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Thursday 22 June 2017

Traditional Chinese Medicine for Cardiovascular disease


Traditional Chinese Medicine May Benefit Some Heart Disease Patients

Alternative medicine could complement some Western therapies


Contact: Nicole Napoli, nnapoli@acc.org, 202-375-6523
WASHINGTON (Jun 12, 2017) -
Traditional Chinese medicine might be effective as a complement or alternative to traditional Western medicine for primary and secondary prevention of heart disease, according to a state of the art review paper published today in the Journal of the American College of Cardiology.
Heart disease is the No. 1 cause of death worldwide, and despite advances in Western medicine for treating and preventing heart disease, unmet needs remain. As a result, traditional Chinese medicine is being increasingly looked at as a supplement to Western medicine, but to date randomized controlled trials are overall of poor quality and flawed.
Western scientists often reject Chinese medicine for specific reasons: the formula consists of dozens of ingredients with many chemical molecules, making it hard to clarify the therapeutic mechanism; the medications available in China do not undergo the same rigorous approval process as Western drugs to guarantee efficacy and safety; and most trials were conducted in China by traditional Chinese medicine physicians with medications largely unavailable in the United States.
Researchers in this review looked at studies published over the past 10 years on randomized controlled trials of traditional Chinese medicine used for patients with hypertension, dyslipidemia, diabetes/pre-diabetes, atherosclerotic cardiovascular disease and chronic heart failure to assess the efficacy and safety of traditional Chinese medicine.
In all, certain Chinese medications showed suggested benefits for each of the cardiovascular health conditions studied. For example, researchers looked at eight randomized controlled trials on traditional Chinese medicine and hypertension. The evidence indicated that Tiankuijiangya, Zhongfujiangya, Qiqilian, Jiangya and Jiangyabao have antihypertensive effects and a good safety profile, making them a potential good alternative for patient intolerant of or who cannot afford Western medications.
However, whether those benefits transferred into long-term positive cardiovascular outcomes would have to be determined by long-term trials.
“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,” said Yuxia Zhao, senior author of the review and a physician in the Department of Traditional Chinese Medicine at Shandong University Qilu Hospital in Jinan, Shandong, China. “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 cardiovascular disease.”



Journal of the American College of Cardiology


Traditional Chinese Medicine for Cardiovascular Disease
Evidence and Potential Mechanisms


Author + information


Central Illustration

Abstract

Traditional Chinese medicine (TCM) has more than 2,000 years of history and has gained widespread clinical applications. However, the explicit role of TCM in preventing and treating cardiovascular disease remains unclear due to a lack of sound scientific evidence. Currently available randomized controlled trials on TCM are flawed, with small sample sizes and diverse outcomes, making it difficult to draw definite conclusions about the actual benefits and harms of TCM. Here, we systematically assessed the efficacy and safety of TCM for cardiovascular disease, as well as the pharmacological effects of active TCM ingredients on the cardiovascular system and potential mechanisms. Results indicate that TCM might be used as a complementary and alternative approach to the primary and secondary prevention of cardiovascular disease. However, further rigorously designed randomized controlled trials are warranted to assess the effect of TCM on long-term hard endpoints in patients with cardiovascular disease.
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Footnotes

  • This work was supported by the National 973 Basic Research Program of China (2013CB530703 and 2015CB553604), the National Natural Science Foundation of China (81400284, 81425004, 91339109, and 81270350), the Program of Introducing Talents of Discipline to Universities (B07035), the State Key Program of National Natural Science of China (61331001 and 81530014), the International Collaboration and Exchange Program of China (81320108004), the Natural Science Foundation of Shandong Province (ZR2014HM044 and ZR2014HP045), the Clinical Medicine Science and Technology Innovation Plan of Jinan Science and Technology Bureau (201602157 and 201506002), and Shenzhen Science and Technology Research and Development Fund (JCYJ20160331183804137). The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
  • Received June 27, 2016.
  • Revision received April 7, 2017.
  • Accepted April 10, 2017.