A Chinese herbal formula shows beneficial effects on comorbid depression and coronary heart disease based on the philosophy of psycho-cardiology

Abstract

Depression is one of the major risk factors for the development, progression and prognosis of coronary heart disease (CHD). Patients with depression and CHD have high mortality and morbidity. Conventional antidepressant therapies achieve limited success in CHD patients. The aim of the present study was to determine the efficacy of a formulation of Chinese herbal medicine called the “Bu Xin Qi decoction (BXQD)” on the symptoms of depression and cardiac prognosis in patients with comorbid depression and CHD. Chinese patients with symptoms that fulfilled the diagnosis criteria were recruited. A total of 280 patients were eligible and randomized to receive escitalopram or BXQD for 8 weeks and follow-up for additional 4 weeks post-treatment. The primary endpoints included episodes of angina pectoris and duration, HAM-D score. Other outcome measures contained the incidence of cardiac events, the levels of high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), adrenaline (NE) and 5-serotonin (5-HT). After 8-week treatment, BXQD significantly decreased episodes and duration of angina pectoris from baseline. HAM-D score was also remarkably decreased in both treatment group. Cardiac events were 11% in the BXQD-treated group and 22% in escitalopram group. Furthermore, treatment with BXQD strikingly decreased the levels of hs-CRP and IL-6, and increased 5-HT and NE levels. Our results showed that BXQD possessed a favorable improvement on symptoms of depression and cardiac prognosis, which could be used in combination with usual care for the treatment of patients with these comorbidities. (The name of the clinical registry: Efficient Traditional Chinese Medicine for Treating Coronary Heart Disease Accompanied by Depression. The registration number: ChiCTR-INC-17012872).