Efficacy and safety of berberine for several cardiovascular diseases: A systematic review and meta-analysis of randomized controlled trials

Yang et al., 2023 | Phytomedicine | Meta Analysis

Citation

Yang Lele, Zhu Wenyu, ... Shen Tao. Efficacy and safety of berberine for several cardiovascular diseases: A systematic review and meta-analysis of randomized controlled trials. Phytomedicine. 2023-Apr;112:154716. doi:10.1016/j.phymed.2023.154716

Abstract

BACKGROUND: Berberine has been widely used for the adjuvant therapy of several cardiovascular diseases (CVDs). However, evidence for its efficacy remains controversial. PURPOSE: This study aimed to evaluate the efficacy and safety of berberine in CVDs. STUDY DESIGN: A systematic review and meta-analysis of randomized controlled trials (RCTs). METHODS: We searched ten electronic databases for articles from inception to December 23, 2022. RCTs comparing berberine alone or combined with statins versus statins or routine for CVDs were included. Meta-analysis was performed according to the Cochrane Handbook. RESULTS: Forty-four RCTs were included with 4606 patients. There were no differences between berberine alone and routine or statins in improving total cholesterol (TC) (SMD, 0.43; 95% CI, -0.39 to 1.24; p = 0.30; I2 = 95%), triglyceride (TG) (SMD, -0.14; 95% CI, -0.49 to 0.21; p = 0.44; I2 = 76%), low-density lipoprotein cholesterol (LDL-C) (SMD, 0.69; 95% CI, -0.23 to 1.60; p = 0.14; I2 = 96%), high-density lipoprotein cholesterol (HDL-C) (SMD, 0.55; 95% CI, -0.48 to 1.57; p = 0.30; I2 = 96%), and Crouse score levels. Berberine alone significantly reduced National Institute of Health Stroke Scale (NIHSS) score, high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and intima-media thickness (IMT) levels than routine therapy. Berberine plus statins significantly reduced TC, TG, LDL-C, NIHSS score, hs-CRP, TNF-α, IMT, Crouse score, and number of unstable plaques levels than routine or statins. However, no differences were found between groups in improving HDL-C and IL-6 levels. There were no significant differences between groups in the incidence of adverse reactions. CONCLUSION: This study suggests that berberine may be a promising alternative for CVDs with no serious adverse reactions. However, our results may be limited by the quality of existing research. High-quality RCTs are needed to provide more convinced evidence.

Key Findings

Forty-four RCTs were included with 4606 patients. There were no differences between berberine alone and routine or statins in improving total cholesterol (TC) (SMD, 0.43; 95% CI, -0.39 to 1.24; p = 0.30; I2 = 95%), triglyceride (TG) (SMD, -0.14; 95% CI, -0.49 to 0.21; p = 0.44; I2 = 76%), low-density lipoprotein cholesterol (LDL-C) (SMD, 0.69; 95% CI, -0.23 to 1.60; p = 0.14; I2 = 96%), high-density lipoprotein cholesterol (HDL-C) (SMD, 0.55; 95% CI, -0.48 to 1.57; p = 0.30; I2 = 96%), and Crous

Outcomes Measured

• C-reactive protein

Population

MeSH Terms

• Humans
• Hydroxymethylglutaryl-CoA Reductase Inhibitors
• Berberine
• Cardiovascular Diseases
• Cholesterol, LDL
• C-Reactive Protein
• Tumor Necrosis Factor-alpha
• Interleukin-6
• Randomized Controlled Trials as Topic
• Triglycerides
• Cholesterol, HDL

Evidence Classification

• Level: Meta Analysis
• Publication Types: Meta-Analysis, Systematic Review, Journal Article
• Vertical: berberine

Provenance

• PMID: 36805484
• DOI: 10.1016/j.phymed.2023.154716
• PMCID: Not in PMC
• Verified: 2026-04-09 via PubMed E-utilities API

Source extracted via PubMed E-utilities API on 2026-04-09