Efficacy of Sumac in Blood Pressure Modulation: A Narrative Review

Authors

DOI:

https://doi.org/10.14288/hfjc.v17i2.845

Keywords:

Antihypertensive Agents, Antioxidant, Diastolic Blood Pressure, Hypertension, Metabolic Syndrome, Systolic Blood Pressure

Abstract

Background: Hypertension is a prevalent cardiovascular risk factor, contributing to various debilitating conditions. Although pharmacological interventions are available, the side effects of medications negatively affect individuals’ adherence and quality of life. Plants from the genus Rhus, also known as sumac, have been traditionally used to treat cardiovascular and gastrointestinal diseases. Purpose: This narrative review aimed to assess the efficacy of sumac in blood pressure management through a comprehensive review of available clinical and pre-clinical trials. Methods: A systemic search of databases Medline, Excerpta Medica dataBASE and Cumulative Index to Nursing and Allied Health Literature was conducted up to March 2024. Results: Among 41 screened studies, five studies (four clinical and one pre-clinical) were included. All clinical trials demonstrated that sumac administration caused a significant reduction in systolic blood pressure (SBP). Sumac was effective in the reduction of diastolic blood pressure (DBP) in two studies. A pre-clinical study also showed a significant reduction in both SBP and DBP alongside increased nitric oxide expression. Conclusion: Sumac could have therapeutic and preventative effects on hypertension, potentially attributed to its antioxidant properties and ability to enhance nitric oxide production. However, further studies with longer duration and exploration of different sumac species are warranted to validate these findings and establish their therapeutic efficacy in blood pressure modulation. This review provides a foundation for future clinical investigations into sumac's role in hypertension management.

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References

Alsamri, H., Athamneh, K., Pintus, G., Eid, A. H., & Iratni, R. (2021). Pharmacological and antioxidant activities of Rhus coriaria L. (sumac). Antioxidants, 10(1), 73. https://doi.org/10.3390/antiox10010073

Ardalani, H., Moghadam, M. H., Rahimi, R., Soltani, J., Mozayanimonfared, A., Moradi, M., & Azizi, A. (2016). Sumac as a novel adjunctive treatment in hypertension: A randomized, double-blind, placebo-controlled clinical trial. RSC Advances, 6(14), 11507–11512. https://doi.org/10.1039/C5RA22840A

Asgary, S., Salehizadeh L., Keshvari M., Taheri M., Spence N.D., Farvid M.S., Rafieian-Kopaei M., & Sarrafzadegan N. (2018). Potential cardioprotective effects of sumac capsule in patients with hyperlipidemia: A triple-blind Randomized, placebo-controlled crossover trial. Journal of the American College of Nutrition, 37(4), 286–292. Embase. https://doi.org/10.1080/07315724.2017.1394237

Campbell, N. R. C., Paccot Burnens, M., Whelton, P. K., Angell, S. Y., Jaffe, M. G., Cohn, J., Espinosa Brito, A., Irazola, V., Brettler, J. W., Roccella, E. J., Maldonado Figueredo, J. I., Rosende, A., & Ordunez, P. (2022). 2021 World Health Organization guideline on pharmacological treatment of hypertension: Policy implications for the region of the Americas. Lancet Regional Health - Americas, 9, 100219. https://doi.org/10.1016/j.lana.2022.100219

Connelly, P. J., Currie, G., & Delles, C. (2022). Sex differences in the prevalence, outcomes and management of hypertension. Current Hypertension Reports, 24(6), 185–192. https://doi.org/10.1007/s11906-022-01183-8

Ehsani, S., Zolfaghari H., Kazemi S., & Shidfar F. (2022). Effects of sumac (Rhus coriaria) on lipid profile, leptin and steatosis in patients with non-alcoholic fatty liver disease: A randomized double-blind placebo-controlled trial. Journal of Herbal Medicine, 31(100525). https://doi.org/10.1016/j.hermed.2021.100525

Fyhrquist, F., Metsärinne, K., & Tikkanen, I. (1995). Role of angiotensin II in blood pressure regulation and in the pathophysiology of cardiovascular disorders. Journal of Human Hypertension, 9 Suppl 5, S19-24.

Gillis, E. E., & Sullivan, J. C. (2016). Sex differences in hypertension. Hypertension, 68(6), 1322–1327. https://doi.org/10.1161/HYPERTENSIONAHA.116.06602

Heart and Stroke Foundation of Canada. (2022). Health professionals concerned about blood pressure in Canada. Heart and Stroke Foundation of Canada. https://www.heartandstroke.ca/en/what-we-do/media-centre/news-releases/health-professionals-concerned-about-blood-pressure-in-canada/

Hegde, S., Ahmed, I., & Aeddula, N. R. (2024). Secondary hypertension. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK544305/

Iqbal, A. M., & Jamal, S. F. (2024). Essential hypertension. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK539859/

Kamyab, R., Namdar, H., Torbati, M., Ghojazadeh, M., Araj-Khodaei, M., & Fazljou, S. M. B. (2021). Medicinal plants in the treatment of hypertension: A review. Advanced Pharmaceutical Bulletin, 11(4), 601–617. https://doi.org/10.34172/apb.2021.090

Kossah, R., Nsabimana, C., Zhao, J., Chen, H., Tian, F., Zhang, H., & Chen, W. (2009). Comparative study on the chemical composition of Syrian sumac (Rhus coriaria L.) and Chinese sumac (Rhus typhina L.) fruits. Pakistan Journal of Nutrition, 8, 1570–1574. https://doi.org/10.3923/pjn.2009.1570.1574

Kossah, R., Zhang, H., & Chen, W. (2011). Antimicrobial and antioxidant activities of Chinese sumac (Rhus typhina L.) fruit extract. Food Control, 22(1), 128–132. https://doi.org/10.1016/j.foodcont.2010.06.002

Kowalski, S., Goniewicz, K., Moskal, A., Al-Wathinani, A. M., & Goniewicz, M. (2023). Symptoms in hypertensive patients presented to the emergency medical service: A comprehensive retrospective analysis in clinical settings. Journal of Clinical Medicine, 12(17), 5495. https://doi.org/10.3390/jcm12175495

Krogh, H. B., Storebø, O. J., Faltinsen, E., Todorovac, A., Ydedahl-Jensen, E., Magnusson, F. L., Holmskov, M., Gerner, T., Gluud, C., & Simonsen, E. (2019). Methodological advantages and disadvantages of parallel and crossover randomised clinical trials on methylphenidate for attention deficit hyperactivity disorder: A systematic review and meta-analyses. BMJ Open, 9(3), e026478. https://doi.org/10.1136/bmjopen-2018-026478

Liu, C., & Huang, Y. (2016). Chinese herbal medicine on cardiovascular diseases and the mechanisms of action. Frontiers in Pharmacology, 7, 469. https://doi.org/10.3389/fphar.2016.00469

Mirenayat, F. S., Hajhashemy Z., Siavash M., & Saneei P. (2023). Effects of sumac supplementation on metabolic markers in adults with metabolic syndrome: A triple-blinded randomized placebo-controlled cross-over clinical trial. Nutrition Journal, 22(1), 25. https://doi.org/10.1186/s12937-023-00854-9

Ng, C. H., Wong, Z. Y., Chew, N. W. S., Chan, K. E., Xiao, J., Sayed, N., Lim, W. H., Tan, D. J. H., Loke, R. W. K., Tay, P. W. L., Yong, J. N., Kong, G., Huang, D. Q., Wang, J.-W., Chan, M., Dalakoti, M., Tamaki, N., Noureddin, M., Siddiqui, M. S., … Muthiah, M. (2022). Hypertension is prevalent in non-alcoholic fatty liver disease and increases all-cause and cardiovascular mortality. Frontiers in Cardiovascular Medicine, 9, 942753. https://doi.org/10.3389/fcvm.2022.942753

Otsuka, T., Takada, H., Nishiyama, Y., Kodani, E., Saiki, Y., Kato, K., & Kawada, T. (2016). Dyslipidemia and the risk of developing hypertension in a working‐age male population. Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, 5(3), e003053. https://doi.org/10.1161/JAHA.115.003053

Petrovska, B. B. (2012). Historical review of medicinal plants’ usage. Pharmacognosy Reviews, 6(11), 1–5. https://doi.org/10.4103/0973-7847.95849

Ravindran, P. N., Pillai, G. S., & Divakaran, M. (2012). 28 - Other herbs and spices: Mango ginger to wasabi. In K. V. Peter (Ed.), Handbook of Herbs and Spices (Second Edition) (pp. 557–582). Woodhead Publishing. https://doi.org/10.1533/9780857095688.557

Rees, A., Dodd, G. F., & Spencer, J. P. E. (2018). The Effects of flavonoids on cardiovascular health: A Review of human intervention trials and implications for cerebrovascular function. Nutrients, 10(12), Article 12. https://doi.org/10.3390/nu10121852

Singletary, K. W. (2023). Sumac: Potential health benefits. Nutrition Today, 58(2), 77. https://doi.org/10.1097/NT.0000000000000595

Stanciu, S., Rusu, E., Miricescu, D., Radu, A. C., Axinia, B., Vrabie, A. M., Ionescu, R., Jinga, M., & Sirbu, C. A. (2023). Links between metabolic syndrome and hypertension: The relationship with the current antidiabetic drugs. Metabolites, 13(1), 87. https://doi.org/10.3390/metabo13010087

Tedla, Y. G., & Bautista, L. E. (2016). Drug side effect symptoms and adherence to antihypertensive medication. American Journal of Hypertension, 29(6), 772–779. https://doi.org/10.1093/ajh/hpv185

Vervoort, D., Kimmaliardjuk, D. M., Ross, H. J., Fremes, S. E., Ouzounian, M., & Mashford-Pringle, A. (2022). Access to cardiovascular care for Indigenous peoples in Canada: A rapid review. CJC Open, 4(9), 782–791. https://doi.org/10.1016/j.cjco.2022.05.010

Wang, G., Wang, H., Wang, J., Venugopal, J., Kleiman, K., Guo, C., Sun, Y., & Eitzman, D. T. (2018). Angiotensin II-induced hypertension is reduced by deficiency of p-selectin glycoprotein ligand-1. Scientific Reports, 8(1), 3223. https://doi.org/10.1038/s41598-018-21588-3

Wang, Q., Cui C., Guo Y., Jin F., Liu P., Zhang B., & Zhao Y. (2016). Protective effect of Chinese sumac (Rhus typhina L.) fruit extract on angiotensin II-induced hypertension. International Journal of Clinical and Experimental Medicine, 9(2), 3160–3166. Embase.

Wang, S., & Zhu, F. (2017). Chemical composition and biological activity of staghorn sumac (Rhus typhina). Food Chemistry, 237, 431–443. https://doi.org/10.1016/j.foodchem.2017.05.111

Whelton, P. K., Carey, R. M., Mancia, G., Kreutz, R., Bundy, J. D., & Williams, B. (2022). Harmonization of the American College of Cardiology/American Heart Association and European Society of Cardiology/European Society of Hypertension Blood Pressure/Hypertension guidelines: Comparisons, reflections, and recommendations. European Heart Journal, 43(35), 3302–3311. https://doi.org/10.1093/eurheartj/ehac432

World Health Organization. (2023). Hypertension. https://www.who.int/news-room/fact-sheets/detail/hypertension

Wyszyńska, J., Łuszczki, E., Sobek, G., Mazur, A., & Dereń, K. (2023). Association and risk factors for hypertension and dyslipidemia in young adults from Poland. International Journal of Environmental Research and Public Health, 20(2), 982. https://doi.org/10.3390/ijerph20020982

Zannou, O., Oussou, K. F., Chabi, I. B., Alamou, F., Awad, N. M. H., Miassi, Y. E., Loké, F. C. V., Abdoulaye, A., Pashazadeh, H., Redha, A. A., Kpoclou, Y. E., Guclu, G., Koca, I., Selli, S., & Ibrahim, S. A. (2024). Phytochemical and nutritional properties of sumac (Rhus coriaria): A potential ingredient for developing functional foods. Journal of Future Foods, 5(1), 21–35. https://doi.org/10.1016/j.jfutfo.2024.01.002

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Published

2024-06-30

How to Cite

Hosseinzadeh, A., Coleman, R., & Parvin, N. (2024). Efficacy of Sumac in Blood Pressure Modulation: A Narrative Review. The Health & Fitness Journal of Canada, 17(2), 12–22. https://doi.org/10.14288/hfjc.v17i2.845

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Vol. 17 No. 2 (2024)

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STUDENTS' CORNER

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Copyright (c) 2024 Ali Hosseinzadeh, Ryan Coleman, Neda Parvin

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