Increased risk of major adverse cardiovascular events in young and middle-aged adults with obesity receiving Chinese herbal medicine: A nationwide cohort study

Wen-Chieh Yang; Te-I Weng; Ying-Hsiu Shih; Lu-Ting Chiu

doi:10.1097/JCMA.0000000000001163

Increased risk of major adverse cardiovascular events in young and middle-aged adults with obesity receiving Chinese herbal medicine: A nationwide cohort study

J Chin Med Assoc. 2024 Sep 13. doi: 10.1097/JCMA.0000000000001163. Online ahead of print.

Authors

Wen-Chieh Yang¹, Te-I Weng^{2

3}, Ying-Hsiu Shih⁴, Lu-Ting Chiu⁴

Affiliations

¹ Department of Traditional Chinese Medicine, Taipei Veterans General Hospital Hsinchu Branch, Hsinchu, Taiwan, ROC.
² Department of Emergency Medicine, National Taiwan University College of Medicine, and National Taiwan University Hospital, Taipei, Taiwan, ROC.
³ Department of Forensic Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan, ROC.
⁴ Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan, ROC.

PMID: 39267390
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 versus 8.27 per 1,000 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% confidence interval [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.