Chinese herbal medicine treatment and the association with long-term major adverse cardiac events in patients with chronic kidney disease: A propensity-score matched cohort study.

Researchers in Taiwan investigated whether Chinese herbal medicine could help protect chronic kidney disease (CKD) patients from heart problems and death. CKD is a condition where the kidneys gradually lose function, and people with CKD face significantly higher risks of heart disease, heart attacks, strokes, and early death.

The study analyzed health records from over 12,700 CKD patients between 2000 and 2017, comparing those who used Chinese herbal medicine alongside conventional treatment with those who received standard care alone. Researchers carefully matched patients to ensure fair comparisons based on age, gender, existing health conditions, and medications.

The results were encouraging. Patients who used Chinese herbal medicine showed a 23-31% lower risk of serious heart problems, including heart failure, heart attacks, and strokes. They also had lower rates of death from cardiovascular causes and from all causes combined. These benefits remained significant even after accounting for other factors that might influence outcomes.

The most commonly prescribed herbal formula was Ji-Sheng-Shen-Qi-Wan, and the most frequently used single herb was Danshen (Salvia miltiorrhiza), both traditional remedies with documented cardiovascular benefits in Chinese medicine. Patients typically used these herbs as complementary therapy alongside their regular kidney disease treatments.

What this means for patients: If you have chronic kidney disease, Chinese herbal medicine used alongside conventional treatment may offer additional cardiovascular protection. However, this study shows association rather than definitive cause-and-effect. Herbs can interact with medications and must be properly dosed, especially with compromised kidney function. If you're considering Chinese herbal medicine for CKD, consult with a qualified practitioner trained in both traditional Chinese medicine and herbal safety for kidney patients.

This propensity-score matched cohort study examined cardiovascular outcomes in CKD patients using Chinese herbal medicine (CHM) as adjunct therapy. From Taiwan's National Health Insurance Research Database, researchers identified 6,351 matched pairs of newly diagnosed CKD patients aged ≥20 years, followed from 2000-2017 (mean age 49.4±15.3 years, 56.4% female).

CHM use demonstrated significant protective effects against major adverse cardiac events (MACEs), with adjusted hazard ratios showing 23-31% risk reduction across cardiovascular outcomes including heart failure, myocardial infarction, ischemic stroke, cardiovascular death, and all-cause mortality (P<0.001). The most frequently prescribed formula was Ji-Sheng-Shen-Qi-Wan (JSSQW), while Danshen (Salviae Miltiorrhizae) was the predominant single herb.

Clinical takeaway: This large-scale observational study provides compelling evidence for CHM's cardiovascular protective effects in CKD patients. While the study design precludes causal conclusions, the substantial risk reductions warrant consideration of CHM as complementary therapy. Practitioners should note the specific formulations associated with benefit and remain cognizant of herb-drug interactions and renal dosing considerations when treating this vulnerable population.