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COMPLEMENTARY AND ALTERNATIVE MEDICINE

Systematic Review of the Effects of Ginseng on Cardiovascular Risk Factors

Clinical Research Fellow, Division for Research and Education in Complementary and Integrative Medical Therapies, Harvard Medical School, Boston, MA

Gloria Y Yeh, MD MPH

Instructor in Medicine, Division for Research and Education in Complementary and Integrative Medical Therapies, Harvard Medical School

Russell S Phillips, MD

Chief, Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston; Professor of Medicine, Harvard Medical School

Murray A Mittleman, MD DrPH

Director, Cardiovascular Epidemiology Research Unit, Beth Israel Deaconess Medical Center; Associate Professor of Medicine, Harvard Medical School; Associate Professor of Epidemiology, Harvard School of Public Health

Ted J Kaptchuk, OMD

Director, Program on Asian Medicine and Healing, Osher Institute, Medical School, Harvard University; Assistant Professor of Medicine, Medical School, Harvard University

Reprints: Dr. Buettner, Division for Research and Education in Complementary and Integrative Medical Therapies, Harvard Medical School, 401 Park Dr., Ste. 22A-West, Boston, MA 02215-3325, fax 617/384-8555, catherine_buettner{at}hms.harvard.edu

OBJECTIVE: To examine the evidence for the efficacy of ginseng (Panax spp.) on cardiovascular risk factors, including blood pressure, lipid profiles, and blood glucose, and to summarize reported cardiovascular adverse events.

DATA SOURCES: We searched MEDLINE, AMED, BIOSIS, CAB, EMBASE, and the Cochrane Controlled Trials databases through July 2005 and performed hand searches of bibliographies.

STUDY SELECTION AND DATA EXTRACTION: Short- or long-term, randomized, controlled trials and nonrandomized studies published in English were included. Data were extracted in a standardized manner, and 2 independent investigators assessed methodologic quality of the studies. Thirty-four studies were identified with results for blood pressure, lipids, and/or blood glucose. Due to heterogeneity of the studies, we were unable to perform a meta-analysis. Data on cardiovascular adverse events were extracted from events reported in identified studies and from case reports.

DATA SYNTHESIS: The majority of studies were short term. Ginseng may slightly decrease blood pressure compared with placebo (range 0-4%). We found mixed results for an effect on lipids, with 5 of 9 studies showing improvement in one or more lipid parameters compared with baseline (range 7-44%). We identified several studies showing that ginseng lowers blood glucose, but overall studies were inconsistent.

CONCLUSIONS: Current evidence does not support the use of ginseng to treat cardiovascular risk factors. Some studies suggest a small reduction in blood pressure. Despite some evidence showing that ginseng lowers blood glucose and improves lipid profiles, well-designed, randomized, controlled trials evaluating its effects are lacking.

Key Words: ginseng; panax, blood glucose, blood pressure, cardiovascular diseases, lipids

Published Online, December 6, 2005. www.theannals.com, DOI 10.1345/aph.1G216