\r\n \r\n Dyslipidemia and Sour tea (Hibiscus sabdariffa)
\n
\nHibiscus sabdariffa, or sour tea, is a genus of the Malvaceae family. In Iran,
\nit is typically known as sour tea, in English-speaking countries is it called
\nRed Sorrel.
\n
\nOriginally from Angola, it is now cultivated throughout tropical regions,
\nespecially from Sudan, Egypt, Thailand, Mexico and China.
\n
\nThe calyces of H. sabdariffa are prolific in many modern commercial blends of
\ncold and hot drinks due to it\'s pleasing taste. Approximately 15%-30% of the
\nplant is made up of plant acids, including citric, malic, tartaric acids and
\nallo-hydroxycitric acid lactone�i.e. hibiscus acid which is specific to this
\nplant.
\n
\nOther chemical constituents are many, including alkaloids, L-ascorbic
\nacid, anthocyanin, Beta-carotene, Beta-sitosterol, citric acid, polysaccharides
\narabins and arabinogalactans, quercetin, gossypetin and small amounts of
\ngalactose, arabinose, glucose, xylose, mannose and rhamnose.
\n
\nHistorically,
\nfolk medicine has used H. sabdariffa for the treatment of high blood pressure,
\nliver diseases and fevers. In large amounts, hibiscus tea acts as a mild
\nlaxative. In African folk medicine it has been used for its spasmolytic,
\nantibacterial, cholagogic, diuretic and anthelmintic properties.
\n
\nScientific interest in Hibiscus has grown in the last several years with a small
\nburst of published research studies, especially in the area of dyslipidemia and
\nhypertension.
\n
\nOver twenty years ago, water extracts of hibiscus flowers were
\nreported to have a relaxation effect on the uterus and to lower the blood
\npressure.[i] Studies in both animal[ii], [iii], [iv], [v] and human models have
\ndemonstrated that extracts or infusions affects atherosclerosis mechanisms,
\nblood sugar, lipids and blood pressure [vi], [vii]
\n
\n
\nIn 2007, a clinical trial showed that Hibiscus reduced cholesterol by 8.3% to
\n14.4% after just one month.[viii] A total of 42 subjects were randomized to 3
\ngroups for the study, conducted in Taiwan. The hibiscus extract capsules
\ncontained 500 mg of dried herb by macerating 150 g of hibiscus flowers in 6 L of
\nhot water for 2 hours and then drying and filtering the extract. Group 1
\nreceived 1 capsule of extract 3 times daily (1,500 mg/day), group 2 received 2
\ncapsules 3 times daily (3,000 mg/day), and group 3 received 3 capsules 3 times
\ndaily (4,500 mg/day)
\n
\n
\nOverall, subjects in group 2 responded best to the hibiscus extract treatment.
\nGroups 1 and 2, but not group 3, experienced a significant reduction in serum
\ncholesterol levels at week 4, compared with baseline levels. In addition, group
\n2 experienced a significant reduction in serum cholesterol levels at week 2,
\ncompared with baseline levels. At week 2, there was a 42.9% responder rate in
\ngroups 1 and 3 and a 64.3% responder rate in group 2. By week 4, group 2 had a
\ncholesterol reduction response from 71.4% of the subjects. In group 1, 50.0%
\nwere responders, and 42.9% subjects in group 3 were responders at week 4.
\n
\nIt
\nappeared that group 2, taking 1,000 mg taken three times daily was the optimum
\ndose in achieving cholesterol reduction effects. While this study is small with
\na small number of subjects in each of the study groups, as well as a short
\nduration of 4 weeks, there was indeed a clear effect with significant reductions
\nin serum cholesterol seen as early as week 2, in the 1,000 mg tid group. Oddly
\nenough, the responders in group 3, receiving the highest dose (4,500 mg/day),
\nhad the smallest response to the hibiscus extract with an average of 8.3%
\nreduction at week 4. Group 1 received a 14.4% reduction at week 4.
\n
\nIn 2009, 60 Type 2 diabetics, mostly women, were given either Hibiscus tea from
\nSaudi Arabia or black tea, 1 cup twice per day. [ix] Seven individuals withdrew
\nfrom the study and after one month, mean HDL cholesterol increased significantly
\n(48.2 mg/dL to 56.1 mg/dL) whereas apolipoprotein A1 and lipoprotein (a) were
\nnot significant. There was also a significant decrease in the mean of total
\ncholesterol (236.2 to 218.6), LDL cholesterol (137.5 to 128.5), triglycerides
\n(246.1 to 209.2) and Apo-B100 (80.0 to 77.3) in the Hibiscus group. Only HDLc
\nshowed a significant change in the black tea group (46.2 to 52.01).
\n
\nSomething as
\nsimple as Hibiscus tea in a diabetic, is a welcomed intervention. Achieving a
\n7.6% decrease in total cholesterol, an 8.0% decrease in LDLc, a 14.9% decrease
\nin triglycerides, a 3.4% decrease in Apo-B100, a 4.2% increase in Apo-A1 and a
\n16.7% increase in HDLc is no small accomplishment with merely two cups of tea
\nper day.
\n
\nHibiscus extract was also studied in 222 patients some with and some without
\nmetabolic syndrome (MS).[x] A total daily dose of 100 mg Hibiscus sabdariffa
\nextract powder (HSEP) was given for one month to men and women, 150 without MS
\nand 72 with MS. They were randomly assigned to a preventive diet, HSEP treatment
\nor diet combined with HSEP treatment. The MS patients receiving HSEP had
\nsignificantly reduced glucose, total cholesterol and LDL-c and increased HDL-c.
\n
\nA triglyceride lowering effect was seen in all groups but was only significant
\nin the control group that was treated with diet. The triglyceride/HDL-c ratio
\nwas also significantly reduced with HSEP in the control and MS groups,
\nindicating an improvement in insulin resistance. It has been hypothesized that
\nthe anthocyanins regulate adipocyte function, which has definite and important
\nimplications for both preventing and treating metabolic syndrome. Due to both
\nits hypolipidemic and hypotensive effects, Hibiscus extract would be an
\nexcellent option for individuals with metabolic syndrome.
\n
\nA double-blind, placebo control, randomized trial in 69 subjects with elevated
\nLDL and ho history of coronary heart disease did not appear to show a blood
\nlipid lowering effect from Hibiscus extract. [xi] The treatment group received
\n1,000mg/day Hibiscus extract for 90 days in addition to dietary and physical
\nactivity. Body weight, serum LDL cholesterol and triglyceride levels decreased
\nin both the extract and placebo groups, with no significant differences between
\nthe two. It is likely that the positive effects were due to dietary and
\nexercise activity. One wonders why the results of this study were negative and
\nthe 3 previous studies above, showed positive results. The doses and product
\nused in all four studies were different. One a tea, another used dried powdered
\nflowers, another used a standardized extract powder of the sepals of the
\nflowers, and this one, an ethyl alcohol/water extract, dried and then powder of
\nthe leaves. It is reasonable to consider that these different preparations
\nwould yield different results. With more consistent product selection and
\ndosages used in larger randomized trials, we would hope that this would clarify
\nthe best intervention to use.
\n
\nPractitioners should be encouraged about the modern research in Hibiscus,
\nalthough more robust high quality randomized controlled trials would be welcomed
\nand a worthy addition in our ability to help stem the tide of the impact of
\ncardiovascular disease on the lives of men and women.
\n
\nFor the ever growing
\nnumber of patients who refuse and even loathe the aggressive prescribing of
\nstatins, Hibiscus can be an important tool especially in the context of
\ncomprehensive lifestyle changes and other nutraceutical/botanical interventions
\nto reduce life threatening or debilitating cardiovascular disease
\n
\n
\n[i] Franz M, Franz G. Hibiscus sabdariffa. Phytotherapy 1988;9(2):63
\n
\n[ii] Adegunloye B, Omoniyi J, Owolabi O, et al. Mechanisms of the blood
\npressure lowering effect of the calyx extract of Hibiscus sabdariffa in rats.
\nAfr J Med Med Sci 1996; 25:235-238.
\n
\n[iii] Ali M, Salih W, Mohamed A, Homeida A. Investigation of the antispasmodic
\npotential of Hibiscus sabdariffa calyces. J Ethnopharmacol 1991;31:249-257.
\n
\n[iv] Odigie I, Ettarh R, Adigun S. Chronic administration of aqueous extract of
\nHibiscus sabdariffa attenuates hypertension and reverses cardiac hypertrophy in
\n2K-1C hypertensive rats. J Ethnopharmacol 2003;86:181-185.
\n
\n[v] Onyenekwe P, Ajani E, Ameh D, Gamaniel K. Antihypertensive effect of
\nroselle calyx infusion in spontaneously hypertensive rats and a comparison of
\nits toxicity with that in Wistar rats. Cell Biochem Funct 1999;17:199-206.
\n
\n[vi] Chen C, Chou F, Ho W, et al. Inhibitory effects of Hibiscus sabdariffa L
\nextact on low-density lipoprotein oxidation and anti-hyperlipidemia in
\nfructose-fed and cholesterol-fed rats. J Sci food and agr 2004;84:1989-1996.
\n
\n[vii] Herra-Arellano A, Flores-Romero S, Chavez-Soto M, Tortoriello J.
\nEffectiveness and tolerability of a standardized extract from Hibiscus
\nsabdariffa in patients with mild to moderate hypertension: a controlled and
\nrandomized clinical trial. Phytomedicine 2004;11:375-382.
\n
\n[viii] Lin T, Lin H, Chen C, et al. Hibiscus sabdariffa extract reduces serum
\ncholesterol in men and women. Nutr Res 2007;27:140-145.
\n
\n[ix] Mozaffari-Khosravi H, Jalali-Khanabadi B, Afkhami-Ardehani M, Fatehi F.
\nEffects of sour tea (Hibiscus sabdariffa) on lipid profile and lipoproteins in
\npatients with Type II diabetes. J Altern and Comp Med 2009;15(8):899-903.
\n
\n[x] Gurrola-Diaz C, Garcia-Lopez P, Sanchez-Enriquez S, et al. Effects of
\nHibiscus sabdariffa extract powder and preventive treatment (diet) on the lipid
\nprofiles of patients with metabolic syndrome (MeSy). Phytomedicine
\n2010;17:500-505.
\n
\n[xi] Kuriyan R, Kumar D, Rajendran R, Kurpad A. An evaluation of the
\nhypolipidemic effect of an extract of Hibiscus sabdariffa leaves in
\nhyperlipdemic Indians: a double blind, placebo controlled trial. BMC Compl and
\nAlt Med 2010;10:27
\n
\n(peacefulmind.com)\r\n

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\r\n "We can judge the heart of a man by his treatment of animals." ~Immanual Kant~
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