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26 3 (2005 9 ) J Korean Oriental Med 2005;26(3):228-238 The Effect of Korean, Chinese and American Ginseng on Blood Pressure of Hypertensive Patients Cha-ro Lee, Sang-Ho Lee 1), Jun-Woo Rhee, Byong-Jo Na, Tae-Hun Kim, Woo-sang Jung, Sang-Kwan Moon, Ki-Ho Cho, Hyung-Sup Bae, Young-Suk Kim Department of Cardiovascular and Neurologic Disease(Stroke Center) College of Oriental Medicine, Kyunghee University, Seoul, Korea Department of Internal Medicine of Bupyeong Serim Oriental Hospital, Korea 1) Objectives : We conducted a randomized, double-blinded clinical trial to assess the anti-hypertensive effect of Ginseng and to know the difference of the effect according to it Øs growing districts and species by 24-hour ambulatory blood pressure measurement (ABPM). Methods : We allocated 96 hypertensive patients enrolled in this trial to Korean ginseng (KG), American ginseng (AG), Chinese ginseng (CG), and Korean red ginseng (KRG) groups by randomization. Each subject was administered 4.5mg/day of encapsulated ginseng for 4 weeks. We assessed anti-hypertensive effect, blood pressure variability using ABPM and toxicity by blood chemistry before and after treatment. We also evaluated changes of symptoms due to hypertension and adverse effect in all groups at the first visit, 2 weeks later and 4 weeks later. Results : Blood pressure after treatments showed significant decrease of systolic blood pressure (sbp) in the CG-group (p<0.05) and diastolic blood pressure (dbp) in the KRG-group (p<0.05). However, there were no significant changes of sbp (or dbp) after treatment in the other groups and no significant difference in changes of BP between before and after treatment among the 4 groups. Blood pressure variability in the CG-group showed significant decrease after treatment but not in the KRG-group. Symptoms such as headache or neck stiffness and heating sensation due to hypertension improved significantly in all groups, especially in the KRG-group. All patients had no adverse effect after treatment and there was no liver or kidney toxicity. Conclusions : CG and KRG seem to have anti-hypertensive effects, but there was no significantly different effect depending on growing district and species of Ginseng. Key Words: Blood pressure, ginseng, ambulatory blood pressure measurement, blood pressure variability, average real variability. : 2005 7 20 : 2005 8 14 : 2004 8 30 :. (Tel : 02-958-9129, Fax : 02-958-9132, E-mail : withiscar@korea.com) 2000,,,,,,. 228

(687) 1),,, 2). 3) 4). short term anti-hypertensive effect 5),, 6).,, 4. 1) 2004 6 2004 10 2 18, 70 24 JNC (Joint National Comitee On Prevention, Detection, Evaluation and Treatment of High Blood Pressure) 7) (prehypertension) 1 (Stage 1 hypertension),. 24 (,,, X, ), -HCG,. ( >1.5mg/dl, AST, ALT ) 2 3 (,, ) 2). 20% (2 3 ) 3) 24 120-139/80-99mmHg 140-150/90-99mmHg,,,., Panax Ginseng C.A. Meyer (American Ginseng) Panax quinquefolius., (Table 1). 1.0mm K-11-1(Japan) 229

(688) 26 3 (2005 9 ) 375mg., 4 1 4, 4., 2. 1),, (100 ), 8. 2) 24 4 24 (TM-2421 made in A&D company, Japan) Oscillometric method, 10 10, 24 1. :. 24 : Blood Pressure Variability(BPV), Average Real Variability(ARV). Visual Analogue Scale(VAS).,, 3., 2, 4. 3) :,,. : 2. 24 >240mmHg or <50mmHg, >140mmHg or <40mmHg, >100mHg or <20mmHg, >125 or <45 8), 3 data 5 13. VAS, paired t-test, Wilcoxon signed rank test, one-way ANOVA test, Kruskall-Wallis test, Chi-square test. SPSS 12.0, p<0.05. (2004.5.17). 123 14, 13 3 96. 28, 1 2 230

(689) Table 1. Remaining Agricultural Chemicals from Chinese Ginseng, American Ginseng, Korean Ginseng and Korean Red Ginseng Used in this Study. Agricultural Permitted Limit Chemicals Name (ppm) KG AG CG KRG BHC 0.2 ND. ND. 0.007 ND. DDT 0.1 ND. ND. ND. ND. Aldrin/Diedrin 0.01 ND. ND. ND. ND. Endrin 0.01 ND. ND. ND. ND. Quintozene 1.0 0.107 0.590 0.009 0.008 Endosulfan 0.2 0.099 ND. ND. 0.056 Captan 2.0 ND. ND. ND. ND. Parathion 0.1 ND. ND. ND. ND. Diazinon 0.1 ND. ND. ND. ND. Metalaxyl 1.0 - - - - Carbendazim 0.5 - - - - Deltamethrin 0.02 ND. ND. ND. ND. Diethofencarb 0.5 ND. ND. ND. ND. Cypermethrin 0.1 ND. ND. ND. ND. Azoxystrobin 0.5 ND. ND. ND. ND. TolyFluanid 0.3 ND. ND. ND. ND. Tolclofosmethyl 1.0 0.088 ND. 0.012 0.055 Difenoconazole 0.2 ND. ND. ND. ND. Procymidone 0.4 0.400 ND. ND. 0.214 Limits are based upon standard of dry ginseng KG indicates Korean Ginseng; AG, American Ginseng; CG, Chinese Ginseng; KRG, Korean Red Ginseng; BHC, Benzene hexachloride; DDT, Dichloro-diphenyl-trichloroethane; ND. No detected. Table 2. Baseline Characteristics in Chinese Ginseng, American Ginseng, Korean Ginseng and Korean Red Ginseng Group. Korean American Chinese Korean Red Ginseng Ginseng Ginseng Ginseng Sig. (n=22) (n=25) (n=24) (n=25) Age (yr) 50.4 8.2 51.3 9.3 51.6 5.8 50.3 10.9 NS.* Sex (M/F) 11/11 13/12 12/12 13/12 NS. sbp(mmhg) 131.2 8.8 130.9 11.8 132.3 8.0 135.2 8.4 NS.* dbp(mmhg) 83.7 8.1 84.8 7.5 84.8 7.0 85.8 6.2 NS.* Medical history HTN medication 7 7 9 5 NS. Diabetes 0 1 1 0 NS. Hyperlipidemia 0 3 1 2 NS. * by One-way ANOVA test by Chisquare test Sig. indicates Significance; NS., non-significant; HTN, Hypertension; sbp, systolic blood pressure; dbp, diastolic blood pressure..,, lipid profile. (Table 2). 1) 231

(690) 26 3 (2005 9 ) Table 3. Changes of Blood Pressure from Baseline in Korean Ginseng, American Ginseng, Chinese Ginseng and Korean Red Ginseng Group. Korean American Chinese Korean Red Ginseng Ginseng Ginseng Ginseng Sig.* (n=22) (n=25) (n=24) (n=25) sbp, mmhg Baseline 131.2 8.8 130.9 11.8 132.3 8.0 135.2 8.4 After 4 weeks 129.5 12.5 132.1 13.5 129.2 8.1 132.7 11.4 Change -1.7 10.0 1.2 7.9-3.1 6.2-2.5 8.5 NS. Sig. NS. NS..023 NS. dbp, mmhg Baseline 83.7 8.1 84.8 7.5 84.8 7 85.8 6.2 After 4 weeks 82.0 9.9 85.2 9.7 83.0 7.1 83.2 8.1 Change -1.6 7.8 0.3 5.2-1.8 4.8-2.6 5.2 NS. Sig. NS. NS. NS..019 Values are mean standard deviation * by One-way ANOVA test by Paired T-test Sig. indicates Significance; NS., non-significant; sbp, Systolic blood pressure; dbp, Diastolic blood pressure. Table 4. Changes of Blood Pressure Variability in Korean Red Ginseng and Chinese Ginseng Group. sbp dbp Baseline After Mx. Sig.* Baseline After Mx. Sig.* KRG(n=25) BPV 17.7 6.3 16.1 4.2 NS. 13.5 4.3 13.3 3.8 NS. ARV 15.8 7.0 15.3 4.5 NS. 12.5 4.6 12.4 4.7 NS. CG(n=24) BPV 16.9 4.5 15.4 4.3 NS. 14.2 4.5 11.4 3.6.006 ARV 15.2 3.5 13.6 4.8 NS. 14.9 4.2 11.4 4.1 <.001 Values are mean standard deviation * by Paired T-test sbp indicates Systolic blood pressure; dbp, Diastolic blood pressure; Mx, Medication; Sig., Significance; NS., non-significant; KRG, Korean Red Ginseng; CG, Chinese Ginseng; BPV, Blood Pressure Variability; ARV, Average Real Variability. Table 5. Changes of Symptoms (Visual Analogue Sclae) Due to High Blood Pressure in All Subjects. Baseline After Mx. Sig. Headache or Heating (n=33) 57.4 24.3 29.1 26.1 <0.001* Headache (n=23) 53.3 23.0 28.5 22.0 <0.001* Heating (n=7) 67.9 24.0 37.9 38.5 0.043 Values are mean standard deviation * by Paired T-test by Wilcoxon signed rank test Mx. indicates Medication; Sig., Significance.,,., 4 (Table 3). 2) 24 BPV 232

(691) Table 6. Changes of Symptoms(Visual Analogue Scale) Due to High Blood Pressure in Korean Red Ginseng Group Only. Baseline After Mx. Sig.* Headache or Heating (n=12) 58.8 21.0 20.0 28.0.001 Headache (n=7) 57.1 18.9 22.9 23.6.016 Heating (n=4) 60.0 29.7 20.0 40.0 NS. Values are mean standard deviation * by Wilcoxon signed rank test Mx. indicates Medication; Sig., Significance; NS., non-significant. Table 7. Changes of Aspartate aminotransferase(ast), Alanine aminotransferase(alt), Blood urea nitrogen(bun), Creatine(Cr) in All subjects Baseline After Mx. Sig.* AST(U/L) 22.2 7.9 23.6 6.8.027 ALT(U/L) 23.6 16.4 24.3 14.6 N.S. BUN(mg/dl) 13.3 3.5 13.2 3.5 N.S. Cr(mg/dl) 0.87 0.17 0.87 0.18 N.S. Values are mean standard deviation by Paired t-test Mx. indicates Medication; Sig., Significance; AST, aspartate aminotransferase; ALT, alanine aminotransferase; BUN, Blood urea nitrogen; Cr, Creatine.. BPV ARV. BPV (Table 4). 3),, VAS (Table 5). (Table 6), 3. 3. 4. AST,. ALT, BUN, Cr (Table 7). 2000 9), 2001 1000 259.8, 10).,,. 1991 29.9% 2001 10.2% 10,11). 12) 1999 (36.0%) angiotensin-converting enzyme (ACE) inhibitor(18.1%)., amlodipine 22%, ACE inhibitor 3-25% 13). ACE inhibitor 14), 15). 233

(692) 26 3 (2005 9 ) 16). 17), 18), 19), 20). Kim 21) NO, oxygen free radical injury, Jeon 22) Gillis 25) NO. Han 23) 12 NO level, Sung 24) NO.,., 24. 24 26), 4)., 27) 3.0g/,. 28) 3-4g/, 4.5g/, 4). 4.5g/.,,, 4. Panax ginseng (Asian ginseng), Panax quinquefolius (American ginseng), Panax japonicus (Japanese ginseng) 3. Panax ginseng, Panax quinquefolius (American ginseng),, 29)., asian ginseng, american ginseng.,,,,., Pringle 30) BPV stroke cardiovascular event, end-organ damage BPV 31). 24 2-4. 1, 1, 7 32)., BPV ARV 33). BPV ARV. 4.,., Han 4). 234

(693) 24 BPV. BPV ARV., BPV...,,,, 34,35).,,,, (Health Related Quality of Life, HRQoL) 36).,.,, 37)...,,. 38,39 )., 4) 8. 4.5g/. 3g, 15g 2 133 14,,, 35).,. 24 1 96,, 4. 1.,,. 4. 2. BPV(SD ARV),. 3. VAS,. 4., 235

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