Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

The effect of ginseng (genus Panax) on blood pressure: a systematic review and meta-analysis of randomized controlled clinical trials


Pre-clinical evidence indicates the potential for ginseng to reduce cardiovascular disease risk and acutely aid in blood pressure (BP) control. Clinical evidence evaluating repeated ginseng exposure, however, is controversial, triggering consumer and clinician concern. A systematic review and meta-analysis were conducted to assess whether ginseng has an effect on BP. MEDLINE, EMBASE, Cochrane and CINAHL were searched for relevant randomized controlled trials 4 weeks that compared the effect of ginseng on systolic (SBP), diastolic (DBP) and/or mean arterial (MAP) BPs to control. Two independent reviewers extracted data and assessed methodological quality and risk of bias. Data were pooled using random-effects models and expressed as mean differences (MD) with 95% confidence intervals (CIs). Heterogeneity was assessed and quantified. Seventeen studies satisfied eligibility criteria (n=1381). No significant effect of ginseng on SBP, DBP and MAP was found. Stratified analysis, although not significant, appears to favour systolic BP improvement in diabetes, metabolic syndrome and obesity (MD=−2.76 mm Hg (95% CI=−6.40, 0.87); P=0.14). A priori subgroup analyses revealed significant association between body mass index and treatment differences (β=−0.95 mm Hg (95% CI=−1.56, −0.34); P=0.007). Ginseng appears to have neutral vascular affects; therefore, should not be discouraged for concern of increased BP. More high-quality, randomized, controlled trials assessing BP as a primary end point, and use of standardized ginseng root or extracts are warranted to limit evidence of heterogeneity in ginseng research and to better understand its cardiovascular health potential.

This is a preview of subscription content, access via your institution

Access options

Rent or buy this article

Prices vary by article type



Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3


  1. Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012; 380 (9859): 2224–2260.

    Article  Google Scholar 

  2. Seigel RK . Ginseng Abuse Syndrome. Problems With the Pancreas. JAMA 1979; 241 (15): 1614–1615.

    Article  Google Scholar 

  3. Hien TT, Kim ND, Pokharel YR, Oh SJ, Lee MY, Kang KW . Ginsenoside Rg3 increases nitric oxide production via increases in phosphorylation and expression of endothelial nitric oxide synthase: Essential roles of estrogen receptor-dependent PI3-kinase and AMP-activated protein kinase. Toxicol Appl Pharmacol 2010; 246: 171–183.

    Article  CAS  Google Scholar 

  4. Jeon BH, Kim CS, Kim HS, Park JB, Nam KY, Chang SJ . Effect of Korean red ginseng on blood pressure and nitric oxide production. Acta Pharmacol Sin 2000; 21 (12): 1095–1100.

    CAS  PubMed  Google Scholar 

  5. Kang SY, Schini-Kerth VB, Kim ND . Ginsenosides of the protopanaxatriol group cause endothelium-dependent relaxation in the rat aorta. Life Sci 1995; 56 (19): 1577–1586.

    Article  CAS  Google Scholar 

  6. Wang Y, Dong J, Liu P, Lau CW, Gao Z, Zhou D et al. Ginsenoside Rb3 attenuates oxidative stress and preserves endothelial function in renal arteries from hypertensive rats. Br J Pharmacol 2014; 171 (13): 3171–3181.

    Article  CAS  Google Scholar 

  7. Jovanovski E, Bateman EA, Bhardwaj J, Fairgrieve C, Mucalo I, Jenkins AL et al. Effect of Rg3-enriched Korean red ginseng (Panax ginseng) on arterial stiffness and blood pressure in healthy individuals: a randomized controlled trial. J Am Soc Hypertens 2014; 8: 537–541.

    Article  CAS  Google Scholar 

  8. Rhee MY, Kim YS, Bae JH, Nah DY, Kim YK, Lee MM et al. Effect of Korean red ginseng on arterial stiffness in subjects with hypertension. J Altern Complement Med 2011; 17 (1): 45–49.

    Article  Google Scholar 

  9. Park BJ, Lee YJ, Lee HR, Jung DH, Na HY, Kim HB 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 (4): 190–196.

    Google Scholar 

  10. Jovanovski E, Jenkins AL, Dias A, Peeva V, Sievenpiper JL, Arnason JT et al. Effects of Korean Red Ginseng (Panax ginseng C.A. Mayer) and Its Isolated Ginsenosides and Polysaccharides on Arterial Stiffness in Healthy Individuals. Am J Hypertens 2010; 23 (5): 469–472.

    Article  CAS  Google Scholar 

  11. Mucalo I, Jovanovski E, Rahelic D, Bozikov V, Romic Z, Vuksan V . Effect of American ginseng (Panax quinquefolius L.) on arterial stiffness in subjects with type-2 diabetes and concomitant hypertension. J Ethnopharmacol 2013; 150 (1): 148–153.

    Article  CAS  Google Scholar 

  12. Stavro PM, Woo M, Leiter LA, Heim TF, Sievenpiper JL, Vuksan V . Long-term intake of North American ginseng has no effect on 24-hour blood pressure and renal function. Hypertension 2006; 47 (4): 791–796.

    Article  CAS  Google Scholar 

  13. Vuksan V, Sung MK, Sievenpiper JL, Stavro PM, Jenkins AL, Di BM et al. Korean red ginseng (Panax ginseng) improves glucose and insulin regulation in well-controlled, type 2 diabetes: results of a randomized, double-blind, placebo-controlled study of efficacy and safety. Nutr Metab Cardiovasc Dis 2008; 18 (1): 46–56.

    Article  Google Scholar 

  14. Yoon J, Kang S, Vassy J, Shin H, Lee Y, Ahn H et al. Efficacy and safety of ginsam, a vinegar extract from Panax Ginseng, in Type 2 diabetic patients: Results of a double-blind, placebo-controlled study. J Diabetes Invest 2012; 3 (3): 309–317.

    Article  CAS  Google Scholar 

  15. Moher D, Liberati A, Tetzlaff J, Altman DG . Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ 2009; 339: b2535.

    Article  Google Scholar 

  16. Agency EM . Guideline on Clinical Investigation of Medicinal Products in the Treatment of Hypertension. European Medicines Agency: London, UK, 2013.

    Google Scholar 

  17. Heyland DK, Novak F, Drover JW, Jain M, Su X, Suchner U . Should immunonutrition become routine in critically ill patients? A systematic review of the evidence. JAMA 2001; 286 (8): 944–953.

    Article  CAS  Google Scholar 

  18. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 2011 [updated 2011],

  19. Ha V, Sievenpiper JL, de Souza RJ, Chiavaroli L, Wang DD, Cozma AI et al. Effect of fructose on blood pressure: a systematic review and meta-analysis of controlled feeding trials. Hypertension 2012; 59 (4): 787–795.

    Article  CAS  Google Scholar 

  20. Cherdrungsi P, Rungroeng K . Effect of standardized ginseng extract and exercise training on aerobic and anaerobic exercise capacity in humans. Korean J Ginseng Sci 1995; 2: 93–100.

    Google Scholar 

  21. Kwon DH, Bose S, Song MY, Lee MJ, Lim CY, Kwon BS et al. Efficacy of Korean Red Ginseng by Single Nucleotide Polymorphism in Obese Women: Randomized, Double-blind, Placebo-controlled Trial. J Ginseng Res 2012; 36 (2): 176–189.

    Article  Google Scholar 

  22. Kaneko H, Nakanishi K, Kuwashima K, Ikeda K . Effects of the long-term administration of red ginseng on working stress and changes of physiological parameters of workers. Ther Res 2000; 21 (5): 1451–1463.

    Google Scholar 

  23. Kim JY, Park JY, Kang HJ, Kim OY, Lee JH . Beneficial effects of Korean red ginseng on lymphocyte DNA damage, antioxidant enzyme activity, and LDL oxidation in healthy participants: a randomized, double-blind, placebo-controlled trial. Nutr J 2012; 11: 47.

    Article  CAS  Google Scholar 

  24. Seo J, Lee S, Lee K, Leem S, Jeong T, An H et al. Double blind Randomized Controlled Trials on Blood Pressure and Pulse Rate in Korean Ginseng and American Ginseng in Koreans and Chineses. Korean J Oriental Physiol Pathol 2004; 18 (2): 606–6011.

    Google Scholar 

  25. Caron MF, Hotsko AL, Robertson S, Mandybur L, Kluger J, White CM . Electrocardiographic and hemodynamic effects of Panax ginseng. Ann Pharmacother 2002; 36 (5): 758–763.

    Article  Google Scholar 

  26. Caso MA, Vargas RR, Salas VA, Begona IC . Double-blind study of a multivitamin complex supplemented with ginseng extract. Drugs Exp Clin Res 1996; 22 (6): 323–329.

    Google Scholar 

  27. Dickman JR, Koenig RT, Ji LL . American ginseng supplementation induces an oxidative stress in postmenopausal women. J Am Coll Nutr 2009; 28 (2): 219–228.

    Article  CAS  Google Scholar 

  28. Kim H, Park M, Han J . Effects of Fermented Red Ginseng Supplementation on Blood Glucose and Insulin Resistance in Type 2 Diabetic Patients. J Korean Soc Food Sci Nutr 2011; 40 (5): 696.

    Article  CAS  Google Scholar 

  29. Liang MT, Podolka TD, Chuang WJ . Panax notoginseng supplementation enhances physical performance during endurance exercise. J Strength Cond Res 2005; 19 (1): 108–114.

    Article  Google Scholar 

  30. Xu Z . Role of Nitric Oxide in the Treatment of Type 2 Diabetes with American ginseng (Panax quinquefolius. L.). Thesis. University of Toronto, Toronto, ON, Canada, 2000.

  31. Hur M, Lee M, Yang H, Kim C, Bae I, Ernst E . Ginseng for reducing the blood pressure in patients with hypertension: A systematic review and meta-analysis. J Ginseng Res 2010; 34 (4): 342–347.

    Article  Google Scholar 

  32. Buettner C, Yeh GY, Phillips RS, Mittleman MA, Kaptchuk TJ . Systematic review of the effects of ginseng on cardiovascular risk factors. Ann Pharmacother 2006; 40 (1): 83–95.

    Article  CAS  Google Scholar 

  33. Kim ND, Kang SY, Schini VB . Ginsenosides evoke endothelium-dependent vascular relaxation in rat aorta. Gen Pharmacol 1994; 25 (6): 1071–1077.

    Article  CAS  Google Scholar 

  34. Scott GI, Colligan PB, Ren BH, Ren J . Ginsenosides Rb1 and Re decrease cardiac contraction in adult rat ventricular myocytes: role of nitric oxide. Br J Pharmacol 2001; 134 (6): 1159–1165.

    Article  CAS  Google Scholar 

  35. Yu J, Eto M, Akishita M, Kaneko A, Ouchi Y, Okabe T . 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 (3): 764–769.

    Article  CAS  Google Scholar 

  36. Sievenpiper JL, Arnason JT, Vidgen E, Leiter LA, Vuksan V . A systematic quantitative analysis of the literature of the high variability in ginseng (Panax spp.): should ginseng be trusted in diabetes? Diabetes Care 2004; 27 (3): 839–840.

    Article  Google Scholar 

  37. Terrin N, Schmid CH, Lau J, Olkin I . Adjusting for publication bias in the presence of heterogeneity. Stat Med 2003; 22 (13): 2113–2126.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to V Vuksan.

Ethics declarations

Competing interests

VV is holder of an American (No. 7,326,404 B2) and Canadian (No. 2,410,556) patent for use of viscous fibre blend in diabetes, metabolic syndrome and cholesterol lowering; currently holds grant support for ginseng research from the Canadian Diabetes Association (CDA), Canada and the National Institute of Horticultural and Herbal Science, RDA, Korea. JLS has received research support from the Canadian Institutes of Health Research (CIHR), the Calorie Control Council, Coca-Cola Company (investigator initiated, unrestricted grant), Pulse Canada, and the International Tree Nut Council Nutrition Research and Education Foundation. He has received travel funding, speaker fees and/or honoraria from the American Heart Association, the American College of Physicians, the American Society for Nutrition, the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health, the CDA, the Canadian Nutrition Society, the Calorie Control Council, the Diabetes and Nutrition Study Group of the European Association for the Study of Diabetes, the International Life Sciences Institute North America, the International Life Sciences Institute, Brazil, the Abbott Laboratories, Pulse Canada, Dr Pepper Snapple Group and Coca-Cola Company. He is on the Clinical Practice Guidelines Expert Committee for Nutrition Therapy of both the CDA and the European Association for the study of diabetes, as well as being on the American Society for Nutrition writing panel for a scientific statement on the metabolic and nutritional effects of fructose, sucrose and high-fructose corn syrup. He is an unpaid scientific advisor for the International Life Science Institute North America, Food, Nutrition and Safety Program. His wife is employed by Unilever Canada. RJdS is funded by a CIHR Postdoctoral Fellowship Award and has received research support from the CIHR, the Calorie Control Council, the Canadian Foundation for Dietetic Research and Coca-Cola Company (investigator initiated, unrestricted grant). He has served as an external resource person to the WHO's Nutrition Guidelines Advisory Group and received travel support from WHO to attend group meetings. He is the lead author of two systematic reviews and meta-analyses commissioned by WHO of the relation of saturated fatty acids and trans fatty acids with health outcomes. ES received funding from the Embassy of the State of Kuwait, Kuwait University. VH has received research support from the Ontario Graduate Scholarship (OGS) and the CIHR. AK, EJ and SBM have declared no conflict of interest.

Additional information

Supplementary Information accompanies this paper on the Journal of Human Hypertension website

Supplementary information

Rights and permissions

Reprints and Permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Komishon, A., Shishtar, E., Ha, V. et al. The effect of ginseng (genus Panax) on blood pressure: a systematic review and meta-analysis of randomized controlled clinical trials. J Hum Hypertens 30, 619–626 (2016).

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:

This article is cited by


Quick links