Hibiscus sabdariffa L. (local names: bissap, karkade) and Combretum micranthum (kinkeliba) are widely known in traditional medicines and popular beliefs for their antihypertensive effect. This study assessed the clinical effectiveness of these two plants in the galenic forms of tablet and brew (decoction) in noncomplicated hypertensive patients. In total, 219 hypertensive patients with systolic blood pressure (SBP) between 140 and 180 mmHg and/or diastolic blood pressure (DBP) between 90 and 110 mmHg, without cardiovascular or renal complications, were involved in a multicentric randomized clinical trial in Senegal comparing five treatment regimens: bissap tablets (2 × 375 mg/day), bissap brew (10 g of calyx/day), kinkeliba tablets (2 × 200 mg/day), kinkeliba brew (10 g of leaves/day), and captopril (2 × 50 mg/day) as control. During the 6 months’ follow-up, a significant and equivalent decrease of SBP was observed with the herbal drug approach (−19.5 ± 16.1 mmHg, p < 0.001) and control group (−19.7 ± 16.7, p < 0.001). Regarding the galenic forms, the brews tended to be slightly more effective than tablets (reduction of SBP: −20.7 ± 15.1 mmHg vs −18.7 ± 16.7). The rates of clinically significant effectiveness (decrease in SBP ≥ 10 mmHg) were 75%, 67%, and 65% with bissap, kinkeliba, and captopril, respectively. After 6 months, target blood pressure of <140/90 mmHg was attained by 49% of patients with bissap, 51% with kinkeliba and 40% with captopril. Bissap and kinkeliba appeared, at doses utilized, to be as effective as captopril over the 6 months’ follow-up. In subsequent studies, brews might be started with a lower dosage.
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The patients and the professional staff involved in this study, Medical authorities in Senegal, DIXA AG, Patrick Moneuse and Christiane Ruffieux for the statistical revision, Liesl Graz for English revision of the text.
Conflict of interest
In the future, we hope to raise money for further research on widely accessible health care solutions based on a shared-benefits agreement for the sale of hibiscus tablets for those patients who prefer not to have to prepare their brew every day.
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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Bourqui, A., Niang, E.A.B., Graz, B. et al. Hypertension treatment with Combretum micranthum or Hibiscus sabdariffa, as decoction or tablet: a randomized clinical trial. J Hum Hypertens 35, 800–808 (2021). https://doi.org/10.1038/s41371-020-00415-1