The Safety of Common Herbal Supplements in Patients with Diabetes and Hypertension: A Systematic Review of Herb-Drug Interactions

Abstract

Introduction: Patients with diabetes and hypertension are often on multiple medications and frequently use herbal supplements. The potential for herb-drug interactions in this population is high but not well-documented. This review synthesizes the evidence on interactions between common herbs and anti-diabetic or anti-hypertensive drugs.

Methods: A systematic search of clinical studies and case reports was conducted in PubMed and toxicology databases. We focused on interactions between herbs like St. John's Wort, ginseng, and garlic and drugs like metformin, sulfonylureas, ACE inhibitors, and beta-blockers.

Results: Significant interactions were identified. For instance, St. John's Wort can reduce the efficacy of certain calcium channel blockers, while ginseng may have additive hypoglycemic effects when taken with sulfonylureas, increasing the risk of severe hypoglycemia. Garlic may potentiate the effects of anticoagulants and some antihypertensives.

Discussion: Clinically relevant herb-drug interactions are a major safety concern for patients with diabetes and hypertension. A lack of patient disclosure and clinician awareness exacerbates the risk.

Conclusion: There is a significant risk of adverse herb-drug interactions in patients with diabetes and hypertension, warranting increased vigilance.