In the Journals

Select traditional Chinese medicine may benefit patients with heart disease

Unmet needs in Western medicine have made traditional Chinese medicine a more common alternative for primary and secondary CVD prevention, but more randomized trials of such therapies are needed, according to a review in the Journal of the American College of Cardiology.

“Most traditional Chinese medicine studies are of poor quality and the conclusions drawn are not accepted by Western society,” Yuxia Zhao, MD, from the department of traditional Chinese medicine at Shandong University Qilu Hospital in Jinan, Shandong, China, and colleagues wrote. “To clarify these doubts about traditional Chinese medicine, high-quality clinical trials of traditional Chinese medicine are needed, and recent progress in randomized controlled trials has spurred the modernization of [traditional Chinese medicine] in China.”

Zhao and colleagues studied randomized clinical trials looking at the effects of traditional Chinese medicine on hypertension, atherosclerotic CVD and chronic HF.

Hypertension

Zhao and colleagues included eight randomized controlled studies that focused on the effect of traditional Chinese medicines on hypertension.

The medicines commonly consisted of ramulus uncariae cum uncis, milkvetch root, Achyranthes bidentata, ligusticum wallichii, tall gastrodia tuber, radix rehmanniae and glossy privet fruit, all of which have been shown to be effective in BP lowering.

Sample sizes for these studies were between 102 and 480 patients and the mean follow-up was between 4 weeks to 1 year.

The researchers concluded that evidence suggests that certain traditional Chinese medicines have antihypertensive effects and are a viable alternative to Western medicine.

Dyslipidemia

Zhao and colleagues evaluated six randomized trials comparing traditional Chinese medications with placebo or atorvastatin for treatment of dyslipidemia.

They found that jiangzhitongluo, Salvia miltiorrhiza, Pueraria lobata and zhibitai “have a potent lipid-lowering effect and may serve as an alternative to Western medications for the treatment of dyslipidemia,” but noted it is not known whether they have any effect on CV outcomes.

Diabetes

In comparisons of traditional Chinese medications to placebo or Western medications, xiaoke, tangminling, jinlida and jianyutangkang improved glycemic control and/or beta-cell function in patients with type 2 diabetes, according to the researchers.

In addition, tangzhiping and tianqi appear to attenuate the progression from prediabetes to diabetes, they wrote.

However, long-term effects of these medications are unknown.

Atherosclerotic CVD

Traditional Chinese medicines such as red sage root, ligusticum wallichii, safflower and curcuma root were assessed in 13 randomized controlled trials and were found to improve angina symptoms, as well as clinical outcomes.

Sample sizes in these trials ranged from 100 to 4,870 and had a mean follow-up ranging from 4 weeks to 4.5 years.

Although further, large-scale studies are required to come to a definitive conclusion, treatment with some traditional Chinese medicine may alleviate angina symptoms, myocardial perfusion abnormalities or neurological deficit in patients with CAD, Zhao and colleagues wrote.

Chronic HF

Nine randomized clinical trials enrolling 100 to 512 patients with HF were evaluated by the researchers to assess the effect of traditional Chinese medicine on patients with chronic HF.

Treatments such as qiliqiangxin, nuanxin, shencaotongmai and yangxinkang may be effective in the improvement of cardiac remodeling and function and showed a good safety profile, but the long-term effects of traditional Chinese medicine in these patients is unknown, Zhao and colleagues wrote.

“Of note, one should bear in mind that traditional Chinese medicine medications are usually prescribed as complex formulae, which are often further manipulated by the practitioner on a personalized basis,” Zhao said in a press release. “The pharmacological effects and the underlying mechanisms of some active ingredients of traditional Chinese medications have been elucidated. Thus, some medications might be used as a complementary and alternative approach for primary and secondary prevention of [CVD].” – by Dave Quaile

Disclosures: The researchers report no relevant financial disclosures.

 

Unmet needs in Western medicine have made traditional Chinese medicine a more common alternative for primary and secondary CVD prevention, but more randomized trials of such therapies are needed, according to a review in the Journal of the American College of Cardiology.

“Most traditional Chinese medicine studies are of poor quality and the conclusions drawn are not accepted by Western society,” Yuxia Zhao, MD, from the department of traditional Chinese medicine at Shandong University Qilu Hospital in Jinan, Shandong, China, and colleagues wrote. “To clarify these doubts about traditional Chinese medicine, high-quality clinical trials of traditional Chinese medicine are needed, and recent progress in randomized controlled trials has spurred the modernization of [traditional Chinese medicine] in China.”

Zhao and colleagues studied randomized clinical trials looking at the effects of traditional Chinese medicine on hypertension, atherosclerotic CVD and chronic HF.

Hypertension

Zhao and colleagues included eight randomized controlled studies that focused on the effect of traditional Chinese medicines on hypertension.

The medicines commonly consisted of ramulus uncariae cum uncis, milkvetch root, Achyranthes bidentata, ligusticum wallichii, tall gastrodia tuber, radix rehmanniae and glossy privet fruit, all of which have been shown to be effective in BP lowering.

Sample sizes for these studies were between 102 and 480 patients and the mean follow-up was between 4 weeks to 1 year.

The researchers concluded that evidence suggests that certain traditional Chinese medicines have antihypertensive effects and are a viable alternative to Western medicine.

Dyslipidemia

Zhao and colleagues evaluated six randomized trials comparing traditional Chinese medications with placebo or atorvastatin for treatment of dyslipidemia.

They found that jiangzhitongluo, Salvia miltiorrhiza, Pueraria lobata and zhibitai “have a potent lipid-lowering effect and may serve as an alternative to Western medications for the treatment of dyslipidemia,” but noted it is not known whether they have any effect on CV outcomes.

Diabetes

In comparisons of traditional Chinese medications to placebo or Western medications, xiaoke, tangminling, jinlida and jianyutangkang improved glycemic control and/or beta-cell function in patients with type 2 diabetes, according to the researchers.

In addition, tangzhiping and tianqi appear to attenuate the progression from prediabetes to diabetes, they wrote.

However, long-term effects of these medications are unknown.

Atherosclerotic CVD

Traditional Chinese medicines such as red sage root, ligusticum wallichii, safflower and curcuma root were assessed in 13 randomized controlled trials and were found to improve angina symptoms, as well as clinical outcomes.

PAGE BREAK

Sample sizes in these trials ranged from 100 to 4,870 and had a mean follow-up ranging from 4 weeks to 4.5 years.

Although further, large-scale studies are required to come to a definitive conclusion, treatment with some traditional Chinese medicine may alleviate angina symptoms, myocardial perfusion abnormalities or neurological deficit in patients with CAD, Zhao and colleagues wrote.

Chronic HF

Nine randomized clinical trials enrolling 100 to 512 patients with HF were evaluated by the researchers to assess the effect of traditional Chinese medicine on patients with chronic HF.

Treatments such as qiliqiangxin, nuanxin, shencaotongmai and yangxinkang may be effective in the improvement of cardiac remodeling and function and showed a good safety profile, but the long-term effects of traditional Chinese medicine in these patients is unknown, Zhao and colleagues wrote.

“Of note, one should bear in mind that traditional Chinese medicine medications are usually prescribed as complex formulae, which are often further manipulated by the practitioner on a personalized basis,” Zhao said in a press release. “The pharmacological effects and the underlying mechanisms of some active ingredients of traditional Chinese medications have been elucidated. Thus, some medications might be used as a complementary and alternative approach for primary and secondary prevention of [CVD].” – by Dave Quaile

Disclosures: The researchers report no relevant financial disclosures.