We aimed to assess the efficacy of hibiscus sabdariffa in patients with mild to moderate hypertension or metabolic syndrome (MetS) by comparing it against placebo, antihypertensive drugs, or other herbal products.Four databases were searched for randomized clinical trials (RCTs) examining the efficacy of hibiscus sabdariffa in patients with mild to moderate hypertension or hypertension associated with MetS. Data on the change in systolic blood pressure (SBP) and diastolic blood pressure (DBP) were extracted and analyzed using Review Manager Version 5.3.A total of 13 RCTs (1205 participants) were analyzed. Hibiscus sabdariffa significantly reduced both SBP and DBP compared to placebo (MD -6.67, P=0.004 and -4.35 mmHg, P=0.02). Subgroup analysis showed that change in SBP and DBP was statistically significant in patients with only hypertension while not significant in patients with hypertension associated with MetS. When hibiscus sabdariffa was compared to active controls (antihypertensive drugs or other herbals), the change in SBP and DBP was not statistically significant (all P>0.05).Hibiscus sabdariffa is effective in reducing the SBP and DBP in patients with mild to moderate hypertension but was neither effective in those with MetS nor superior to antihypertensive drugs. Further RCTs are required to determine the long-term efficacy of hibiscus sabdariffa and to describe patients who would benefit most from this treatment.

中文翻译：

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木槿花对降低轻度至中度高血压患者血压的功效：对已发表的随机对照试验的系统回顾和荟萃分析。

我们的目的是通过将木槿花与安慰剂、抗高血压药物或其他草药产品进行比较，评估木槿花对轻度至中度高血压或代谢综合征 (MetS) 患者的疗效。在四个数据库中检索了检查疗效的随机临床试验 (RCT)木槿花治疗轻度至中度高血压或与 MetS 相关的高血压患者。使用 Review Manager 5.3 版提取和分析收缩压 (SBP) 和舒张压 (DBP) 变化的数据。总共分析了 13 个随机对照试验（1205 名受试者）。与安慰剂相比，木槿显着降低收缩压和舒张压（MD -6.67，P=0.004 和 -4.35 mmHg，P=0.02）。亚组分析显示，SBP和DBP的变化在仅有高血压的患者中具有统计学意义，而在伴有MetS的高血压患者中则不具有统计学意义。洛神花与活性对照（降压药或其他草药）相比，SBP和DBP的变化无统计学意义（均P>0.05）。洛神花可有效降低轻中度高血压患者的SBP和DBP但对 MetS 患者既无效，也不优于抗高血压药物。需要进一步的随机对照试验来确定木槿花的长期疗效，并描述哪些患者将从这种治疗中受益最多。