Efficacy and safety of Chinese herbal medicine Xiao Yao San in hypertension: A systematic review and meta-analysis

Phytomedicine

Volumn 61, Issue , 2019, Pages

  Xiong, Xingjiang ^a   Wang, Pengqian ^a   Duan, Lian ^a   Liu, Wei ^b   Chu, Fuyong ^b   Li, Shengjie ^c,d   Li, Xiaoke ^e   Su, Kelei ^f   You, Hu ^f,g   Xing, Yanwei ^a  

^a INSTITUTE OF CHINESE MATERIA MEDICA   (China)

^b BEIJING UNIVERSITY OF CHINESE MEDICINE   (China)

^c TSINGHUA UNIVERSITY   (China)

^d PEKING UNION MEDICAL COLLEGE HOSPITAL   (China)

^e MCLEAN HOSPITAL   (United States)

^f NANJING UNIVERSITY OF CHINESE MEDICINE   (China)

^g NANJING MEDICAL UNIVERSITY   (China)

Author keywords

Blood pressure; Hypertension; Meta analysis; Systematic review; Traditional Chinese medicine; Xiao Yao San

Indexed keywords

ANTIHYPERTENSIVE AGENT; C REACTIVE PROTEIN; CHINESE DRUG; HIGH DENSITY LIPOPROTEIN CHOLESTEROL; HOMOCYSTEINE; LOW DENSITY LIPOPROTEIN CHOLESTEROL; PLACEBO; TRIACYLGLYCEROL; UNCLASSIFIED DRUG; XIAO YAO SAN; HERBACEOUS AGENT; LIPID; XIAOYAO;

BLOOD PRESSURE REGULATION; CHINESE MEDICINE; CHOLESTEROL BLOOD LEVEL; COMPETITIVE INHIBITION; DEPRESSION; DIASTOLIC BLOOD PRESSURE; DRUG EFFICACY; DRUG SAFETY; HAMILTON ANXIETY SCALE; HERBAL MEDICINE; HIGH DENSITY LIPOPROTEIN CHOLESTEROL LEVEL; HUMAN; HYPERTENSION; HYPERTENSIVE PATIENT; INFLAMMATION; META ANALYSIS; PATIENT HEALTH QUESTIONNAIRE; PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL (TOPIC); REVIEW; SELF-RATING DEPRESSION SCALE; SYSTEMATIC REVIEW; SYSTOLIC BLOOD PRESSURE; TREATMENT DURATION; TRIACYLGLYCEROL BLOOD LEVEL; BLOOD; BLOOD PRESSURE; DRUG EFFECT;

ANTIHYPERTENSIVE AGENTS; BLOOD PRESSURE; DEPRESSION; DRUGS, CHINESE HERBAL; HUMANS; HYPERTENSION; LIPIDS; RANDOMIZED CONTROLLED TRIALS AS TOPIC;

EID: 85064669449     PISSN: 09447113     EISSN: 1618095X     Source Type: Journal    
DOI: 10.1016/j.phymed.2019.152849     Document Type: Review

References (80)

1. Aaron, K.H., et al. Association of anxiety and depression with hypertension control: a U.S. multi-disciplinary group practice observational study. J. Hypertens. 33 (2015), 2215–2222.
2. Borghi, C., et al. The association between blood pressure and lipid levels in Europe: european study on cardiovascular risk prevention and management in usual daily practice. J. Hypertens. 34 (2016), 2155–2163.
3. Brook, R.D., et al. Beyond medications and diet: alternative approaches to lowering blood pressure. Hypertension 61 (2013), 1360–1383.
4. Chen, J.H., et al. Estrogenic effects of flavonoid components in Xiaoyao powder. Genet. Mol. Res. 15 (2016), 1–9.
5. Chen, X.X., Zhu, Y., Effect of total glucosides of paeony on hyperglycemia and hypertension in insulin resistance rats. Neimonggu. J. Tradit. Chin. Med. 32 (2013), 37–39.
6. Chobanian, A.V, et al. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. J. Am. Med. Assoc. 289 (2003), 2560–2572.
7. Dai, Y, et al. Metabolomics study on the anti-depression effect of xiaoyaosan on rat model of chronic unpredictable mild stress. J. Ethnopharmacol. 128 (2010), 482–489.
8. Ding, X.F, et al. Xiao Yao San improves depressive-like behaviors in rats with chronic immobilization stress through modulation of locus coeruleus-norepinephrine system. Evid. Based Complement. Alternat. Med., 2014, 2014, e605914.
9. Efferth, T., Kaina, B., Toxicities by herbal medicines with emphasis to traditional Chinese medicine. Curr. Drug Metab. 12 (2011), 989–996.
10. Ettehad, D, et al. Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis. Lancet 387 (2016), 957–967.
11. Feng, R.E, et al. Effects of total glucosides of paeong on improving insulin sensitivity, lowering blood pressure and enhancing antioxidation in metabolic syndrome-hypertensive rats. Chin. J. Clin. Pharmacol. Ther. 15 (2010), 154–159.
12. Go, A.S, et al. Heart disease and stroke statistics — 2014 update: a report from the American heart association. Circulation 129 (2014), 28–292.
13. Gong, C.Q., Effect of Xiao Yao San on hypertensive patients with liver stagnation and spleen deficiency syndrome. Guangxi Univ. Chin. Med., 2010, 1–56.
14. Gong, X., et al. Efficacy and safety of Dan Zhi Xiao Yao Wan in treating hypertension with anxiety disorders. Cardio. Dise. J. Integr. Tradit. Chin. West Med. 2 (2014), 173–174.
15. Guo, F., et al. Trends in prevalence, awareness, management, and control of hypertension among United States adults, 1999–2010. J. Am. Coll. Cardiol. 60 (2012), 599–606.
16. Halperin, R.O, et al. Dyslipidemia and the risk of incident hypertension in men. Hypertension 47 (2006), 45–50.
17. Higgins, J.P, et al. Measuring inconsistency in meta-analyses. BMJ 327 (2003), 557–560.
18. Higgins, J.P.T. & Green, S. 2014. Cochrane Reviewers’ Handbook 5.3.0 [updated March 2014], Review Manager (RevMan)[Computer program]. Version 5.3.0. Available from www.cochrane-handbook.org.
19. Ho, A.K, et al. Association of anxiety and depression with hypertension control: a US multidisciplinary group practice observational study. J. Hypertens. 33 (2015), 2215–2222.
20. James, P.A, et al. 2014 Evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). J. Am. Med. Assoc. 311 (2014), 507–520.
21. Kayano, H, et al. Impact of depression on masked hypertension and variability in home blood pressure in treated hypertensive patients. Hypertens. Res. 38 (2015), 751–757.
22. Kearney, P.M, et al. Global burden of hypertension: analysis of worldwide data. Lancet 365 (2005), 217–223.
23. Laaksonen, D.E, et al. Dyslipidaemia as a predictor of hypertension in middle-aged men. Eur. Heart J. 29 (2008), 2561–2568.
24. Lawes, C.M., et al. Global burden of blood-pressure-related disease, 2001. Lancet 371 (2008), 1513–1518.
25. Li, E.M., Clinical observation on Dan Zhi Xiao Yao San in treating 45 cases of patients with early hypertension by Yuepeng Xing. Shizhen. Med. Materia Medica Res. 26 (2015), 476–477.
26. Li, M.T., Xiang, H., Advances in effective ingredients and pharmacological action of Xiaoyao Pill or Xiaoyao San research. J. Chin. Med. Mater. 33 (2010), 1968–1972.
27. Li, N, et al. TCM formula Xiaoyaosan decoction improves depressive-like behaviors in rats with type 2 diabetes. Evid. Based Complement. Alternat. Med., 2015, 2015, e415243.
28. Li, Y.Y., et al. Clinical observation of modified Xiaoyao powder combined with valsartan for treatment of climacteric hypertension. J. New Chin. Med. 44 (2012), 63–65.
29. Lim, S.S, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 380 (2012), 2224–2260.
30. Lin, C., Effect of Xiao Yao Wan combined with amlodipine besylate table in the treatment of menopausal hypertension. J. Front. Med. 5 (2012), 203–204.
31. Liu, P., et al. Effect of Xiao Yao Wan combined with western medicine in treating 59 cases of patients with menopausal hypertension. Shanxi J. Tradit. Chin. Med. 30 (2009), 789–790.
32. Liu, X.J, et al. Anti-depressant effects of Xiaoyaosan on rat model of chronic unpredictable mild stress: a plasma metabonomics study based on NMR spectroscopy. J. Pharm. Pharmacol. 64 (2012), 578–588.
33. Liu, Y.L., Dong, S.L., Effect of Dan Zhi Xiao Yao Wan in treating hypertension with anxiety disorders. Chin. J. Integr. Tradit. West Med. 28 (2008), 280–281.
34. Ma, Y.Y., Li, C.X., Clinical observation on hypertension with anxiety symptom treated with traditional Chinese combine with western medicine. J. Shanxi Coll. Tradit. Chin. Med. 16 (2015), 67–68.
35. Maatouk, I, et al. Association of hypertension with depression and generalized anxiety symptoms in a large population-based sample of older adults. J. Hypertens. 34 (2016), 1711–1720.
36. MacMahon, S, et al. Blood pressure, stroke, and coronary heart disease. Part 1, Prolonged differences in blood pressure: prospective observational studies corrected for the regression dilution bias. Lancet 335 (1990), 765–774.
37. Mao, Y.X., Preliminary study on the effect and mechanism of Xiao Yao Wan on gastrointestinal smooth muscle, heart, and blood pressure. Jinan, 2011, 1–45.
38. Meng, L., et al. Depression increases the risk of hypertension incidence: a meta-analysis of prospective cohort studies. J. Hypertens. 30 (2012), 842–851.
39. Moher, D., et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Plos Med., 6, 2009, e1000097.
40. Moise, N., et al. Depression and clinical inertia in patients with uncontrolled hypertension. JAMA Intern. Med. 174 (2014), 818–819.
41. Nakamura, H, et al. Primary prevention of cardiovascular disease with pravastatin in Japan (MEGA study): a prospective randomised controlled trial. Lancet 368 (2006), 1155–1163.
42. Neal, B., et al. Effects of ACE inhibitors, calcium antagonists, and other blood-pressure-lowering drugs: results of prospectively designed overviews of randomised trials. Blood pressure lowering treatment trialists’ collaboration. Lancet 356 (2000), 1955–1964.
43. Neupane, D, et al. Prevalence of undiagnosed depression among persons with hypertension and associated risk factors: a cross-sectional study in urban Nepal. PLoS One, 10, 2015, e0117329.
44. Ogden, L.G., et al. Long-term absolute benefit of lowering blood pressure in hypertensive patients according to the JNC VI risk stratification. Hypertension 35 (2000), 539–543.
45. Otsuka, T, et al. Dyslipidemia and the risk of developing hypertension in a working-age male population. J. Am. Heart Assoc., 5, 2016, e003053.
46. Sesso, H.D., et al. A prospective study of plasma lipid levels and hypertension in women. Arch. Intern. Med. 165 (2005), 2420–2427.
47. Sharifi-Rad, M, et al. Inhibitory activity on type 2 diabetes and hypertension key-enzymes, and antioxidant capacity of Veronica persica phenolic-rich extracts. Cell Mol. Biol. 62 (2016), 80–85.
48. Shepherd, J, et al. Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia. West of Scotland coronary prevention study group. N. Engl. J. Med. 333 (1995), 1301–1307.
49. Sterne, J.A., Egger, M., Funnel plots for detecting bias in meta-analysis: guidelines on choice of axis. J. Clin. Epidemiol., 54, 2001, 1046 1045.
50. Sun, C.L., Liu, C.H., Clinical observation on treatment of 60 cases of hypertension with anxiety symptoms by integrative medicine. J. New Chin. Med. 47 (2015), 60–61.
51. Teng, C.X., Effect of modified Xiao Yao San on 30 cases of hypertensive patients with anxiety. Hunan J. Tradit. Chin. Med. 25 (2009), 44–46.
52. The SPRINT Research Group. A randomized trial of intensive versus standard blood-pressure control. N. Engl. J. Med. 373 (2015), 2103–2116.
53. Vasan, R.S, et al. Impact of high-normal blood pressure on the risk of cardiovascular disease. N. Engl. J. Med. 345 (2001), 1291–1297.
54. Vogel, J.H, et al. American college of cardiology foundation task force on clinical expert consensus documents (Writing committee to develop an expert consensus document on complementary and integrative medicine). Integrating complementary medicine into cardiovascular medicine. A report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents (Writing Committee to Develop an Expert Consensus Document on Complementary and Integrative Medicine)J. Am. Coll. Cardiol. 46 (2005), 184–221.
55. Wang, J., Xiong, X.J., Current situation and perspectives of clinical study in integrative medicine in China. Evid. Based Complement. Alternat. Med., 2012, 2012, e268542.
56. Wang, J., Xiong, X.J., Control strategy on hypertension in Chinese medicine. Evid. Based Complement. Alternat. Med., 2012, 2012, e284847.
57. Wang, J., Xiong, X.J., Evidence-based Chinese medicine for hypertension. Evid. Based Complement. Alternat. Med., 2013, 2013, e978398.
58. Wang, L, et al. Effects of volatile oil of Angelica sinensis on the expression levels of ET-1, PGI2 and VEGF in spontaneously hypertensive rats. J. Clin. Cardio. 34 (2018), 297–300.
59. Wang, P.Q., et al. Efficacy and safety of a traditional Chinese herbal formula Xuefu Zhuyu Decoction for hypertension: a systematic review and meta-analysis. Medicine, 94, 2015, e1850.
60. Wang, Z.S., Dong, L., Effect of modified Dan Zhi Xiao Yao Wan in treating 30 cases of hypertension with anxiety disorders. Tradit. Chin. Med. Res. 25 (2012), 22–24.
61. Wang, W.H., et al. Clinical observation on 45 cases of patients with essential hypertension treated by body and mind adjustment combined with modified Dan Zhi Xiao Yao San. Hebei J. Tradit. Chin. Med. 36 (2014), 519–520.
62. World Health Report, Reducing risks, Promoting Healthy Life, 2002, 2002, World Health Organization, Geneva, Switzerland http://www.who.int/whr/2002.
63. Wu, H., Chen, X.K., Clinical observation on 42 cases of patients with menopausal hypertension treated by modified Xiao Yao San. Clin. J. Anhui Tradit. Chin. Med., 15, 2003, 479.
64. Xie, H., Effect of integrative medicine in treating hypertension with anxiety disorders. Zhejiang J. Integr. Tradit. Chin. West Med. 16 (2006), 237–239.
65. Xiong, X.J, et al. Chinese herbal formulas for treating hypertension in traditional Chinese medicine: perspective of modern science. Hypertens. Res. 36 (2013), 570–579.
66. Xiong, X.J, et al. Trends in the treatment of hypertension from the perspective of traditional Chinese medicine. Evid. Based Complement. Alternat. Med., 2013, 2013, e275279.
67. Xiong, X.J, et al. Herbal medicines for cardiovascular diseases. Evid. Based Complement. Alternat. Med., 2014, 2014, e809741.
68. Xiong, X.J., Integrating traditional Chinese medicine into Western cardiovascular medicine: an evidence-based approach. Nat. Rev. Cardiol., 12, 2015, e374.
69. Xiong, X.J., et al. Effects of traditional Chinese patent medicine on essential hypertension: a systematic review. Medicine, 94, 2015, e442.
70. Xiong, X.J, et al. Garlic for hypertension: a systematic review and meta-analysis of randomized controlled trials. Phytomedicine 32 (2015), 352–361.
71. Xiong, X.J., et al. The effect of Chinese herbal medicine Jian Ling Decoction for the treatment of essential hypertension: a systematic review. BMJ Open, 5, 2015, e006502.
72. Xiong, X.J., et al. The effects of red yeast rice dietary supplement on blood pressure, lipid profile and C-reactive protein in hypertension: a systematic review. Crit. Rev. Food Sci. Nutr. 57 (2015), 1831–1851.
73. Ye, L.L., Effect of Xiao Yao Wan on blood pressure, anxiety and depression in hypertensive patients. Clin. J. Chin. Med. 6 (2014), 26–27.
74. Yi, L, et al. Effects of volatile oil of Angelica sinensis on ACE2/Ang1-7/Mas receptor axis in spontaneously hypertensive rats. J Clin. Cardio. 33 (2017), 584–587.
75. Yokoyama, M, et al. Effects of eicosapentaenoic acid on major coronary events in hypercholesterolaemic patients (JELIS): a randomised openlabel, blinded endpoint analysis. Lancet 369 (2007), 1090–1098.
76. Zhang, Y.Q., et al. Chinese herbal formula Xiao Yao San for treatment of depression: a systematic review of randomized controlled trials. Evid. Based Complement. Alternat. Med., 2012, 2012, e931636.
77. Zhou, B.Q., Clinical observation on hypertension with depression treated by integrative medicine. Cardio. Dise. J. Integr. Tradit. Chin. West Med. 3 (2015), 32–33.
78. Zhou, X.Q., Qi, T.S., Clinical observation on 59 cases of patients with menopausal hypertension treated by integrative medicine. Sichuan Med. J. 27 (2006), 1271–1272.
79. Zhu, X, et al. Xiao Yao San improves depressive-like behavior in rats through modulation of β-arrestin 2-mediated pathways in hippocampus. Evid. Based Complement. Alternat. Med., 2014, 2014, e902516.
80. Zhu, Y.F., Effect of Modified Xiao Yao Wan on Insulin Resistance in T2DM Mice Under Chronic Psychological Stress. 2013, Guangzhou University of Chinese Medicine, Guangzhou, 1–80.