The red-flowered hibiscus shrub is a widely cultivated ornamental, and because of its pleasant, tangy taste it is a common constituent of herbal beverage teas. Medicinally, hibiscus has been taken internally for the treatment of various forms of digestive upset, along with scurvy, anxiety, and fevers. It is said to have an antiseptic and astringent effect when used topically.
Animal studies have suggested that hibiscus might have a blood pressure–lowering effect.1,2 Based on this, preliminary human studies have been conducted. Unfortunately, all of these suffered from marked scientific flaws.
In one study, 54 people with hypertension were given either hibiscus tea or no extra treatment for 2 weeks.3 By the end of the study, people in the hibiscus group had significantly improved blood pressure as compared to those in the group receiving no extra treatment. Unfortunately, these results mean little; for a variety of reasons, people who are enrolled in a study and given a treatment tend to improve, regardless of whether the treatment itself actually works. In order to actually show that a treatment works, it must be compared against a placebo.
Another flawed study enrolled 90 people with hypertension and compared the effectiveness of hibiscus (10 grams dried hibiscus calyx in water daily) against the standard drug captopril (25 mg twice daily).4 The results showed equal benefit. Unfortunately, once more the study is less meaningful than it sounds. This study also failed to use a placebo group. In addition, it was not conducted in a double-blind manner. (For detailed information on why double-blind, placebo-controlled studies are essential, see Why Does This Database Rely on Double-blind Studies?)
In one double-blind study of hibiscus for hypertension, 171 people were given either hibiscus extract (250 mg anthocyanins daily) or the standard drug lisinopril (10 mg daily).16 The results showed that hibiscus was less effective than the standard drug. Properly speaking, this is the only conclusion that can be drawn from the study. The researchers take pains to emphasize that people taking hibiscus showed blood pressure improvements. However, as noted above, in the absence of a placebo to compare these improvements against, they cannot be taken as indicating any specific effect of hibiscus itself. Thus, at present, there is no reliable evidence that hibiscus exerts any anti-hypertensive effect.
In another double-blind trial, hibiscus was compared to black tea among 60 diabetic patients with mild hypertension.17 While subjects taking hibiscus significantly lowered their systolic (higher number) blood pressure over one month, those taking black tea significantly raised their systolic blood pressure over the same period. Again, without directly comparing hibiscus with a placebo, it is difficult to determine whether or not hibiscus effectively lowers blood pressure.
Finally, in a 2010 review of 4 trials involving 390 adults, investigators summarized the available research on Hibiscus sabdariffa for hypertension by concluded that there is insufficient evidence to support it effectiveness .18
Hibiscus contains substances called anthocyanins, antioxidants similar to those found in bilberry, cranberry, and red wine. Very weak evidence, too weak to be relied upon at all, hints that hibiscus or its anthocyanin constituents may have anti-cancer5-10 and liver-protective11,12 effects, and might also improve cholesterol profile.13,14
A typical adult dosage of hibiscus is 10 grams of dried calyx (part of the flower), or an extract that provides 250 mg of anthocyanins daily.
As a widely used beverage tea, hibiscus is presumed to have a high degree of safety. However, comprehensive safety testing has not been performed. Maximum safe doses in pregnant or nursing women, young children, or individuals with severe liver or kidney disease have not been established.
Some evidence suggests that hibiscus might slightly alter the metabolism of the drug acetaminophen, though the effect is probably not large enough to be very important.15
Adegunloye BJ, Omoniyi JO, Owolabi OA, et al. Mechanisms of the blood pressure lowering effect of the calyx extract of Hibiscus sabdariffa in rats. Afr J Med Med Sci. 1999;25:235–8.
Onyenekwe PC, Ajani EO, Ameh DA, et al. Antihypertensive effect of roselle ( Hibiscus sabdariffa) calyx infusion in spontaneously hypertensive rats and a comparison of its toxicity with that in Wistar rats. Cell Biochem Funct. 1999;17:199–206.
Haji Faraji M, Haji Tarkhani A. The effect of sour tea ( Hibiscus sabdariffa) on essential hypertension. J Ethnopharmacol. 1999;65:231–6.
Herrera-Arellano A, Flores-Romero S, Chavez-Soto MA, et al. Effectiveness and tolerability of a standardized extract from Hibiscus sabdariffa in patients with mild to moderate hypertension: a controlled and randomized clinical trial. Phytomedicine. 2004;11:375–82.
Chang YC, Huang HP, Hsu JD, et al. Hibiscus anthocyanins rich extract-induced apoptotic cell death in human promyelocytic leukemia cells. Toxicol Appl Pharmacol. 2005;205:201–12.
Lin HH, Huang HP, Huang CC, et al. Hibiscus polyphenol-rich extract induces apoptosis in human gastric carcinoma cells via p53 phosphorylation and p38 MAPK/FasL cascade pathway. Mol Carcinog. 2005;43:86–99.
Adetutu A, Odunola OA, Owoade OA, et al. Anticlastogenic effects of Hibiscus sabdariffa fruits against sodium arsenite-induced micronuclei formation in erythrocytes in mouse bone marrow. Phytother Res. 2004;18:862–4.
Tseng TH, Kao TW, Chu CY, et al. Induction of apoptosis by hibiscus protocatechuic acid in human leukemia cells via reduction of retinoblastoma (RB) phosphorylation and Bcl-2 expression. Biochem Pharmacol. 2000;60:307–15.
Chewonarin T, Kinouchi T, Kataoka K, et al. Effects of roselle ( Hibiscus sabdariffa Linn.), a Thai medicinal plant, on the mutagenicity of various known mutagens in Salmonella typhimurium and on formation of aberrant crypt foci induced by the colon carcinogens azoxymethane and 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine in F344 rats. Food Chem Toxicol. 1999;37:591–601.
Tseng TH, Hsu JD, Lo MH, et al. Inhibitory effect of Hibiscus protocatechuic acid on tumor promotion in mouse skin. Cancer Lett. 1998;126:199–207.
Amin A, Hamza AA. Hepatoprotective effects of Hibiscus, Rosmarinus and Salvia on azathioprine-induced toxicity in rats. Life Sci. 2005;77:266–78.
Wang CJ, Wang JM, Lin WL, et al. Protective effect of Hibiscus anthocyanins against tert-butyl hydroperoxide-induced hepatic toxicity in rats. Food Chem Toxicol. 2000;38:411–6.
Chen CC, Hsu JD, Wang SF, et al. Hibiscus sabdariffa extract inhibits the development of atherosclerosis in cholesterol-fed rabbits. J Agric Food Chem. 2003;51:5472–7.
Chen CC, Chou FP, Ho YC. Inhibitory effects of Hibiscus sabdariffa L extract on low-density lipoprotein oxidation and anti-hyperlipidemia in fructose-fed and cholesterol-fed rats. J Sci Food Agric. 2004;84:1989–96.
Kolawole JA, Maduenyi A. Effect of zobo drink ( Hibiscus sabdariffa water extract) on the pharmacokinetics of acetaminophen in human volunteers. Eur J Drug Metab Pharmacokinet. 2004;29:25–9
Herrera-Arellano A, Miranda-Sanchez J, Avila-Castro P, et al. Clinical effects produced by a standardized herbal medicinal product of Hibiscus sabdariffa on patients with hypertension: a randomized, double-blind, lisinopril-controlled clinical trial. Planta Med. 2007;73:6-12.
Mozaffari-Khosravi H, Jalali-Khanabadi BA, Afkhami-Ardekani M, et al. The effects of sour tea (Hibiscus sabdariffa) on hypertension in patients with type II diabetes. J Hum Hypertens. 2008 Aug 7.
Wahabi HA, Alansary LA, Al-Sabban AH, et al. The effectiveness of Hibiscus sabdariffa in the treatment of hypertension: a systematic review. Phytomedicine. 2010 Feb;17(2):83.
Last reviewed September 2014 by EBSCO CAM Review Board
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.