Effectiveness and Safety of Ayurvedic Intervention in Essential Hypertension: A Systematic Review with Meta-analysis

Saylee Deshmukh^1*Kuldeep Choudhary¹Azeem Ahmad²Govind Reddy¹BCS Rao²Narayanam Srikanth²Rabinarayan Acharya²

• ¹Raja Ramdeo Anandilal Podar Ayurveda Cancer Research Institute, Mumbai, India
• ²Central Council for Research in Ayurvedic Sciences, New Delhi, India

Background: Essential hypertension (EH), a major contributor to cardiovascular morbidity and mortality, remains a public health challenge owing to poor control and adherence. Many clinical trials exhibit the effectiveness of Ayurvedic formulation and procedures in the management of Essential Hypertension. This systematic review and meta-analysis evaluated the effectiveness and safety of Ayurvedic interventions compared to the conventional therapy in Essential Hypertension. Method: A systematic review and meta-analysis followed PRISMA guidelines. Literature was searched through PubMed, Cochrane Library, Directory of Open Access Journals (DOAJ), Google Scholar, AYUSH Research Portal, and Ayurveda Research Database (ARD) up to May 2025. Studies included randomized and non-randomized controlled trials, observational, and pre-post studies of Ayurvedic interventions for EH. Primary outcomes were systolic and diastolic blood pressure changes. Risk of bias of ten RCTs included in meta-analysis was assessed using Cochrane guidelines. Meta-analysis was performed in two groups-Ayurveda vs placebo and Ayurveda vs standard antihypertensives using RevMan 5.4. Result: 44 studies were included in the systematic review, with ten RCTs involving 524 participants in the meta-analysis. Interventions included single herbs, polyherbal/herbomineral formulations, and Panchakarma therapies. Compared to placebo (n=118), Ayurveda showed a non-significant reduction in systolic BP (MD = −2.63 mmHg; 95% CI: −6.04 to 0.79; p=0.13) and diastolic BP (MD = −2.67 mmHg; 95% CI: −7.44 to 2.09; p=0.27). Compared to standard antihypertensives (n=396), reductions in systolic BP (MD = −0.22 mmHg; 95% CI: −0.82 to 0.38; p=0.47) and diastolic BP (MD = −0.66 mmHg; 95% CI: −1.67 to 0.35; p=0.20) were non-significant. High heterogeneity (I² > 90%) was observed. Conclusion: This systematic review shows Ayurvedic interventions, while not achieving significant blood pressure reductions versus conventional treatments, may provide clinical benefits with good safety. Study heterogeneity and methodology limit conclusions. High-quality, multicenter RCTs with standardized interventions are needed for assessment of effectiveness.