Abstract
<title>Abstract</title> <p> Systemic Arterial Hypertension (SAH) affects about 30% of adults and 60% of those aged 65 or older in Brazil, and medicinal plants are widely used as hypotensives. This review asked whether the hypotensive effects popularly attributed to plants used in Brazil are corroborated, contradicted, or simply unstudied in the pharmacological literature for the same species, and characterised their patterns of use. A narrative review with a structured literature search was conducted in ScienceDirect, PubMed/MEDLINE, SciELO, Springer Link, Wiley and Google Scholar (1985–2024), using English and Portuguese search terms, followed by a species-directed search for pharmacological evidence. A total of 114 species in 46 families were identified from 44 ethnobotanical/ethnopharmacological surveys, with pharmacological data drawn from 95 studies. The most cited species were <italic>Cymbopogon citratus</italic> (14), <italic>Lippia alba</italic> (11) and <italic>Sechium edule</italic> (10); the most cited families were Lamiaceae, Poaceae and Asteraceae. Leaves (76.3%) and infusion (59.6%) predominated. Evidence was graded by category and level. No species (0%) showed pharmacological evidence contradicting its popular hypotensive use; 39 species (34.2%) had no blood-pressure study identified (evidence gap); and 75 (65.8%) had supporting evidence, although only 49 (43.0% of all species) rested on direct in vivo or human blood-pressure data, the remainder being indirect/mechanistic. Thus the apparent “divergence” reflects evidence gaps rather than disagreement. Most popular uses are plausible, but the largely preclinical evidence base warrants caution before clinical recommendation and supports further validation within Primary Health Care. </p>