Roselle (Hibiscus sabdariffa L.) extract as an adjunct to valsartan in patients with mild chronic kidney disease: A double-blind randomized controlled clinical trial

Dehkhoda, Behdad; Enayati, Ayesheh; Mirzaei, Hassan; Ghorbani, Somayeh; Soleimani, Mohammad Hadi; Amirkhanlou, Saeid; Sahebkar, Amirhossein

doi:10.22038/ajp.2024.23871

Roselle (Hibiscus sabdariffa L.) extract as an adjunct to valsartan in patients with mild chronic kidney disease: A double-blind randomized controlled clinical trial

Document Type : Original Research Article

Authors

Behdad Dehkhoda ¹

Ayesheh Enayati ¹

Hassan Mirzaei ¹

Somayeh Ghorbani ²

Mohammad Hadi Soleimani ³

Saeid Amirkhanlou ¹

Amirhossein Sahebkar ⁴

¹ Ischemic Disorders Research Center, Golestan University of Medical Sciences, Gorgan, Iran

² Rheumatology Research Center, Golestan University of Medical Sciences, Gorgan, Iran

³ Giah Essence Phytopharm-Dr. Soleimani Co.

⁴ Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran. Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

10.22038/ajp.2024.23871

Abstract

Objective: The objective of this study was to evaluate the
effectiveness of Hibiscus sabdariffa L. extract (HS) as an adjunct
to valsartan in the treatment of high blood pressure in patients with
mild chronic kidney disease (CKD).
Materials and Methods: This trial was conducted in Gorgan,
Iran. Seventy-two participants with CKD and high blood pressure
were randomly assigned to either the HS group, receiving a 350
mg pill every 12 hr for 90 days along with 40 mg of valsartan
every 12 hr, or the control group (40 mg valsartan + 12.5 mg
hydrochlorothiazide). The primary objective was to assess the
improvement of hypertension, while secondary objectives included
the evaluation of proteinuria, albuminuria, kidney function, lipid
profile, and electrolyte levels. Molecular docking analysis was
performed to examine the mechanisms of action of the isolated
components of HS.
Results: Out of 80 initial participants, 72 were included in the
analysis. Both groups showed a significant reduction in blood
pressure (p<0.001). The HS group demonstrated a statistically
significant decrease in lipid profile (p<0.001). There were no
statistically significant differences between the groups regarding
the reduction of renal markers. Molecular docking analysis
revealed that the compounds present in HS, particularly its
anthocyanins and flavonoids, exhibited greater angiotensinconverting enzyme (ACE) inhibitory potential than
hydrochlorothiazide in both domains. Moreover, the compounds
met the criteria for drug likeness and Lipinski rules.
Conclusion: Adjunctive therapy with HS showed promising
results in reducing hypertension and improving lipid profile in
patients with CKD.

Keywords

Chronic kidney disease

Hypertenstion

Valsartan

Hibiscus sabdariffa

Antocyanidin

Hydrochlorothiazide

Lipid profile

Molecular docking

Subjects