Antihypertensive effect and mechanism of the traditional recipe of medicine food homology (Buyang Huanwu Decoction) in China: Meta analysis and network pharmacological exploration.

BACKGROUND

Hypertension has become a part of the lives of many people worldwide. With the development, an increasing number of people have begun to control their hypertension through products of medicine food homology, such as Buyang Huanwu Decoction (BYHWD). However, there has been no objective review of the regulation of hypertension by BYHWD.

METHODS

As of 9 October 2023, this review made a detailed search of nine databases to look for random controlled trials (RCTs) focused on the use of BYHWD for treating hypertension. This was followed by network pharmacological analysis, and molecular docking assessment using AutoDockTools to explore the mode of action.

RESULTS

BYHWD was effective in reducing SBP (MD: 0.767; 95 % CI: 0.629, 0.905;  = 0.000), DBP (MD: 0.427; 95 % CI: 0.292, 0.561;  = 0.000), 24h SBP (MD: 0.665; 95 % CI: 0.368, 0.962;  = 0.000), 24h DBP (MD: 0.547; 95 % CI: 0.318, 0.777;  = 0.000), dSBP (MD: 0.625; 95 % CI: 0.395, 0.855;  = 0.000), dDBP (MD: 0.632; 95 % CI: 0.401, 0.862;  = 0.000), nSBP (MD: 0.859; 95 % CI: 0.340, 1.377;  = 0.001), nDBP (MD: 0.704; 95 % CI: 0.297, 1.112;  = 0.001), pv (MD: 1.311; 95 % CI: 0.363, 2.259;  = 0.007) and NIHSS (MD: 1.149; 95 % CI: 0.100, 2.199;  = 0.032), and elevating CER (OR = 2.848; 95 % CI: 1.388, 5.843;  = 0.004). However, BYHWD did not significantly reduce HCY, and there was no significant difference in the incidence of AE. In terms of the mechanism of action, the main active ingredient of BYHWD is quercetin, and the core targets are AKT1, MMP9, and others. Molecular docking also showed that quercetin mainly interacts with the amino acid residue CYS-28 of MMP2. Second, the KEGG analysis showed that BYHWD mainly act on HIF-1, Apelin, and cGMP-PKG signalling pathways, and GO analysis showed that it related to the apical part of the cell, circulatory system processes, and nuclear receptor activity. BYHWD can lowered blood pressure, reduced plasma viscosity, and restored neurological function with good tolerability, and had no significant effect on HCY levels. This study further demonstrated that quercetin is the main active ingredient of BYHWD that acts via the AKT1 and HIF-1 signalling pathways. These results provide new guidance for people's dietary choices by the general public.