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As a traditional edible beverage and medicinal application for high-pressure blood treatment with no side effects, Hibiscus sabdariffa L. (HS) has high prospect to be nutraceuticals as diet additive for anti-hypertension. The anti-hypertension effect of HS has also been scientific validated recently especially in diabetic patient and post-partum mothers. In this paper, we reviewed up-to-date mechanisms found for the anti-hypertensive effect of HS extracts. Those included the inhibition of angiotensin-converting enzymes (ACE) activity, diuretic effect, endothelium-derived nitric oxide-cGMP-relaxant pathway and inhibition of calcium (Ca2+)-influx into vascular smooth muscle cells, cholinergic and/or histaminergic mechanisms, reduction in the diffusion distance between capillaries and myocytes as well as new vessel formation. Phenolic acids, anthocyanins (e.g. cyanidin-3-sambubioside and delphinidin-3-sambubioside) and anthocyanin metabolites probably contribute mostly to the hypotensive activity.