Philippine Traditional Herbal Remedies For Hypertension
Philippine Traditional Herbal Remedies For Hypertension
 Corresponding Author:
 Meliza Parba
 Department of Biological Sciences, College of Science and Mathematics,
 Mindanao State University-Iligan Institute of Technology
 Iligan City, Philippines
 Email: [email protected]
1.     INTRODUCTION
           Ischemic heart disease continues to be the leading cause of death in the Philippines in the first half of
2023 [1]. One of the major risk factors for this disease is hypertension (HTN), commonly known as high blood
pressure. The 2020 Philippine Society for Hypertension clinical practice guideline defines hypertension as an
office blood pressure (BP) of 140/90 mmHg or higher, recorded at least twice on two separate days [2]. In
2005, Kearney et al. [3] forecasted that the number of adults with hypertension worldwide would increase to
approximately 1.56 billion in the year 2025. Although the exact causes of hypertension are unknown, several
contributing factors have been identified that may increase susceptibility to developing hypertension. These
include smoking, obesity, high sodium intake, or a sedentary lifestyle [4].
           The treatment for hypertension involves both non- and pharmacological methods. Non-
pharmacological methods include a change in lifestyle that addresses the risk factors [5] and is considered the
first step in managing hypertension. On the other hand, pharmacological approaches involve the use of various
drugs, belonging to different classes, to control blood pressure. These include diuretics, sympathomimetic
agents, renin, and angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs),
calcium channel, α-adrenergic, and β-adrenergic blockers, and vasodilators [6]. However, a significant portion
of the population in the Philippines lacks the privilege of consulting a professional healthcare provider [7],
forcing them to continually rely on traditional non-pharmacological approaches such as herbal medicines.
           Plants have a long history of use for the treatment of various diseases [8], including hypertension [9].
Several clinical trials have been conducted worldwide to evaluate the antihypertensive properties of medicinal
plants. For example, powdered leaves of Hibiscus sabdariffa and Olea europaea were found to have
comparable antihypertensive efficacy and safety to captopril, a common antihypertensive drug [10]. Another
clinical trial reported significant reductions in systolic, diastolic, and mean arterial pressures of subjects treated
with Mentha longifolia, Viola odorata, and Urtica dioica, which were dependent on the dose and duration of
the treatment [11]. The results of these studies highlight the promising potential of plants as a source of
pharmaceutical drugs for hypertension.
           Currently, ten medicinal plants are endorsed by the Department of Health (DOH) and have been
thoroughly tested and clinically proven by the Philippine Institute of Traditional and Alternative Health Care
(PITAHC) as alternative medicines for certain conditions [12]. However, none of these plants has been
approved for the treatment of hypertension. Additionally, there are no published articles on the compilation of
plant species specifically used for the treatment of hypertension. Previous publications have focused on other
health issues such as cancer or tumors [13], gynecologic diseases [14], anemia [12], and obstetric care [15].
Hence, this study aims to address this gap by determining the medicinal plants used for treating hypertension
in the Philippines and providing a list of potential plants to be validated that could be used to develop future
hypertension treatments. In this systematic review, we also identified the most common plant parts, modes of
preparation, and administration used to treat hypertension in the Philippines.
2.    METHOD
          This study is a systematic review of medicinal plants used to treat hypertension in the Philippines.
This is conducted based on Preferred Reporting Items For Systematic Reviews And Meta-Analyses (PRISMA)
flow diagram [16], as shown in Figure 1. This diagram provides a visual representation of the study selection
process, which records the number of studies identified, screened, and included, and the reasons for exclusion
at each stage of the review.
Int J Public Health Sci, Vol. 14, No. 3, September 2025: 1585-1594
Int J Public Health Sci                        ISSN: 2252-8806                                                1587
[14], reflecting how the communities in the Philippines are using these medicinal plants for the treatment of
hypertension. Other types of articles, such as systematic reviews, literature reviews, and correspondence, were
excluded.
          Table 1. Synthesis of the studies with data on plants used for hypertension in the Philippines
 Author               Province                        Informants           Sample   Number of plant species used for
                                                                            Size            hypertension
  [18]    Batanes                             Locals                        112                   9
  [19]    Bataan                              Kanawan Aytas                  61                   2
  [20]    Agusan del Sur                      Manobo                         39                   1
  [21]    Ifugao                              Kalanguya tribe               125                   4
  [22]    Benguet                             Locals                         47                   1
  [23]    Aurora                              Ilongot-Eǵongot                65                   6
                                              community
  [24]    Albay                               Locals                        74                     3
  [25]    Leyte                               Locals with home garden       171                    2
  [26]    South Cotabato                      T'boli                        28                     1
  [27]    Iloilo                              Locals                        111                   13
  [28]    Cavite                              Local herbalists              106                    9
  [29]    Aklan                               Ati Tribe                     106                    2
  [30]    Antique                             Locals                        16                     1
  [31]    Agusan del Sur                      Manobos                       122                   20
  [32]    Laguna                              Local patients                15                    10
  [33]    Metro Manila                        Residents                     32                     2
  [34]    Surigao del Sur                     Residents                     65                     1
  [35]    Surigao del Sur                     Residents                     35                     1
  [36]    Davao del Sur                       Matigsalug Tribe              35                     1
  [37]    Zamboanga del Norte, del Sur, and   Bajau                         36                     2
          Sibugay
  [38]    Agusan del Norte and Surigao del    Mamanwa Tribe                  15                    1
          Norte
  [39]    Surigao del Sur                     Locals                        46                     2
  [40]    South Cotabato and Sarangani        Obo, T'boli, Blaan and        136                    1
                                              Tagakaolo
  [41]    Surigao and Agusan del Norte        Mamanwa Tribe                 78                     2
  [42]    Bukidnon                            Talaandig Tribe               66                     3
  [43]    Misamis Occidental                  Subanen Healers               60                     1
  [44]    Lanao del Norte                     Higaonon Tribe                62                     5
  [45]    Lanao del Norte                     Muslim Meranaos               122                   12
  [46]    Guimaras                            Ati Negrito                   142                   12
  [47]    Bataan                              Aetas                         77                     2
  [48]    Agusan del Sur                      Manobo Tribe                  40                     2
  [49]    Surigao del Sur                     Manobos                       66                     2
  [50]    Zamboanga del Sur                   Subanen Tribe                 89                     7
  [51]    Kalinga                             Locals                        80                     4
  [52]    Oriental Mindoro                    Mangyan                       114                    4
  [53]    Bohol                               Eskaya Traditional Healers    85                    22
3.2. Most common plant families and species used to treat hypertension in the Philippines
          A total of 44 plant families and 86 species were recorded as being used for the treatment of
hypertension. Figure 3 presents the most commonly reported (a) families and (b) species of plants used in the
Philippines. Among all plant families reported, the most represented was Poaceae, with 12 species mentioned
for the treatment of hypertension, as depicted in Figure 3(a). The dominance of Poaceae, also known as the
grass family, can be attributed to its being one of the most important flowering plant families, with a vast
distribution and abundance [54]. Family Poaceae is composed of 789 genera and 11,783 species belonging to
12 subfamilies and 54 tribes [55]. Plant families with high species richness have been reported to have more
useful species [56]. Additionally, Asteraceae is one of the second families with the greatest number of
representative species used to treat hypertension. A review of medicinal plants for hypertension therapy in Iran
[57] and South Africa [58] also listed the highest number of medicinal plants from the Asteraceae family.
          Figure 3(b) shows that the most frequently mentioned plant species is Cymbopogon citratus (DC.)
Stapf. with 16 records. This finding differs from the results of other systematic reviews, such as those conducted
globally [9] and in Nigeria [59]. These differences in species utilization could be the result of diverse social
and cultural backgrounds, which greatly influence medicinal practices across different countries [60]. They
could also be attributed to the differences in each geographical area in terms of environmental factors, such as
climate, soil fertility, and soil salinity, which affect the phytochemical composition of medicinal plants [61].
Lastly, these differences can be due to the availability of the same medicinal plants in these areas. On the other
hand, Allium sativum L., the third most frequently cited species in the Philippines, is also reported by [4], [59]
as the most mentioned plant species for treating hypertension. This commonality across different countries may
indicate the potential of Allium sativum L. as a potent remedy for hypertension.
Int J Public Health Sci, Vol. 14, No. 3, September 2025: 1585-1594
Int J Public Health Sci                       ISSN: 2252-8806                                             1589
(a)
(b)
Figure 3. Most common: (a) families and (b) species of plants used to treat hypertension in the Philippines
          Several studies have reported the antihypertensive properties of the bioactive compounds in medicinal
plants included in this review, particularly those of the frequently mentioned species. Cymbopogon citratus
(DC.) Stapf and citral, the major constituent of this plant, exhibit vasorelaxant effects ex vivo by facilitating
the secretion of endothelial vasodilators and blocking calcium channels [62]. In addition, another essential oil
constituent from C. citratus (DC.) Stapf is citronellol, which acts in the same manner as citral when evaluated
on rats [63]. Moreover, [64] reported that aqueous extracts of Annona muricata L. fruit parts (pericarp, pulp,
and seed) inhibit angiotensin-I converting enzyme (ACE) in vitro, which could be attributed to their phenolic
contents. On the other hand, allicin is the most abundant compound in raw A. sativum L. [65]. Allicin has been
reported to exhibit an antihypertensive effect through vasodilatory properties and hydrogen sulfide (H 2S)
mechanisms in spontaneously hypertensive rats [66]. These findings suggest the potential of these medicinal
plants as an alternative for managing hypertension.
3.3. Most common plant parts, mode of preparation, and administration of medicinal plants used to
       treat hypertension in the Philippines
         Figure 4 illustrates the most common 4(a) plant parts, 4(b) mode of preparation, and 4(c) administration
of medicinal plants used to treat hypertension in the Philippines. As shown in Figure 4(a), the most common
plant part used for herbal preparations was leaves (45 records). Similar findings with leaves as the most
commonly used plant parts have been recorded by other systematic reviews [9], [67]. The high usage of leaves
might be explained by the abundance of compounds found in leaves, which serve as sites for the synthesis of
secondary metabolites [68]. These secondary metabolites contribute to a variety of plant bioactivities and are
the active components of most herbal preparations [18], [28]. Additionally, leaves are widely available and are
common plant parts, especially in tropical countries, such as the Philippines [27]. This also ensures
sustainability in the use of medicinal plants compared to other plant parts, as leaves can regenerate quickly,
unlike other parts such as roots and stems [69]. The excessive use of fruits and seeds also has negative impacts
on plant genetic diversity and distribution owing to their role in sexual reproduction and dispersal [70].
           Filipinos use various methods to prepare medicinal plants for the management of hypertension. As
illustrated in Figure 4(b), the most frequently used mode of medicinal preparation was decoction, with 60 plant
species prepared this way. This result is in congruence with other systematic reviews [9], [67]. Both previous
studies reported that the common mode of medicinal preparation was decoction. Decoction is known to be one of
the simplest and oldest herbal preparations [28], which involves boiling plant materials for a certain period.
According to [71], [72], using heat on aqueous extracts accelerates biological reactions and the extraction of
bioactive components. In a randomized clinical trial assessing the effectiveness of two medicinal plants in galenic
forms of tablets and decoction for hypertension treatment, the decoction was more effective than tablets. This
result could be due to the higher absorption of bioactive compounds when prepared in this manner [73].
         Furthermore, based on Figure 4(c), the major route of administration was oral, accounting for 102
species ingested in various ways, including drinking (70 species), eating (30 species), using as a spice in
cooking, and by taking as a pill (1 species each). Oral administration is mostly preferred due to advantages like
high patient compliance, convenient administration, and minimal preparation [74]. The prevalence of oral
administration may also be attributed to the higher efficacy of plant-healing agents when taken internally [75].
(a)
(b)
(c)
 Figure 4. Most common: (a) plant parts, (b) mode of preparation, and (c) administration of medicinal plants
                               used to treat hypertension in the Philippines
         This review identifies common plants, plant parts, modes of preparation, and administration utilized
by Indigenous and local users in the Philippines for treating hypertension. This implies the essential role of
plants as a vital source of medicine in the Philippines, especially for people in remote areas with limited and
no access to modern health services. This review may help promote the conservation of valuable plant species
and the geographical areas where these plant species thrive, as medicinal plants are increasingly threatened due
to habitat destruction resulting from industrialization and climate change, as modernization progresses [17].
Int J Public Health Sci, Vol. 14, No. 3, September 2025: 1585-1594
Int J Public Health Sci                           ISSN: 2252-8806                                                     1591
The findings of this study may provide a list of potential plants that can be scientifically validated for the
treatment of hypertension, ultimately leading to drug development.
         This study has several limitations. Observational studies with data on medicinal plants for treating
hypertension have only come from fifteen regions in the Philippines. This suggests the possibility of
undocumented medicinal plants in other regions that may be useful for treating hypertension. Additionally, this
review mainly focused on the plant species, family, locale of the study, plant part used, mode of preparation,
and administration. Another systematic review must be done on the pharmacological properties of these plant
species to know which have been validated and are most effective against hypertension. Lastly, toxicological
studies are needed to determine and verify the safety of these medicinal plants in treating hypertension.
4.    CONCLUSION
          This study presents data on medicinal plants used in the Philippines to treat hypertension. Eighty-six
plant species belonging to forty-four families were reported, retrieved from 36 ethnobotanical studies included
after the eligibility screening. The findings of this study imply that medicinal plants have been used for treating
hypertension, highlighting the need to provide a scientific basis for these medicinal plants. Consequently, this
review can be used as a reference list to help discover alternative therapeutic options for treating hypertension.
Lastly, pharmacological and toxicological studies should be conducted to ensure the efficacy and safety of
medicinal plants used for hypertension treatment in the Philippines.
ACKNOWLEDGEMENTS
         The authors would like to acknowledge the Department of Science and Technology - Accelerated
Science and Technology Human Resource Development Program (DOST-ASTHRDP) for the financial
assistance, as well as the Center of Integrative Health, Premier Research Institute of Science and Mathematics
(PRISM) at Mindanao State University-Iligan Institute of Technology for providing the necessary support
needed to complete this study.
FUNDING INFORMATION
        This study is funded by the Department of Science and Technology (DOST) through the Accelerated
Science and Technology Human Resource Program (ASTHRDP).
 Name of Author              C     M       So      Va     Fo     I     R     D   O        E       Vi     Su      P     Fu
 Meliza Parba                ✓     ✓       ✓       ✓      ✓      ✓     ✓     ✓   ✓                ✓                    ✓
 Cesar G. Demayo             ✓     ✓               ✓             ✓                        ✓              ✓       ✓     ✓
DATA AVAILABILITY
        The data that support the findings of this study are available from the corresponding author, [MP],
upon reasonable request.
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Int J Public Health Sci                                 ISSN: 2252-8806                                                            1593
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BIOGRAPHIES OF AUTHORS
Int J Public Health Sci, Vol. 14, No. 3, September 2025: 1585-1594