Increased risk of major adverse cardiovascular events in young and middle-aged adults with obesity receiving Chinese herbal medicine: A nationwide cohort study.
Journal
Journal of the Chinese Medical Association
Journal Volume
87
Journal Issue
12
Start Page
1031
End Page
1038
ISSN
1728-7731
Date Issued
2024-12-01
Author(s)
DOI
10.1097/JCMA.0000000000001163
Abstract
Background: Many patients with obesity in Taiwan seek Chinese herbal medicines (CHM) from traditional Chinese medicine (TCM) clinics. This study aimed to estimate the risk of major adverse cardiovascular events (MACEs) in adults diagnosed with obesity, with or without CHM. Methods: Patients with obesity aged 18 to 50 years were identified using diagnostic codes from Taiwan's National Health Insurance Research Database between 2008 and 2018. We randomized 67 655 patients with or without CHM using propensity score matching. All patients were followed up from the start of the study until MACEs, death, or the end of 2018. A Cox proportional regression model was used to evaluate the hazard ratios of MACEs in the CHM and non-CHM cohorts. Results: During a median follow-up of 4.2 years, the CHM group had a higher incidence of MACEs than the non-CHM control cohort (9.35 vs 8.27 per 1000 person-years). The CHM group had a 1.13-fold higher risk of MACEs compared with the non-CHM control (adjusted hazard ratio [aHR] = 1.13; 95% CI], 1.07-1.19; p < 0.001), especially in ischemic stroke (aHR = 1.18; 95% CI, 1.07-1.31; p < 0.01), arrhythmia (aHR = 1.26; 95% CI, 1.14-1.38; p < 0.001), and young adults aged 18 to 29 years (aHR = 1.22; 95% CI, 1.05-1.43; p < 0.001). Conclusion: Although certain CHMs offer cardiovascular benefits, young and middle-aged obese adults receiving CHM exhibit a higher risk of MACEs than those not receiving CHM. Therefore, TCM practitioners should be cautious when prescribing medications to young patients with obesity, considering their potential cardiovascular risks.
SDGs
Type
journal article