Effect of Korean Red Ginseng (Panax Ginseng C.A. Meyer) and American Ginseng (Panax Quinquefolius L.) on Blood Pressure Control and Cardiometabolic Risk Factors

Hypertension is a strong risk driver of cardiovascular disease, particularly prevalent in type 2 diabetes. Suboptimal risk management supports evidence-based adjunctive approaches to standard therapy to help attain treatment targets. Ginseng ranks among most highly used herbal supplement with equivocal clinical evidence. Korean red ginseng (KRG) and American ginseng (AG) may have cardio-metabolic benefits relating to blood pressure (BP) and vascular function in addition to regulating hyperglycemia. In particular, ginsenoside Rg3, present in KRG, was identified to have BP lowering potential. The objective of this thesis was to asses: 1) the effect of single dose ginsenoside Rg3-enriched KRG administration on hemodynamic indices in healthy individuals in a pilot randomized controlled trial (RCT) and subsequently 2) the effect of 12-week co-administration of Rg3-enriched KRG and AG intervention on systolic BP (primary outcome) in addition to metabolic risk factors and safety monitoring in individuals with type 2 diabetes and hypertension in a RCT, and 3) the impact of the combined intervention on related vascular function markers and pulse pressure wave components within the 12-week study. Results: Single dose Rg3-enriched KRG administration significantly improved the hemodynamic profile 3h-post intake including augmentation index, central systolic, diastolic and mean arterial BP. A 12-week combined Rg3-KRG and AG intervention resulted in a reduction of 24-h-systolic BP (-3.98±2.0 mmHg, p=0.04) relative to control. Additionally, HbA1c (-0.35±0.2%, p=0.02) and lipids, including non-HDL-C (-0.54±0.2 mmol/l, p=0.01) and triglycerides (-0.43±0.2 mmol/l, p=0.01) were reduced, in absence of adverse effects. Central systolic BP reduction (-4.7±2.2 mmHg, p=0.04) was paralleled by improvement in systolic waveform components, but no effect on measured markers of endothelial function, arterial stiffness or pressure augmentation. Use of standardized ginseng combination may serve as a viable natural health product adjunct to pharmacotherapy for cardiometabolic management of type 2 diabetes.Ph.D.2020-03-25 00:00:0