Concomitant use of medicinal plants and conventional medicines among hypertensive patients in five hospitals in Ethiopia


Background: Even if the use of medicinal plants has a long tradition in Ethiopia, little is known about which medicinal plants are concomitantly used with which conventional medicines, since patients’ disclosure to their treating physicians is low. The concomitant use of medicinal plants and conventional medicines may increase the risk of unwanted interactions, unexpected toxicities and possible under-treatment. The aim of this study was to identify plants concomitantly used with conventional medicines by hypertensive patients. Methods: A total of 365 patients and 17 healers were surveyed to identify medicinal plants commonly used by hypertensive patients. In addition, patients’ charts were reviewed to identify if they had any co-morbid conditions or history of taking medicinal plants. Descriptive statistics were used for the analysis. Results: Of 365 hypertensive patients, 171(46.8%) reported having co-morbidities, mainly hypercholesterolemia(28, 7.7%), diabetes mellitus(38, 4.9%) and asthma (12, 3.3%). While the majority (319, 87.4%) of patients preferred modern medicines for the management of their hypertension, some preferred taking holy water (24, 6.69%) and using medicinal plants (20,5.5%). The concomitant use of medicinal plants and conventional medicines was practiced by just under half of the patients (171, 46.8%). Hydrochlorothiazide, enalapril, nifedipine, amlodipine, atenolol and aspirin were the most commonly used conventional medicines. Moringa (Moringa stenopetala), damakase (OcimumlamiifoliumHochst.), haregresa (ZehneriascabraSond.) and thyme(Thymus serrulatus)were the most commonly used plants. However, none of these medicinal plants were standardized in terms of the dose, frequency, duration or method of preparation. Conclusions: Conventional medicine was the initial primary treatment choice for hypertensive patients. However, a high tendency of using medicinal plants concomitantly was observed due to the side-effects of conventional medicines, patients’ curiosity to try medicinal plants and the desire to achieve better blood pressure control. [Ethiop. J. Health Dev. 2019; 33(4):239-249] Key words: Hypertension, herb-drug interaction, medicinal plants, conventional medicine, Ethiopia