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

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Abstract

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.

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Authors and Affiliations

  1. Clinical Nutrition and Risk Factor Modification Centre, St Michael’s Hospital, Toronto, Ontario, Canada

    A M Komishon, E Shishtar, V Ha, J L Sievenpiper, R J de Souza, E Jovanovski, H V T Ho & V Vuksan

  2. Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada

    A M Komishon, E Shishtar, V Ha, E Jovanovski, H V T Ho & V Vuksan

  3. Department of Pathology, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada

    J L Sievenpiper

  4. Department of Molecular Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada,

    J L Sievenpiper

  5. Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada

    R J de Souza

  6. Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario, Canada

    E Jovanovski & V Vuksan

  7. School of Medicine University of Zagreb, University Clinic for Diabetes, Endocrinology and Metabolic Diseases, Zagreb, Croatia

    L S Duvnjak

  8. Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada

    V Vuksan

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  1. A M Komishon
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Correspondence to V Vuksan.

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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.

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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). https://doi.org/10.1038/jhh.2016.18

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