Demographic and Prescribing Patterns of Chinese Herbal Products for Individualized Therapy for Ischemic Heart Disease in Taiwan: Population-Based Study.

Yu-Chiang Hung,Hsuan-Ju Chen,Ying-Jung Tseng,Tsai-Chung Li,Hsin-Ping Chen,Fang-Yen Su,Pei-Yuan Tsai,Meng-Hsuan Huang,Wen-Long Hu,Natalie Walker

doi:10.1371/journal.pone.0137058

Abstract

ObjectiveCombinations of Chinese herbal products (CHPs) are widely used for ischemic heart disease (IHD) in Taiwan. We analyzed the usage and frequency of CHPs prescribed for patients with IHD.MethodsA nationwide population-based cross-sectional study was conducted, 53531 patients from a random sample of one million in the National Health Insurance Research Database (NHIRD) from 2000 to 2010 were enrolled. Descriptive statistics, the multiple logistic regression method and Poisson regression analysis were employed to estimate the adjusted odds ratios (aORs) and adjusted risk ratios (aRRs) for utilization of CHPs.ResultsThe mean age of traditional Chinese medicine (TCM) nonusers was significantly higher than that of TCM users. Zhi-Gan-Cao-Tang (24.85%) was the most commonly prescribed formula CHPs, followed by Xue-Fu-Zhu-Yu-Tang (16.53%) and Sheng-Mai-San (16.00%). The most commonly prescribed single CHPs were Dan Shen (29.30%), Yu Jin (7.44%), and Ge Gen (6.03%). After multivariate adjustment, patients with IHD younger than 29 years had 2.62 times higher odds to use TCM than those 60 years or older. Residents living in Central Taiwan, having hyperlipidemia or cardiac dysrhythmias also have higher odds to use TCM. On the contrary, those who were males, who had diabetes mellitus (DM), hypertension, stroke, myocardial infarction (MI) were less likely to use TCM.ConclusionsZhi-Gan-Cao-Tang and Dan Shen are the most commonly prescribed CHPs for IHD in Taiwan. Our results should be taken into account by physicians when devising individualized therapy for IHD. Further large-scale, randomized clinical trials are warranted in order to determine the effectiveness and safety of these herbal medicines.

Highlights

Ischemic heart disease (IHD) is the major contributor to the morbidity and mortality associated with coronary artery disease in the United States [1], Taiwan [2], and China [3]
The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript
Our results should be taken into account by physicians when devising individualized therapy for IHD

Summary

Introduction

Ischemic heart disease (IHD) is the major contributor to the morbidity and mortality associated with coronary artery disease in the United States [1], Taiwan [2], and China [3]. According to a WHO report [4], an estimated 17.3 million people died from cardiovascular diseases (CVDs) in 2008, representing 30% of all global deaths. Of these deaths, an estimated 7.3 million were due to coronary heart disease. The number of people who die from CVDs will reach 23.3 million by 2030, 45% of which will be attributed to coronary heart disease [4]. Research on IHD may provide valuable information for public health policy to government health institutions and other global health-research institutions

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