Effect of Chinese herbal medicine for calming GAN and suppressing hyperactive hang on arterial elasticity function and circadian rhythm of blood pressure in patients with essential hypertension

Study:

Location: China

Treatment

The treatment received a modified Tian Ma Gou Teng Yin given to subjects as a granule extract formula in 200ml boiling water:

10g Rhizoma Gastrodiae (Tian Ma)

20g, Ramulus Uncariae cumuncis  (Gou Teng)

30g, Goncha Haliotidia (Shi Jue Ming)

30g Concha Ostreae (Mu Li)

10g , Radix Achyranthis Bidentatae (Niu Xi)

The control group received 10 mg of Enalapril, which was increased for patients who continued to show high blood pressure after two weeks (see paper for more details)

Medical Condition

Stage one or stage two hypertension (defined by conventional blood pressure measurements )  – this equates being in the range of SBP 140-179 and DBP 90-109. Subjects were recruited on a criteria of 24H ABPM equating to a mean waking BP of > 135/85 or an asleep mean BP of > 120/70> note:

Participants

64 patient randomly divided in a 32 subject control group and 32 subject treatment group

Outcomes Measured

1. ABPM – 24h SBP and 24h DBP
2. SBP and DBP were taken in morning and evening periods
3. Trough Peak ratio
4. hemodynamics and physical properties of Carotoid artery (including elasticity)
5. nitric oxide and endothelin-1 levels

Results

Both medications were effective in lower blood pressure. The chinese herbal formula was not statistically different when comparing the metrics of 24ABPM with Enalapril. There was also no significant statistical difference in reducing pressure efficacy between the two groups. The chinese formula produced better results in some measurements:

Recovery of circadian rhythm of blood pressure in more patients than enalapril.

greater effect on NO and ET-1 levels

Trough/Peak was significantly better with Chinese herbs

More About the Treatment

Tian Ma Gou Teng Yin is a classic formula for calming liver yang and liver wind including symptoms of vertigo, insomnia and dizziness. This formula was modified by removing some herbs and adding others. the focus was on calming the liver suppressing wind and benefiting Shen.

Cochrane Quality and Risk Rating (if available)

Not available

Comments

The original formula is actually quite new – documented around 1950 by Hu Guang Ci. This formula has been used in other clinical trials including hypertension, headaches, epilepsy, ischemic stroke and vertigo. However the modification used in this trial removed 8 herbs from Tian Ma Gou Teng Yin  and added 3.

References

Effect of Chinese herbal medicine for calming GAN and suppressing hyperactive hang on arterial elasticity function and circadian rhythm of blood pressure in patients with essential hypertension,

ZHONG Guang-wei (钟广伟)1, CHEN Min-jing (陈民敬)2, LUO Yan-hong (罗艳红)1, XIANG Ling-li (相玲丽)1,XIE Qi-ying (谢启应)3, LI Yun-hui (李云辉)1, ZHANG Chen (张 臣)4, and GAO Feng (高 峰