Efficacy and safety of Hibiscus sabdariffa in cardiometabolic health: An overview of reviews and updated dose-response meta-analysis
Background: Conventional treatments for cardiometabolic diseases face limitations related to cost, efficacy, and side effects. Hibiscus sabdariffa (HS) is a common food product and a potential alternative. However, previous studies have shown inconsistent results and lacked assessments of result cer...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-05-01
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| Series: | Complementary Therapies in Medicine |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S096522992500010X |
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| author | Mostafa Norouzzadeh Minoo Hasan Rashedi Mohammad Hesam Azizi Farshad Teymoori Zohreh Maghsoomi Farzad Shidfar |
| author_facet | Mostafa Norouzzadeh Minoo Hasan Rashedi Mohammad Hesam Azizi Farshad Teymoori Zohreh Maghsoomi Farzad Shidfar |
| author_sort | Mostafa Norouzzadeh |
| collection | DOAJ |
| description | Background: Conventional treatments for cardiometabolic diseases face limitations related to cost, efficacy, and side effects. Hibiscus sabdariffa (HS) is a common food product and a potential alternative. However, previous studies have shown inconsistent results and lacked assessments of result certainty, intervention safety, and subgroup analysis credibility. This study evaluated the efficacy and safety of HS on blood pressure (BP), lipid profiles, glycemic control, anthropometric parameters, inflammatory markers, oxidative stress indicators, and liver enzymes. Methods: To conduct this umbrella review, a systematic search of eligible meta-analyses was performed up to May 2024. The random-effects model was used to synthesize results from individual trials. Quality, certainty, and credibility of evidence were evaluated using the Cochrane Risk of Bias tool, AMSTAR-II, GRADE, and ICEMAN frameworks. Results: Data from 26 randomized controlled trials involving 1797 participants revealed that HS dose-dependently reduced systolic and diastolic BP compared to placebo and other teas. Although no significant differences were found between HS and antihypertensive drugs, HS showed moderate credibility for therapeutic BP reduction (> 10 mmHg), especially in individuals over 50 years, in trials lasting over four weeks, and in those with a low risk of bias. HS also reduced total cholesterol, LDL-C, fasting blood glucose, and increased HDL-C. A minor, clinically insignificant increase in aspartate aminotransferase was observed without elevating adverse event risks. Conclusions: HS showed BP-lowering effects comparable to antihypertensive drugs and beneficial impacts on lipid and glycemic profiles. Although HS is generally considered safe, long-term and therapeutic dosing safety requires careful monitoring. |
| format | Article |
| id | doaj-art-74c4d1e29fee455fba59082cac64f418 |
| institution | DOAJ |
| issn | 0965-2299 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Complementary Therapies in Medicine |
| spelling | doaj-art-74c4d1e29fee455fba59082cac64f4182025-08-20T02:58:50ZengElsevierComplementary Therapies in Medicine0965-22992025-05-018910313510.1016/j.ctim.2025.103135Efficacy and safety of Hibiscus sabdariffa in cardiometabolic health: An overview of reviews and updated dose-response meta-analysisMostafa Norouzzadeh0Minoo Hasan Rashedi1Mohammad Hesam Azizi2Farshad Teymoori3Zohreh Maghsoomi4Farzad Shidfar5Institute for Studies in Medicine History, Persian and Complementary Medicine, Iran University of Medical Science, Tehran, Iran; Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran; Student Research Committee, Iran University of Medical Sciences, Tehran, Iran; Nutritional Sciences Research Center, Iran University of Medical Sciences, Tehran, IranInstitute for Studies in Medicine History, Persian and Complementary Medicine, Iran University of Medical Science, Tehran, Iran; Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran; Student Research Committee, Iran University of Medical Sciences, Tehran, Iran; Nutritional Sciences Research Center, Iran University of Medical Sciences, Tehran, IranInstitute for Studies in Medicine History, Persian and Complementary Medicine, Iran University of Medical Science, Tehran, Iran; Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran; Student Research Committee, Iran University of Medical Sciences, Tehran, IranDepartment of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran; Nutritional Sciences Research Center, Iran University of Medical Sciences, Tehran, IranResearch Center for Prevention of Cardiovascular Disease, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences (IUMS), Tehran, IranInstitute for Studies in Medicine History, Persian and Complementary Medicine, Iran University of Medical Science, Tehran, Iran; Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran; Student Research Committee, Iran University of Medical Sciences, Tehran, Iran; Correspondence to: Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Hemmat Highway, Tehran 15875-4199, Iran.Background: Conventional treatments for cardiometabolic diseases face limitations related to cost, efficacy, and side effects. Hibiscus sabdariffa (HS) is a common food product and a potential alternative. However, previous studies have shown inconsistent results and lacked assessments of result certainty, intervention safety, and subgroup analysis credibility. This study evaluated the efficacy and safety of HS on blood pressure (BP), lipid profiles, glycemic control, anthropometric parameters, inflammatory markers, oxidative stress indicators, and liver enzymes. Methods: To conduct this umbrella review, a systematic search of eligible meta-analyses was performed up to May 2024. The random-effects model was used to synthesize results from individual trials. Quality, certainty, and credibility of evidence were evaluated using the Cochrane Risk of Bias tool, AMSTAR-II, GRADE, and ICEMAN frameworks. Results: Data from 26 randomized controlled trials involving 1797 participants revealed that HS dose-dependently reduced systolic and diastolic BP compared to placebo and other teas. Although no significant differences were found between HS and antihypertensive drugs, HS showed moderate credibility for therapeutic BP reduction (> 10 mmHg), especially in individuals over 50 years, in trials lasting over four weeks, and in those with a low risk of bias. HS also reduced total cholesterol, LDL-C, fasting blood glucose, and increased HDL-C. A minor, clinically insignificant increase in aspartate aminotransferase was observed without elevating adverse event risks. Conclusions: HS showed BP-lowering effects comparable to antihypertensive drugs and beneficial impacts on lipid and glycemic profiles. Although HS is generally considered safe, long-term and therapeutic dosing safety requires careful monitoring.http://www.sciencedirect.com/science/article/pii/S096522992500010XHibiscus sabdariffaDietary supplementsNatural productCardiometabolic risk factorsMetabolic syndromeHypertension |
| spellingShingle | Mostafa Norouzzadeh Minoo Hasan Rashedi Mohammad Hesam Azizi Farshad Teymoori Zohreh Maghsoomi Farzad Shidfar Efficacy and safety of Hibiscus sabdariffa in cardiometabolic health: An overview of reviews and updated dose-response meta-analysis Complementary Therapies in Medicine Hibiscus sabdariffa Dietary supplements Natural product Cardiometabolic risk factors Metabolic syndrome Hypertension |
| title | Efficacy and safety of Hibiscus sabdariffa in cardiometabolic health: An overview of reviews and updated dose-response meta-analysis |
| title_full | Efficacy and safety of Hibiscus sabdariffa in cardiometabolic health: An overview of reviews and updated dose-response meta-analysis |
| title_fullStr | Efficacy and safety of Hibiscus sabdariffa in cardiometabolic health: An overview of reviews and updated dose-response meta-analysis |
| title_full_unstemmed | Efficacy and safety of Hibiscus sabdariffa in cardiometabolic health: An overview of reviews and updated dose-response meta-analysis |
| title_short | Efficacy and safety of Hibiscus sabdariffa in cardiometabolic health: An overview of reviews and updated dose-response meta-analysis |
| title_sort | efficacy and safety of hibiscus sabdariffa in cardiometabolic health an overview of reviews and updated dose response meta analysis |
| topic | Hibiscus sabdariffa Dietary supplements Natural product Cardiometabolic risk factors Metabolic syndrome Hypertension |
| url | http://www.sciencedirect.com/science/article/pii/S096522992500010X |
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