magnesium supplements on blood pressure and other cardiovascular outcomes indicate that the action of magnesium in the vascular system is present but not yet established. Therefore, this mineral supplementation is not indicated as part of antihypertensive treatment, and further studies are needed to better clarify the role of magnesium in the prevention and treatment of cardiovascular diseases.

Source: Ana Rosa Cunha, Bianca Umbelino, Margarida L. Correia, Mario Fritsch Neves. “Magnesium and Vascular Changes in Hypertension ”International Journal of Hypertension (2012) |Article ID 754250.

Effects of Magnesium Supplementation on Blood Pressure

A Meta-Analysis of Randomized Double-Blind Placebo-Controlled Trials

Abstract

The antihypertensive effect of magnesium (Mg) supplementation remains controversial. We aimed to quantify the effect of oral Mg supplementation on blood pressure (BP) by synthesizing available evidence from randomized, double-blind, placebo-controlled trials. We searched trials of Mg supplementation on normotensive and hypertensive adults published up to February 1, 2016 from MEDLINE and EMBASE databases; 34 trials involving 2028 participants were eligible for this meta-analysis. Weighted mean differences of changes in BP and serum Mg were calculated by random-effects meta-analysis. Mg supplementation at a median dose of 368 mg/d for a median duration of 3 months significantly reduced systolic BP by 2.00 mm Hg (95% confidence interval, 0.43–3.58) and diastolic BP by 1.78 mm Hg (95% confidence interval, 0.73–2.82); these reductions were accompanied by 0.05 mmol/L (95% confidence interval, 0.03, 0.07) elevation of serum Mg compared with placebo. Using a restricted cubic spline curve, we found that Mg supplementation with a dose of 300 mg/d or duration of 1 month is sufficient to elevate serum Mg and reduce BP; and serum Mg was negatively associated with diastolic BP but not systolic BP (all P<0.05). In the stratified analyses, a greater reduction in BP tended to be found in trials with high quality or low dropout rate (all P values for interaction <0.05). However, residual heterogeneity may still exist after considering these possible factors. Our findings indicate a causal effect of Mg supplementation on lowering BPs in adults. Further well-designed trials are warranted to validate the BP-lowering efficacy of optimal Mg treatment.

Source: Xi Zhang, Yufeng Li, Liana C. Del Gobbo, Andrea Rosanoff, Jaiwei Wang,Wen Zhang, Yiqing Song.  “Effects of Magnesium Supplementation on Blood Pressure” Hypertension (2016): 68:324–333.

Magnesium and Vascular Changes in Hypertension

Abstract

Many factors have been implicated in the pathogenesis of hypertension, including changes in intracellular concentrations of calcium, sodium, potassium, and magnesium. There is a significant inverse correlation between serum magnesium and incidence of cardiovascular diseases. Magnesium is a mineral with important functions in the body such as antiarrhythmic effect, actions in vascular tone, contractility, glucose metabolism, and insulin homeostasis. In addition, lower concentrations of magnesium are associated with oxidative stress, proinflammatory state, endothelial dysfunction, platelet aggregation, insulin resistance, and hyperglycemia. The conflicting results of studies evaluating the effects of magnesium supplements on blood pressure and other cardiovascular outcomes indicate that the action of magnesium in the vascular system is present but not yet established. Therefore, this mineral supplementation is not indicated as part of antihypertensive treatment, and further studies are needed to better clarify the role of magnesium in the prevention and treatment of cardiovascular diseases.

Source: Ana Rosa Cunha, Bianca Umbelino, Margarida L. Correia, Mario Fritsch Neves. “Magnesium and Vascular Changes in Hypertension” International Journal of Hypertension (2012) Article 754250. 

Effect of magnesium on blood pressure.

Abstract

Twenty patients receiving long term diuretic treatment for arterial hypertension (18 patients) or congestive heart failure (two patients) received magnesium supplementation as aspartate hydrochloride 15 mmol/day for six months. Both systolic and diastolic pressures decreased significantly, by a mean of 12/8 mm Hg. No significant changes were recorded in plasma or urinary electrolytes except for magnesium, 24 hour urinary volumes, or body weight after treatment. The effect of magnesium on blood pressure may be direct or through influences on the internal balance of potassium, sodium, and calcium.

Source: T Dyckner, T O Wester. “Effect of magnesium on blood pressure.” British Medical Journal (1983): 286(6381): 1847–1849

Folic Acid

Folic Acid Supplementation and the Risk of Cardiovascular Diseases: A Meta‐Analysis of Randomized Controlled Trials

Abstract

Background

Results from observational and genetic epidemiological studies suggest that lower serum homocysteine levels are associated with lower incidence of cardiovascular disease (CVD). Numerous randomized controlled trials have investigated the efficacy of lowering homocysteine with folic acid supplementation for CVD risk, but conflicting results have been reported.

Methods and Results

Three bibliographic databases (Medline, Embase, and the Cochrane Database of Systematic Reviews) were searched from database inception until December 1, 2015. Of the 1933 references reviewed for eligibility, 30 randomized controlled trials involving 82 334 participants were included in the final analysis. The pooled relative risks of folic acid supplementation compared with controls were 0.90 (95% CI 0.84–0.96; P=0.002) for stroke, 1.04 (95% CI 0.99–1.09; P=0.16) for coronary heart disease, and 0.96 (95% CI 0.92–0.99; P=0.02) for overall CVD. The intervention effects for both stroke and combined CVD were more pronounced among participants with lower plasma folate levels at baseline (both P<0.02 for interaction). In stratified analyses, a greater beneficial effect for overall CVD was seen in trials among participants without preexisting CVD (P=0.006 for interaction) or in trials with larger reduction in homocysteine levels (P=0.009 for interaction).

Conclusions Our meta‐analysis indicated a 10% lower risk of stroke and a 4% lower risk of overall CVD with folic acid supplementation. A greater benefit for CVD was observed among participants with lower plasma folate levels and without preexisting CVD and in studies with larger decreases in homocysteine levels. Folic acid supplementation had no significant effect on risk of coronary heart disease.

Source: Yanping Li, Tian Huang, Yan Zheng, Tauland Muka, Jenna Troup, Frank B. Hu. “Folic Acid Supplementation and the Risk of Cardiovascular Diseases: A Meta‐Analysis of Randomized Controlled Trials” Journal of the American Heart Association (2016): Vol. 5, No. 8.

High-Dose Folic Acid Supplementation Effects On Endothelial Function And Blood Pressure In Hypertensive Patients: A Meta-Analysis Of Randomized Controlled Clinical Trials

Abstract

Objective Folic acid supplementation has been shown to be an effective agent for improving endothelial function, a prognostic factor for cardiovascular disease; but its effects on systolic and diastolic blood pressure in hypertensive individuals has been met with mixed results. Therefore, the purpose of this study was to provide a comprehensive meta-analysis of randomized controlled trials to investigate the effect of high-dose folic acid supplementation on blood pressure and endothelial function in hypertensive patients.

Methods Twelve randomized controlled trials published between 1970 and December 2007 were identified using Medline and a manual search. All 12 studies used hypertensive subjects who were supplemented with at least 5000 μg/d of folic acid for between 2 and 16 weeks. Three separate meta-analyses were carried out using a random-effects model, and the overall effect sizes were calculated for changes in systolic and diastolic blood pressures and for changes in endothelial function as measured through the percentage of change in flow-mediated dilation.

Results The pooled estimate of effect of folic acid supplementation on systolic and diastolic blood pressure was −2.03 mm Hg (95% confidence interval [CI], −3.63 to −0.43; P = .04) and 0.01 mm Hg (95% CI, −1.12 to 1.13; not significant), respectively. The pooled estimate of effect of folic acid supplementation on change in flow-mediated dilation was 1.61% (95% CI, 1.27 to 1.96; P = .000).

Conclusion Based upon the studies used in this meta-analysis, supplementation with at least 5000 μg/d of folic acid, for a minimum of 6 weeks, can lower systolic blood pressure slightly; but the real clinical benefit is achieved through improved endothelial function.

Source: Marc P. McRae. “High-dose folic acid supplementation effects on endothelial function and blood pressure in hypertensive patients: a meta-analysis of randomized controlled clinical trials” Journal of Chiropractic Medicine (2009): 8(1): 15–24.

The Effect of Folic Acid in Patients with Cardiovascular Disease

A systematic review and meta-analysis

Abstract

Background: The effectiveness of folic acid supplementation in stroke risk has been investigated, however, the available results are inconclusive and conflicting. The purpose of this systemic review and meta-analysis was to assess the effect of folic acid in patients with cardiovascular disease (CVD).

Methods: By searching the PubMed, EMBASE, and Cochrane library databases, we conducted a meta-analysis to evaluate effect of folic acid supplementation in patients with CVD. All-cause mortality, cardiovascular mortality, the risk of coronary heart disease (CHD) and stroke were summarized; hazard ratios (HR), the relative risk (RR) and its 95% confidence interval (CI) were also calculated. Fixed effects models were used to combine the data. A total of 12 randomized controlled trials, which involved 47,523 participants, met the inclusion criteria in this systematic review and meta-analysis.

Results: Our meta-analysis showed that cardiovascular patients who received folic acid therapy had significantly decreased risk of stroke (RR = 0.85, 95% CI = 0.77–0.94, Pheterogeneity = .347, I2 = 10.6%) compared with patients who received control treatment. However, no significant difference in all-cause mortality (HR, 0.97, 95% CI, 0.86–1.10, Pheterogeneity = .315, I2 = 15.4%), cardiovascular mortality (HR, 0.87, 95% CI, 0.66–1.15, Pheterogeneity = .567, I2 = 0) and risk of CHD (RR, 1.04, 95% CI, 0.99–1.10, Pheterogeneity = .725, I2 = 0) were found between the 2 groups.

Conclusion: This meta-analysis suggested that folic acid supplementation significantly reduced the risk of stroke in patients with CVD.

Source: Yuan Wang MS, Yang Jin BS, Yao Wang BS, Li Li MS, Yun Zhang MS, Dan Yu MD. “The Effect of Folic Acid in Patients with Cardiovascular Disease” Medicine (Baltimore) (2019): Volume 98, Issue 37, p e17095.

Potassium

Effect of Short-Term Supplementation of Potassium Chloride and Potassium Citrate on Blood Pressure in Hypertensives

Abstract

Randomized trials have shown that increasing potassium intake lowers blood pressure. However, most previous trials used potassium chloride, whereas potassium in fruits and vegetables is not a chloride salt. It is unclear whether a nonchloride salt of potassium has a greater or lesser effect on blood pressure compared with potassium chloride. We performed a randomized crossover trial comparing potassium chloride with potassium citrate (96 mmol/d, each for 1 week) in 14 hypertensive individuals. At baseline, blood pressure was 151±16/93±7 mm Hg with a 24-hour urinary potassium of 81±24 mmol. During the randomized crossover part of the study, blood pressure was 140±12/88±7 mm Hg with potassium chloride (24-hour urinary potassium: 164±36 mmol) and 138±12/88±6 mm Hg with potassium citrate (24-hour urinary potassium: 160±33 mmol). These blood pressures were significantly lower compared with that at baseline; however, there was no significant difference in blood pressure between potassium chloride and potassium citrate, mean difference (95% confidence interval): 1.6 (−2.3 to 5.6) mm Hg for systolic and 0.6 (−2.4 to 3.7) mm Hg for diastolic. Our results, in conjunction with the evidence from many previous trials that potassium chloride has a significant blood pressure-lowering effect, suggest that potassium citrate has a similar effect on blood pressure as potassium chloride. These results support other evidence for an increase in potassium intake and indicate that potassium does not need to be given in the form of chloride to lower blood pressure. Increasing the consumption of foods high in potassium is likely to have the same effect on blood pressure as potassium chloride.

Source: Feng H. Je, Nirmala D. Markandu, Rosemary Coltart, Jeffrey Barron, Graham A. MacGregor. “Effect of Short-Term Supplementation of Potassium Chloride and Potassium Citrate on Blood Pressure in Hypertensives” Hypertension (2005): Vol. 45, No. 4.

Why Your Mother Was Right: How Potassium Intake Reduces Blood Pressure

Abstract

Low potassium intake, common in western diets, increases blood pressure and enhances salt-sensitivity. Most humans in “Westernized” countries also consume excess salt. In studies using mice, we found that a high-salt, low-potassium diet activates the thiazide-sensitive Na-Cl cotransporter in the kidney. This effect led to sodium retention and increased blood pressure, and was dependent on plasma potassium. We postulated that this effect was mediated by changes in intracellular chloride caused by changes in membrane voltage. We developed a model in cultured cells permitting us to confirm this hypothesis. We then confirmed, using urinary exosomes, that dietary changes in normal humans, affect the thiazide-sensitive Na-Cl cotransporter in the same way. These data show that dietary potassium deficiency increases blood pressure largely by stimulating salt reabsorption along the distal nephron. They suggest that global efforts should focus on increasing potassium intake, which will attenuate the effects of high-salt diets.

Source: David H. Ellison, Andrew S. Terker. “Why Your Mother Was Right: How Potassium Intake Reduces Blood Pressure” Transaction of the American Clinical and Climatological Association (2015): v.126: 46-55.

Hibiscus

Effect Of Hibiscus Sabdariffa On Blood Pressure In Patients With Stage 1 Hypertension

Abstract

Using different drug regimens has been proved to have effective effects on lowering blood pressure, but the adverse effects of long-term usage such medications is evident. According to recent trend in suing herbal and traditional medicines, researchers have been focused on evaluating the effect of different herbals on managing hypertension. The aim of the present study is the evaluation of the antihypertensive effect one of these herbs, sour tea (Hibiscus sabdariffa), on stage one hypertension. Patients with stage one hypertension who were diagnosed by a cardiologist has been included in the present clinical trial after giving informed consent. The patients were divided into two groups. The control and case group received the same lifestyle and dietary advices for controlling blood pressure. The case group received two standard cup of sour tea every morning for 1 month. The blood pressure of both groups was documented at baseline and at the end of the study and the results were analyzed using SPSS software. A total of 46 patients participated in this study and there was no significant difference in terms of age and body mass index between groups. There was a significant reduction in systolic blood pressure in both groups, but the mean reduction in systolic and diastolic blood pressure was significantly higher in the case group (P = 0.004 and P < 0.001, respectively). Using H. sabdariffa as sour tea two times a day can be effective in managing blood pressure in stage one hypertension along with lifestyle and dietary modification.

Source: Majid Jalalyazdi, Javad Ramezani, Azadeh Izadi-Moud, Fershteh Madani-Sani, Shokufeh Shahlaei, Shirin Sadat Ghiasi. “Effect Of Hibiscus Sabdariffa On Blood Pressure In Patients With Stage 1 Hypertension” Journal of Advanced Technology & Research (2019): v. 10(3): 107-111.

Hibiscus Sabdariffa L. In The Treatment Of Hypertension And Hyperlipidemia: A Comprehensive Review Of Animal And Human Studies

Abstract

The effectiveness of Hibiscus sabdariffa L. (HS) in the treatment of risk factors associated with cardiovascular disease is assessed in this review by taking a comprehensive approach to interpreting the randomized clinical trial (RCT) results in the context of the available ethnomedical, phytochemical, pharmacological, and safety and toxicity information. HS decoctions and infusions of calyxes, and on occasion leaves, are used in at least 10 countries worldwide in the treatment of hypertension and hyperlipidemia with no reported adverse events or side effects. HS extracts have a low degree of toxicity with a LD50 ranging from 2,000 to over 5,000 mg/kg/day. There is no evidence of hepatic or renal toxicity as the result of HS extract consumption, except for possible adverse hepatic effects at high doses. There is evidence that HS acts as a diuretic, however in most cases the extract did not significantly influence electrolyte levels. Animal studies have consistently shown that consumption of HS extract reduces blood pressure in a dose dependent manner. In RCTs, the daily consumption of a tea or extract produced from HS calyxes significantly lowered systolic blood pressure (SBP) and diastolic blood pressure (DBP) in adults with pre to moderate essential hypertension and type 2 diabetes. In addition, HS tea was as effective at lowering blood pressure as the commonly used blood pressure medication Captropril, but less effective than Lisinopril. Total cholesterol, low-density lipoprotein cholesterol (LDL-C), and triglycerides were lowered in the majority of normolipidemic, hypolipidemic, and diabetic animal models, whereas high-density lipoprotein cholesterol (HDL-C) was generally not affected by the consumption of HS extract. Over half of the RCTs showed that daily consumption of HS tea or extracts had favorable influence on lipid profiles including reduced total cholesterol, LDL-C, triglycerides, as well as increased HDL-C. Anthocyanins found in abundance in HS calyxes are generally considered the phytochemicals responsible for the antihypertensive and hypocholesterolemic effects, however evidence has also been provided for the role of polyphenols and hibiscus acid. A number of potential mechanisms have been proposed to explain the hypotensive and anticholesterol effects, but the most common explanation is the antioxidant effects of the anthocyanins inhibition of LDL-C oxidation, which impedes atherosclerosis, an important cardiovascular risk factor. This comprehensive body of evidence suggests that extracts of HS are promising as a treatment of hypertension and hyperlipidemia, however more high quality animal and human studies informed by actual therapeutic practices are needed to provide recommendations for use that have the potential for widespread public health benefit.

Source: Allison L. Hopkins, PhD, Marnie G. Lamm, MD, Janet Funk, MD, Cheryl Ritenbaugh, PHD, MPH. “Hibiscus Sabdariffa L. In The Treatment Of Hypertension And Hyperlipidemia: A Comprehensive Review Of Animal And Human Studies” Fitoterapia (2013): 85: 84-94.

Effect of Hibiscus Sabdariffa on Blood Pressure in a University Population

Brief Summary

Hypertension, also known as high blood pressure, is a very common disease and is considered “the silent killer”. Hypertension is responsible for at least 45% of deaths due to heart disease, and 51% of deaths due to stroke. Hypertension plays a part in the worry of heart disease, stroke and kidney failure and premature mortality and disability. If hypertension goes uncontrolled, in the long term, it will cause serious complications, most of which will necessitate costly interventions to be solved and managed. Apparently, these interventions may include cardiac bypass surgery, carotid artery surgery and dialysis, draining individual and government budgets. Recent studies show that hibiscus (Hibiscus sabdariffa) tea can lower blood pressure as effectively as some standard anti-hypertensive drugs can. Hibiscus is widely consumed around the world as a ruby-colored, lemony beverage. Hibiscus is safe and, unlike most blood pressure drugs, rarely causes side effects. All of the studies the investigators found in the literature were either underpowered or inconclusive. All of these studies recommended further studies with bigger samples to accurately assess the effect of hibiscus sabdariffa on blood pressure in hypertensive patients. The aim of this study is to assess the feasibility of a large-scale study assessing the effectiveness of Hibiscus sabdariffa on lowering blood pressure in individuals with elevated blood pressure.

Source: Sulaiman AlRajhi Colleges. “Effect of Hibiscus Sabdariffa on Blood Pressure in a University Population” U.S. National Library of Medicine (2019): ClinicalTrials.gov Identifier: NCT 03804801.

Hibiscus and Hawthorn

Hibiscus, Hawthorn, and the Heart

Modern research supports the use of traditional plants

Abstract

Crataegus oxyacantha (hawthorn) and Hibiscus sabdariffa (sour tea) have a long history of use in traditional botanical medicine in many parts of the world for their multiple health effects, but especially in relation to cardiovascular disorders. In the last 15–20 years, modern research has expanded and clarified those uses. Hawthorn research has focused on congestive heart failure, and sour tea research has focused on hypertension and dyslipidemia, with several clinical trials emerging in the last 3–4 years. This article highlights key research on these two plants and their uses in congestive heart failure, hypertension, and dyslipidemia in particular.

Source: Tori Hudson, ND. “Hibiscus, Hawthorn, and the Heart” Natural Medicine Journal (2011): Vol. 3, Issue 7.

Hawthorn

Hawthorn (Crataegus spp.) in the treatment of cardiovascular disease

The medicinal properties of hawthorn (Crataegus spp., a genus comprising approximately 300 species) have been utilized by many cultures for a variety of therapeutic purposes for many centuries. In the Western world cardiovascular disease (CVD) has become one of the single most significant causes of premature death. Echoing this situation, more recent research into the therapeutic benefits of hawthorn preparations has focused primarily upon its cardiovascular effects. This review covers research into the various mechanisms of action proposed for Crataegus preparations, clinical trials involving Crataegus preparations, and the herb’s safety profile.

Clinical trials reviewed have been inconsistent in terms of criteria used (sample size, preparation, dosage, etc) but have been largely consistent with regard to positive outcomes. An investigation into data available to date regarding hawthorn preparations and herb/drug interactions reveals that theoretical adverse interactions have not been experienced in practice. Further, adverse reactions relating to the use of hawthorn preparations are infrequent and mild, even at higher dosage ranges. A recent retrospective study by Zick et al. has suggested a negative outcome for the long-term use of hawthorn in the prognosis of heart failure. These findings are examined in this paper.

Although further research is needed in certain areas, current research to date suggests that hawthorn may potentially represent a safe, effective, nontoxic agent in the treatment of CVD and ischemic heart disease.

Mary C. Tassell, Rosari Kingston, Deirdre Gilroy, Mary Lehane, Ambrose Furey. “Hawthorn (Crataegus spp.) in the treatment of cardiovascular disease” Pharmacognosy Review (2010): 4(7): 32–41.

Hypotensive effects of hawthorn for patients with diabetes taking prescription drugs: a randomised controlled trial

Abstract

Background Hawthorn (Crataegus laevigata) leaves, flowers and berries are used by herbal practitioners in the UK to treat hypertension in conjunction with prescribed drugs. Small-scale human studies support this approach.

Aim To investigate the effects of hawthorn for hypertension in patients with type 2 diabetes taking prescribed drugs.

Design of study Randomised controlled trial.

Setting General practices in Reading, UK.

Method Patients with type 2 diabetes (n = 79) were randomised to daily 1200 mg hawthorn extract (n = 39) or placebo (n = 40) for 16 weeks. At baseline and outcome a wellbeing questionnaire was completed and blood pressure and fasting blood samples taken. A food frequency questionnaire estimated nutrient intake.

Results Hypotensive drugs were used by 71% of the study population with a mean intake of 4.4 hypoglycaemic and/or hypotensive drugs. Fat intake was lower and sugar intake higher than recommendations, and low micronutrient intake was prevalent. There was a significant group difference in mean diastolic blood pressure reductions (P = 0.035): the hawthorn group showed greater reductions (baseline: 85.6 mmHg, 95% confidence interval [CI] = 83.3 to 87.8; outcome: 83.0 mmHg, 95% CI = 80.5 to 85.7) than the placebo group (baseline: 84.5 mmHg, 95% CI = 82 to 87; outcome: 85.0 mmHg, 95% CI = 82.2 to 87.8). There was no group difference in systolic blood pressure reduction from baseline (3.6 and 0.8 mmHg for hawthorn and placebo groups, respectively; P = 0.329). Although mean fat intake met current recommendations, mean sugar intake was higher and there were indications of potential multiple micronutrient deficiencies. No herb–drug interaction was found and minor health complaints were reduced from baseline in both groups.

Conclusions This is the first randomised controlled trial to demonstrate a hypotensive effect of hawthorn in patients with diabetes taking medication.

Source: Ann F. Walker, PhD, Georgios Marakis, PhD, et al. “Hypotensive effects of hawthorn for patients with diabetes taking prescription drugs: a randomised controlled trial” British Journal of General Practice (2006): 56(527): 437–443.

Rosemary

Effectiveness of Rosmarinus officinalis essential oil as antihypotensive agent in primary hypotensive patients and its influence on health-related quality of life

Abstract

Ethnopharmacological relevance: To study Rosmarinus officinalis (Rosemary) essential oil effect on primary hypotension and its influence on both physical and psychological aspects responsible for health-related quality of life (HRQOL) of patients.

Methodology: Thirty-two patients with diagnosed hypotension were recruited between March 2007 and September 2008 for a prospective study for 72 weeks in a Spanish pharmacy. Clinical evaluation was carried out through the control of systolic and diastolic blood pressure levels (SBP and DBP, respectively) according to the International Standards from the American Society of Hypertension. HRQOL data were recorded within the SF-36 Health Survey(®) questionnaire throughout the study. Statistical methods were used as the essential tools to evaluate the effectiveness of Rosemary essential oil and to assess the relationship between the two quantitative variables (SBP and DBP) and scores from physical and mental summary components (PSC and MSC) obtained from the SF-36 Health Survey.

Results: Both blood pressure variables of SBP and DBP reflect the clinically significant antihypotensive effect of Rosemary essential oil that was maintained throughout the treatment period. After validation of the use of the questionnaire (Cronbach’s alpha coefficient>0.82), statistically significant differences have been found between pre-treatment and post-treatment values of PSC and MSC, which indicate an improvement in these parameters that is directly related to the variation in blood pressure values.

Conclusions: The increase achieved in blood pressure values after administration of Rosemary essential oil is clinically significant. The results obtained from this prospective clinical trial prove the effectiveness of statistical methodology as a new approach to explain the antihypotensive effect of rosemary essential oil and its relationship with the improvement in patients’ quality of life.

Source: L F Fernandez, O M Palomino, G Frutos. “Effectiveness of Rosmarinus officinalis essential oil as antihypotensive agent in primary hypotensive patients and its influence on health-related quality of life” National Library of Medicine (2014): 151(1):509-16.

Simultaneous Aromatherapy Massage with Rosemary Oil on Humans

Abstract

Massage of essential oils is increasing being used for the improvement of the quality of life and for the relief of various symptoms in patients, but scientific evaluation of the effects of fragrances in humans is rather scarce. The aim of this study was to investigate the effect of rosemary oil (Rosmarinus officinalis L., Labiatae) on human autonomic parameters and emotional responses in healthy subjects after transdermal absorption. Thirty five healthy volunteers participated in the experiments. Four autonomic parameters, i.e. blood pressure, breathing rate, pulse rate, skin temperature were recorded. Emotional responses were assessed by means of rating scales. Compared to placebo, rosemary oil caused significant increases of breathing rate, systolic blood pressure, and diastolic blood pressure which indicate an increase of autonomic arousal. At the emotional level, subjects feel more attentive, more alert, more vigorous, and more cheerful than before the administration of the oil. This finding suggests an increase of arousal in terms of self-evaluation. In conclusion, our investigation demonstrates the stimulating effect of rosemary oil and provides evidence for its use in medicines for the relief of depression and stress in humans.

Source: Tapanee Hongratanaworakit. “Simultaneous Aromatherapy Massage with Rosemary Oil on Humans” Scientia Pharmaceutica (2009): 77(2), 375-388.

 

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