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Herbal Products That May Contribute to Hypertension

Jalili, Jamal M.D.; Askeroglu, Ufuk M.D.; Alleyne, Brendan B.S.; Guyuron, Bahman M.D.

Plastic and Reconstructive Surgery: January 2013 - Volume 131 - Issue 1 - p 168–173
doi: 10.1097/PRS.0b013e318272f1bb
Cosmetic: Original Articles

Background: The role of hypertension in the incidence of postoperative hematoma has been well documented. A large number of patients who undergo aesthetic surgery consume a variety of herbal products, some of which may cause or exacerbate hypertension. The purpose of this study was to review the herbal products that are known to cause hypertension and thus may play a role in postoperative complications.

Methods: The MEDLINE and PubMed databases were searched for articles published from 1991 to 2011. Search terms included “hypertension,” “herbal supplements,” “herbals and hypertension,” “blood pressure,” and “dietary supplements.” References from reviews about herbal products and hypertension were searched for additional articles and case reports. A manual search was also conducted based on citations in the published literature.

Results: Of 56 articles that were found to be related to herbal supplements that contribute to hypertension, 27 were excluded because of insufficient demonstration of the association or duplication. Twenty-nine articles, which examined the cause, pathophysiology, and risk factors of hypertension in addition to herbals, were included. In addition, four books were reviewed that contained some information regarding the association of hypertension and herbal products. The herbal products that may cause hypertension include arnica, bitter orange, blue cohosh, dong quai, ephedra, ginkgo, ginseng, guarana, licorice, pennyroyal oil, Scotch broom, senna, southern bayberry, St. John's wort, and yohimbine.

Conclusion: This study lists the herbal products that may cause hypertension and should be considered when a patient undergoes plastic surgery to reduce perioperative morbidity related to the herbal supplements.

Cleveland, Ohio

From the Department of Plastic Surgery, Case Western Reserve University.

Received for publication July 12, 2012; accepted August 10, 2012.

Disclosure:The authors have no financial interest to declare in relation to the content of this article.

Bahman Guyuron, M.D.; 29017 Cedar Road, Cleveland, Ohio 44124,

©2013American Society of Plastic Surgeons