Skip to main content

Thank you for visiting nature.com. 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.

  • Article
  • Published:

The effects of soursop supplementation on blood pressure, serum uric acid, and kidney function in a prehypertensive population in accordance with the 2017 ACC/AHA guideline

Journal of Human Hypertension volume 34, pages 223–232 (2020)Cite this article

Subjects

Abstract

Soursop consumption is beneficial to health, but there have been few clinical studies observing its benefit in human subjects. We investigated the effects of soursop supplementation on blood pressure (BP), serum uric acid (SUA), and kidney function. A total of 143 subjects were included in this randomized controlled trial. Subjects were selected from a prehypertension population dataset (n = 4190) in the “Mlati Study Database” in 2007 (using the Joint National Committee (JNC) 7 guideline). After 10 years, 143 samples showed essential prehypertension combined with high-normal SUA levels. Subjects were randomly allocated into two groups, i.e., the treatment and control group. For a 3-month period, the treatment group was given 2 × 100 g soursop fruit juice per day and the control group was not treated. Using the JNC 7 guideline, the treatment group showed a significantly lower mean systolic BP after being adjusted by three times of examinations (baseline, week 6 and 12) compared with the control group. Furthermore, the control group was more likely to have prehypertension, hypertension, and high-normal and high SUA levels after 6 weeks, as well as after 12 weeks, compared with the treatment group. An additional analysis using the 2017 ACC/AHA guideline for subjects with stage 1 hypertension showed results similar to that using the JNC 7 guideline. Moreover, it indicated that mean of both systolic and diastolic BP of the treatment group was significantly lower compared with the control group after 12 weeks of treatment. We conclude that soursop supplementation can lower BP and SUA levels.

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

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

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

Fig. 1

Similar content being viewed by others

References

  1. Sutters M. Systemic hypertension. In: McPhee S, Papadakis MA, editors. Current medical diagnosis and treatment. New York: McGrawHill Lange; 2017. p. 439–71.

  2. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, et al. The seventh report of the JNC on prevention, detection and treatment of high blood pressure: the JNC 7 report. J Am Med Assoc. 2003;289:2560–72.

    Article  CAS  Google Scholar 

  3. Whelton PK, Carey RM, Aronow WS, Casey DE Jr, Collins KJ, Dennison Himmelfarb C, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: executive summary. A report of the American college of cardiology/American heart association task force on clinical practice guidelines. Hypertension. 2018;71:1269–324.

    Article  CAS  Google Scholar 

  4. Julius S, Nesbitt SD, Egan BM, Weber MA, Michelson EL, Kaciroti N, et al. Feasibility of treating prehypertension with an angiotensin receptor blocker. N Eng J Med. 2006;354:1685–97.

    Article  CAS  Google Scholar 

  5. Ishikawa Y, Ishikawa J, Ishikawa S, Kario K, Kajii E. Progression from prehypertension to hypertension and risk of cardiovascular disease. J Epidemiol. 2017;27:8–13.

    Article  Google Scholar 

  6. Johnson RJ, Kang DH, Feig D, Kivlighn S, Kanellis J, Watanabe S, et al. Is there a pathogenetic role for uric acid in hypertension and cardiovascular and renal disease? Hypertension. 2003;41:1183–90.

    Article  CAS  Google Scholar 

  7. Jonasson T, Ohlin AK, Gottsäter A, Hultberg B, Ohlin H. Plasma homocysteine and markers for oxidative stress and inflammation in patients with coronary artery disease—a prospective randomized study of vitamin supplementation. Clin Chem Lab Med. 2005;43:628–34.

    Article  CAS  Google Scholar 

  8. Niskanen LK, Laaksonen DE, Nyyssönen K, Alfthan G, Lakka HM, Lakka TA, et al. Uric acid levels as a risk factor for cardiovascular and all-cause mortality in middle-aged men: a prospective cohort study. Arch Intern Med. 2004;164:1546–51.

    Article  CAS  Google Scholar 

  9. Soltani Z, Rasheed K, Kapusta DR, Reisin E. Potensial role of uric acid in metabolic syndrome, hypertension, kidney injury, and cardiovascular diseases: is it time for reappraisal? Curr Hypertens Rep. 2013;15:175–81.

    Article  CAS  Google Scholar 

  10. Gavamukulya Y, Wamunyokoli F, El-Shemy HA. Annona muricata: is the natural therapy to most disease conditions including cancer growing in our backyard? A systematic review of its research history and future prospects. Asian Pac J Trop Med. 2017;10:835–48.

    Article  Google Scholar 

  11. Coria-Tellez AV, Montalvo-Gonzalez E, Yahia EM, Obledo-Vazquez EN. Annona muricata: a comprehensive review on its traditional medicinal uses, phytochemicals, pharmacological activities, mechanisms of action and toxicity. Arab J Chem. 2016. https://doi.org/10.1016/j.arabjc.2016.01.004.

    Article  Google Scholar 

  12. Moghadamtousi SZ, Fadaeinasab M, Nikzad S, Mohan G, Ali HM, Kadir HA. Annona muricata (Annonaceae): a review of its traditional uses, isolated acetogenins and biological activities. Int J Mol Sci. 2015;16:15625–28.

    Article  CAS  Google Scholar 

  13. Adefegha SA, Oyeleye SI, Oboh G. Distribution of Phenolic Contents, Antidiabetic Potentials, Antihypertensive Properties, and Antioxidative Effects of Soursop (Annona muricata L.) Fruit Parts In Vitro. Biochem Res Int. 2015;2015:347673. https://doi.org/10.1155/2015/347673.

    Article  Google Scholar 

  14. Ewadh MJ, Smaism MF, Jawad AM, Mkhlof S, Aljubouri OM, Ewadh MM. Using soursop extracts for natural gout treatment. Am J Biosci Bioeng. 2015;3:37–9.

    CAS  Google Scholar 

  15. Nwokocha CR, Owu DU, Gordon A, Thaxter K, McCalla G, Ozolua RI, et al. Possible mechanisms of action of the hypotensive effect of Annona muricata (soursop) in normotensive Sprague–Dawley rats. Pharm Biol. 2012;50:1436–41.

    Article  Google Scholar 

  16. Adewole SO, Ojewole JAO. Protective effects of Annona Muricata Linn. (Annonaceae) leaf aqueous extract on serum lipid profiles and oxidative stress in hepatocytes of streptozotocin-treated diabetic rats. Afr J Tradit CAM. 2009;6:30–41.

    Google Scholar 

  17. Sja’bani M. Hypertension and renoprotective effects of high serum uric acid treatment. In: Annual Scientific Meeting of Indonesian Nephrology in Palembang. South Sumatra, Indonesia: Lembaga Penerbit Ilmu Penyakit Dalam, Bagian Ilmu Penyakit Dalam Fakultas Kedokteran UNSRI, Palembang, 2014.

  18. Saleem U, Ejaz-ul-Haq M, Chudary Z, Ahmad B. Pharmacological screening of Annona muricata: a Review. Asian J Agric Biol. 2017;5:38–46.

    Google Scholar 

  19. Pinto AC, De Q, Cordeiro MCR, De Andrade SRM, Ferreira FR, Filgueiras HA, et al. Annona muricata. In: Williams JT, editor. Annona species, taxonomy and botany inter-national centre underutilised crops. Southampton, UK: University of Southampton. 2005. p. 3–16.

  20. Chaparro SP, Tavera ML, Martínez JJ, Gil JH. Propiedades funcionales de la harina y de los aislados proteicos de la semilla de guanábana (Annona muricata). Rev UDCA Actual Divulgón Científica. 2014;17:151–9.

    Article  CAS  Google Scholar 

  21. Sawant TP, Dongre RS. Bio-chemical compositional analysis of Annona muricata: a miracle fruit’s review. Int J Univ Pharm Bio Sci. 2014;3:82–104.

    Google Scholar 

  22. Djarot P, Badar M. Formulation and production of granule from Annona muricata fruit juice as antihypertensive instant drink. Int J Pharm Pharm Sci. 2017;9:18–22.

    Article  CAS  Google Scholar 

  23. Li QL, Li BG, Zhang Y, Gao XP, Li CQ, Zhang GL. Three angiotensin-converting enzyme inhibitors from Rabdosia coetsa. Phytomedicine. 2008;15:386–8.

    Article  CAS  Google Scholar 

  24. Ranilla LG, Kwon YI, Apostolidis E, Shetty K. Phenolic compounds, antioxidant activity and in vitro inhibitory potential against key enzymes relevant for hyperglycemia and hypertension of commonly used medicinal plants, herbs and spices in latin America. Bioresour Technol. 2010;101:4676–89.

    Article  CAS  Google Scholar 

  25. Oboh G, Ademiluyi AO, Akinyemi AJ, Henle T, Saliu JA, Schawarzenbolz U. Inhibitory effect of polyphenolrich extracts of jute leaf (Corchorus Olitorius) on key enzyme linked to type-2 diabetes (α-amylase and α-glucosidase) and hypertension (angiotensin I converting) in vitro. J Funct Foods. 2012;4:450-–8.

    Article  CAS  Google Scholar 

  26. Ghayur MN, Gilani AH, Afridi MB, Houghton PJ. Cardiovascular effects of ginger aqueous extract and its phenolic constituents are mediated through multiple pathways. Vasc Pharm. 2005;43:234–41.

    Article  CAS  Google Scholar 

  27. Wahyuni S, Putra-Manuaba IB, Rahayu-Artini NP, Wahyu-Dwijani S. Uric acid inhibition activity of annona muricata l leave extract in hyperuricemia-induced wistar rats. Adv Pure Appl Chem. 2012;2:86–90.

    Google Scholar 

  28. Moerfiah WardatunS, Rahma I. Effect of soursop juice (Annona muricata Linn) on decreasing of uric acid of Sprague–Dawley rats. J Tumbuh Obat Indones. 2012;5:63–72.

    Google Scholar 

  29. Lin KC, Lin HY, Chou P. The interaction between uric acid levels and other risk factors on the development of gout among asymptomatic hyperuricemic men in a prospective study. J Rheumatol. 2000;27:1501–05.

    CAS  PubMed  Google Scholar 

  30. Kong LD, Cai Y, Huang WW, Cheng CHK, Tan RX. Inhibition of xanthine oxidase by some Chinese medicinal plants used to treat gout. J Ethnopharmacol. 2000;73:199–207.

    Article  CAS  Google Scholar 

  31. Alta’ee AH, Ewadh MJ, Zaidan HK. Hormonal contents of two types of black seed (nigella sativa) oil: comparative study. Med J Babylon. 2006;3:17–22.

    Google Scholar 

Download references

Acknowledgements

We would like to express our gratitude to the Mlati Study Group, who assisted with this research. We would also like to thank Prodia Laboratory for performing the laboratory examinations during this study.

Funding

Funding

This study was supported by the Mlati Study Group, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.

Author information

Authors and Affiliations

  1. Mlati Study Group, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia

    Haidar Alatas, Mochammad Sja’bani, Mustofa Mustofa, Ali Ghufron Mukti, Lucky A. Bawazier, Fredie Irijanto & Zulaela Zulaela

  2. Department of Pharmacology and Therapy, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia

    Mustofa Mustofa

  3. Department of Public Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia

    Ali Ghufron Mukti

  4. Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia

    Lucky A. Bawazier

  5. Dr. Soeradji Tirtonegoro General Hospital, Klaten, Central Java, Indonesia

    Fredie Irijanto

  6. Department of Mathematics, Faculty of Mathematics and Natural Sciences, Universitas Gadjah Mada, Yogyakarta, Indonesia

    Zulaela Zulaela

  7. Medical Corporation SHOWAKAI, Tokyo, Japan

    Yasuhiko Tomino

Authors
  1. Haidar Alatas
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mochammad Sja’bani
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mustofa Mustofa
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ali Ghufron Mukti
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Lucky A. Bawazier
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Fredie Irijanto
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Zulaela Zulaela
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Yasuhiko Tomino
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mochammad Sja’bani.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s note: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Alatas, H., Sja’bani, M., Mustofa, M. et al. The effects of soursop supplementation on blood pressure, serum uric acid, and kidney function in a prehypertensive population in accordance with the 2017 ACC/AHA guideline. J Hum Hypertens 34, 223–232 (2020). https://doi.org/10.1038/s41371-019-0235-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41371-019-0235-6

Search

Advanced search

Quick links