Effects of peppermint (Mentha x piperita L.) oil on cardiometabolic outcomes in patients with pre- and stage 1 hypertension: A placebo randomized controlled trial.

Clinical Snapshot

Key Findings

• P Value: Not explicitly stated but CI excludes zero indicating statistical significance

• Effect Size: Large effect size (Cohen's d = -0.94)

• Primary Outcome: Systolic blood pressure reduction of 8.48 mmHg in peppermint group vs placebo

• Nnt Or Sensitivity: Not calculable from provided data, but clinically meaningful BP reduction achieved

• Confidence Interval: 95% CI: -14.24 to -2.73 mmHg

Clinical Application

High feasibility - peppermint oil is readily available, low-cost, and well-tolerated with simple twice-daily dosing Relevant to Australian primary care where lifestyle interventions are first-line for pre-hypertension. Not PBS-listed but accessible as complementary medicine. Aligns with RACGP guidelines emphasising non-pharmacological approaches before medication Adults with pre-hypertension and stage 1 hypertension who may benefit from non-pharmacological interventions

Abstract

Hypertension represents the predominant risk factor for cardiovascular disease morbidity and mortality; with significant healthcare utilization and expenditure. Pharmaceutical management is habitually adopted; although its long-term effectiveness remains ambiguous, and accompanying adverse effects are disquieting. Peppermint, which is rich in menthol and flavonoids, may exert potential benefits relevant to hypertension. This trial aimed to explore the effects of twice-daily peppermint oil supplementation in individuals with pre- and stage 1 hypertension. A 20 day, parallel randomized, placebo-controlled trial was adopted (NCT05561543). 40 individuals with pre- and stage 1 hypertension were randomly assigned to receive 100 μL per day of either peppermint oil or peppermint-flavoured placebo. The primary trial outcome was the between-group difference in systolic blood pressure from baseline to 20 days. Secondary outcome measurements were the between-group differences in anthropometric, haematological, diastolic blood pressure/resting heart rate, psychological wellbeing, and sleep efficacy indices. Statistical analysis was conducted on an intention-to-treat basis using baseline-adjusted linear regression models comparing post intervention values between trial arms with the corresponding baseline value entered as a covariate; adjusted mean differences (b), 95% confidence intervals, and effect sizes (d) were calculated. In relation to the primary outcome, adjusted systolic blood pressure at 20 days was significantly lower (b = -8.48 mmHg, 95% CI = -14.24 to -2.73, d = -0.94) in the peppermint trial arm (baseline = 130.05 mmHg, 20 days = 121.97 mmHg) than in placebo (baseline = 130.93 mmHg, 20 days = 131.05 mmHg). Loss to follow-up (N = 1) and adverse events (N = 1) were low, both occurring in the peppermint arm, and compliance was very high in the peppermint (93.3%) trial arm. Given the substantial health and economic burden associated with hypertension worldwide, these findings suggest that twice-daily peppermint supplementation may represent a simple, low-cost, and well-tolerated strategy to support blood pressure reduction in this population. Trial registration ClinicalTrials.gov NCT05561543.

References

1. 1.Sinclair, J., Sant, B., Du, X., Shadwell, G., Dillon, S., Butters, B., & Bottoms, L. (2026). Effects of peppermint (Mentha x piperita L.) oil on cardiometabolic outcomes in patients with pre- and stage 1 hypertension: A placebo randomized controlled trial. PloS one. https://doi.org/10.1177/2150132720940519