US researchers examined the evidence for the efficacy of ginseng (Panax spp.) on cardiovascular risk factors, including blood pressure, lipid profiles and blood glucose, and to summarise reported cardiovascular adverse events. They searched Medline, Amed, Biosis, Cab, Embase and the Cochrane Controlled Trials databases to July 2005 and performed hand searches of bibliographies. Short- or long-term RCTs and non-randomised studies published in English were included. Data were extracted in a standardised manner and two independent investigators assessed the methodological quality of the studies. Thirty-four studies were identified with results for blood pressure, lipids and/or blood glucose. Data on cardiovascular adverse events were extracted from events reported in identified studies and from case reports. The majority of studies were short term. Panax spp. may slightly decrease blood pressure compared with placebo (range 0–4%). Mixed results were found for an effect on lipids, with five of nine studies showing improvement in one or more lipid parameters compared with baseline (range 7–44%). Several studies suggested that ginseng lowers blood glucose, but overall studies were inconsistent.