Prevalence and determinants of herbal medicine utilization and phytochemical analysis of selected used plants among hypertensive patients at Mulago National Referral Hospital, Uganda

Abstract

Background: Hypertension remains a major public health challenge in Uganda, with many patients using herbal medicine alongside conventional treatments. However, data on prevalence, associated factors, commonly used plants, and their phytochemical properties remain limited. This study aimed to determine the prevalence and factors influencing herbal medicine use among hypertensive patients at Mulago National Referral Hospital and analyze the phytochemical composition of two frequently used medicinal plants. Methods: A cross-sectional study was conducted among 384 hypertensive patients attending Mulago Hospital’s outpatient clinic. Data were collected using a structured questionnaire. Two commonly reported plants (Spathodea campanulata and Solanum anguivii) were selected for phytochemical screening using decoction, cold maceration, and Soxhlet extraction methods. Standard tests identified alkaloids, flavonoids, glycosides, saponins, and other bioactive compounds. Modified Poisson regression analyzed factors associated with herbal medicine use. Results: The prevalence of herbal medicine use was 76.8%, with 20.8% concurrently using herbal and conventional medicines. Key factors associated with herbal medicine use included marital status (married patients: aPR=1.59, p=0.002), lower education (primary level: aPR=0.83, p=0.032), and prior hypertension diagnosis (aPR=2.10, p=0.003). Patients receiving information from traditional healers were 11% more likely to use herbal medicine (p=0.049). Garlic (41.1%) and ginger (25.8%) were the most cited plants, followed by Solanum anguivii (12.2%) and Spathodea campanulata (11.2%). Phytochemical analysis of S. anguivii and S. campanulata revealed flavonoids, alkaloids, terpenoids, and glycosides in both plants, supporting their potential antihypertensive effects . Only 15% of participants reported being asked by doctors about herbal medicine use, with 45% experiencing side effects (e.g., nausea, allergic reactions). Conclusion: Herbal medicine is widely used among hypertensive patients in Uganda, driven by accessibility, cultural beliefs, and perceived efficacy. The presence of bioactive compounds in S. campanulata and S. anguivii validates their traditional use but underscores the need for safety and efficacy studies. The low disclosure rate to healthcare providers highlights risks of herb-drug interactions, necessitating policy integration, patient education, and clinician awareness to optimize hypertension management. Future research should expand phytochemical analyses and clinical trials for commonly used plants. Keywords: Hypertension, herbal medicine, phytochemical screening, Spathodea campanulata, Solanum anguivii, prevalence