Efficacy of Chinese herbal medicine on health-related quality of life (SF-36) in hypertensive patients: A systematic review and meta-analysis of randomized controlled trials

• This study systematically assessed published RCTs of Chinese Herbal Medicine improving HRQL in hypertensive patients that employ the SF-36 as an outcome measure.
• Meta-analysis showed that CHM appears to have beneficial effects on improvement of HRQL in hypertensive patients.
• Methodological quality assessment showed the actual situation of RCTs conducted in China. The majority of the included RCTs were poor methodological quality and further high quality RCTs should be carried out and reported in detail according to CONSORT.

SummaryObjectivesThis study aims to evaluate published randomized controlled trials (RCTs) of Chinese Herbal Medicine (CHM) improving health-related quality of life (HRQL) in hypertensive patients that employ the Short-Form 36-Item Health questionnaire (SF-36) as an outcome measure.MethodsFive electronic databases were searched up to October 2013 to identify RCTs of CHM for hypertension. The primary outcome was SF-36. Trial selection, data extraction, methodological quality assessment, and data analyses were conducted according to the Cochrane handbook.ResultsEleven RCTs with total of 1043 participants were identified. The majority of the included trials were assessed to be of poor methodological quality and high clinical heterogeneity. Meta-analysis shows a significant improvement both in physical component summary (PCS) measure and mental component summary (MCS) measure of SF-36, with physical functioning (WMD = 8.54[5.34, 11.74], p < 0.001), role physical (WMD = 13.32[7.03, 19.61], p < 0.001), bodily pain (WMD = 10.53[6.46, 14.60], p < 0.001), general health (WMD = −5.56[2.09, 9.02], p < 0.001), vitality (WMD = 6.84[4.33, 9.53], p < 0.001), social functioning (WMD = 7.50[2.63, 12.36], p < 0.001), role emotional (WMD = 12.06[4.45, 19.68], p < 0.001) and mental health (WMD = −5.68[2.90, 8.47], p < 0.001). CHM can also decrease systolic blood pressure (WMD = −4.45 [−6.71, −2.19], p < 0.001) and relieve symptoms related to hypertension.ConclusionsCHM appears to have beneficial effects on improvement of HRQL in hypertensive patients. However, the findings should be interpreted with caution due to the poor methodological quality and high clinical heterogeneity of the included trials. Further clinical trials should be carried out to provide more reliable evidence.