Medically reviewed on July 16, 2018
Scientific Name(s): Hibiscus sabdariffa L. Family: Malvaceae (mallows)
Common Name(s): Hibiscus , Jamaica sorrel , karkade (Egyptian hibiscus tea), karkadi , red sorrel , red tea , rosa de Jamaica , rosella , roselle , soborodo , sour tea , Zobo drink
The leaves and calyces have been used as food and the flowers steeped for tea. Hibiscus has been used in folk medicine as a diuretic and mild laxative, as well as in treating cancer and cardiac and nerve diseases. Although information is limited, the potential for hibiscus use in treating hypertension and cancer, as well as for its lipid-lowering and renal effects, are being investigated.
In trials investigating the hypotensive effect of hibiscus, daily dosages of dry calyx 10 g (approximately anthocyanin 9.6 mg) as an infusion in water, and total anthocyanin 250 mg per dose have been used for 4 weeks.
Contraindications have not been identified.
Documented adverse reactions. Avoid use.
Studies in healthy volunteers have shown altered chloroquine, acetaminophen, and diclofenac pharmacokinetics. The clinical effects of these interactions have not been evaluated.
Preparations used in clinical trials were well tolerated.
Data are limited.
H. sabdariffa is native to Central and West Africa, but grows throughout many tropical areas. This annual herb grows to 1.5 m or higher and produces elegant red flowers. The flowers (calyx and bract portions) are collected when slightly immature. The major producing countries are Jamaica and Mexico. 1 , 2 , 3 A related species, Hibiscus rosa-sinensis (rose of Sharon), is widely cultivated for ornamental planting.
Hibiscus has a long history of use in Africa and neighboring tropical countries for many conditions, including hypertension, liver diseases, cancer, constipation, and fever. The fleshy red calyx is used in the preparation of jams, jellies, drinks, and cold and warm teas. The plant is also widely used in Egypt, Iran, and Thailand, as well as in Western countries. Hibiscus flowers often are found as components of herbal tea mixtures 2 , 3 , 4 , 5 , 6 ; it is a major component of the popular herbal blend Red Zinger .
A large variety of compounds have been isolated from the hibiscus plant. 2 As expected from their vivid color, hibiscus flowers contain various polyphenols, including anthocyanins, proanthocyanidins, flavonols, and other pigments. 2 , 7 , 8 , 9 Oxalic, malic, citric, stearic, and tartaric acids have been identified and are, along with 15% to 28% of hibiscic or hibiscus acid (lactone of hydroxycitric acid), most likely contribute to the tartness of the herb and its teas. Roselle seed oil contains more than 25 volatile compounds, mainly unsaturated hydrocarbons, aldehydes, and alcohols. 2 , 5 The oil is rich in gamma tocopherol. 10 The saturated fatty acids (palmitic and stearic) and unsaturated fatty acids (oleic and linoleic) contents have been described. 2 , 5 The seeds and flowers contain high amounts of protein and crude oil, ash, and carbohydrate. High amounts of arginine, aspartic acid, and glutamic acid were found in the protein isolated from the seed. 5 , 9
Uses and PharmacologyCancer
Numerous in vitro experiments have evaluated the effects of hibiscus flower or anthocyanin extracts against various cancer cell lines. Proposed mechanisms of action focus on antioxidant activity and the ability to induce apoptosis. 2 , 11 , 12 , 13 , 14 , 15 , 16 , 17Animal data
Studies in rats have evaluated effects against liver, oral, colon, bladder, and stomach cancers. 2Clinical data
Clinical trials evaluating the use of hibiscus as a chemopreventive or therapeutic agent are lacking. In vitro experiments have shown apoptotic activity against human leukemia (HL-60), 2 , 12 , 13 , 14 gastric, 15 and cervical 17 cell lines.Cholesterol
Studies in hyperlipidemic mice, rats, and rabbits have evaluated the effects of dried calyx extracts on the lipid profile. Although not consistently, the experiments largely demonstrate decreases in serum cholesterol, triglycerides, and LDL, with no effect on high-density lipoprotein (HDL). 2 , 18 , 19 , 20 , 21 , 22 , 23 , 24
Clinical trials evaluating the hypolipidemic effect of hibiscus are lacking.Hypertension
Experiments in animals have shown aqueous and methanol extracts of the plant calyces have hypertensive actions. 2 , 25 , 26 , 27 Suggested mechanisms of action include inhibition of angiotensin I converting enzyme, 2 partial cholinergic and/or histaminic mechanisms, 2 vasodilation, 26 and natriuric effects. 27Clinical data
A number of small clinical trials evaluated the effect of aqueous calyx extracts on blood pressure. 2 Methods of randomization and blinding are not clearly described in the studies. In addition, differences in baseline parameters among study groups and lack of intention-to-treat analyses limit confidence in the findings. 6 , 28 , 29
A dose-dependent decrease in systolic and diastolic blood pressure has been demonstrated for aqueous preparations of the hibiscus calyx comparable in effect to that of captopril and lisinopril. A natriuric effect was also observed in these studies. 28 , 29 In an earlier trial, patients with essential, but untreated, hypertension demonstrated a decrease in blood pressure with sour tea therapy. Their hypertensive state returned on cessation of therapy. 6Renal system
Studies in rats suggest a uricosuric effect of the calyx extract. 2Clinical data
Conflicting clinical data exist regarding the effect of hibiscus extracts on the excretion of uric acid. 2 , 30 , 31 The study parameters vary with respect to dose, preparation used, and study population, making conclusions difficult. Increased urinary sodium excretion has been demonstrated in trials evaluating hypotensive effects of hibiscus extracts. 2 , 28 , 29Other effects
Aqueous hibiscus extracts have shown inhibitory effects on the contractility of various muscle tissues, including uterine. 2 , 32 In other experiments, extracts have demonstrated a mild cathartic activity in rats 4 in the absence of increased peristalsis, as well as stimulatory effects in frogs' abdominal/rectal tissues. 2
Roselle tea extract exhibited high inhibition against porcine pancreatic alpha-amylase. Proposed uses for this inhibition include decreased glucose absorption and inhibition of HIV replication. 33
In trials investigating the hypotensive effect of hibiscus, daily dosages of dry calyx 10 g (equivalent to anthocyanin 9.6 mg) as an infusion in water 28 and total anthocyanin 250 mg per dose 29 have been used for 4 weeks. The kinetics and urinary excretion of the anthocyanin glycosides have been studied in healthy volunteers. An estimated half-life of 2.6 hours and a maximum excretion at 1.5 to 2 hours was noted. 37
Studies in healthy volunteers have shown altered chloroquine, 39 acetaminophen, 2 and diclofenac 40 pharmacokinetics with concomitant consumption of hibiscus preparations. The clinical effects of these interactions have not been evaluated.
Data are limited. The median lethal dose of the calyx extract in rats is estimated to be higher than 5 g/kg. 2
An experiment in rats using dosages of up to 5 g/kg daily over 12 weeks found a reduction in epididymal sperm count, evidence of histological damage, and disintegration of sperm cells. 2 Conversely, a study evaluating the effects of hibiscus 1 g/kg/day on cisplatin-induced reproductive toxicity found a protective effect as measured by sperm motility. The effect was attributed to an antioxidant effect. 41
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