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

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Background Hypertension has become a part of many people's lives. With the development, more and more people begin to control hypertension through products of medicine food homology, such as BYHWD. However, there is no objective review of BYHWD regulation of hypertension. Methods As of October 2022, this review made a detailed search of nine databases to look for RCTs of BYHWD for hypertension. This was followed by network pharmacological analysis, and molecular docking using AutoDockTools to explore the mode of action. Results BYHWD was effective in reducing SBP (MD: 0.767; 95 % CI: 0.629, 0.905; p = 0.000), DBP (MD: 0.427; 95 % CI: 0.292, 0.561; p = 0.000), 24h SBP (MD: 0.665; 95 % CI: 0.368, 0.962; p = 0.000), 24h DBP (MD: 0.547; 95 % CI: 0.318, 0.777; p = 0.000), dSBP (MD: 0.625; 95 % CI: 0.395, 0.855; p = 0.000), dDBP (MD: 0.632; 95 % CI: 0.401, 0.862; p = 0.000), nSBP (MD: 0.859; 95 % CI: 0.340, 1.377; p = 0.001), nDBP (MD: 0.704; 95 % CI: 0.297, 1.112; p = 0.001), pv (MD: 1.311; 95 % CI: 0.363, 2.259; p = 0.007) and NIHSS (MD: 1.149; 95 % CI: 0.100, 2.199; p = 0.032), and elevating CER (OR = 2.848; 95 % CI: 1.388, 5.843; p = 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, firstly, the main active ingredient of BYHWD is quercetin, and the core targets are AKT1, MMP9, etc. Molecular docking also showed that quercetin mainly interacts with amino acid residue CYS-28 of MMP2. Secondly, the KEGG analysis showed that BYHWD mainly act on HIF-1, Apelin, and cGMP-PKG signaling pathways, etc and GO analysis showed it related to apical part of cell, circulatory system process and nuclear receptor activity, etc. Conclusion: BYHWD can lower blood pressure, reduce plasma viscosity, and restore neurological function with good tolerability, and there is no significant effect on homocysteine. This study further demonstrated that quercetin is a potentially active compound of BYHWD, acting by AKT1 and HIF-1 signaling pathways. Above research results provide new guidances for people's dietary choices.

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