Abstract
Ephedrine, the main active ingredient of mahuang, may lead to weight loss; however, it can also induce cardiovascular side effects. As ephedrine use remains controversial, this study aimed to systematically review previous studies on ephedrine-containing products and perform meta-analysis of the existing evidence on weight, blood pressure (BP), heart rate, and lipid change effects of ephedrine-containing products. We searched for placebo-controlled randomized studies in PubMed, Web of Science, and EMBASE until July 2021 using the following search terms: (ephedr* OR mahuang) AND (“weight loss” OR obes* OR overweight). Mean differences (MDs) and 95% confidence intervals (CIs) were calculated to evaluate the effects of ephedrine-containing products on weight, BP, heart rate, and lipid profiles. A total of 10 articles were included. Compared with the placebo group, the ephedrine-containing product group was associated with greater weight loss, with an MD of −1.97 kg (95% CI: −2.38, −1.57). In the ephedrine-containing product group, the mean heart rate was 5.76 beats/min higher than in the placebo group (95% CI: 3.42, 8.10), whereas intergroup differences in systolic and diastolic BP were not statistically significant. The ephedrine-containing product group had a significantly higher mean high-density lipoprotein cholesterol level (MD: 2.74 mg/dL; 95% CI: 0.94, 4.55), lower mean low-density lipoprotein cholesterol level (MD: −5.98 mg/dL; 95% CI: −10.97, −0.99), and lower mean triglyceride level (MD: −11.25 mg/dL; 95% CI: −21.83, −0.68) than the placebo group. Compared with placebo, the ephedrine-containing products showed better effects on weight loss and lipid profiles, whereas they caused increased heart rate. The ephedrine-containing products may be beneficial to obese or overweight patients; however, close monitoring is needed, especially heart rate monitoring.
Highlights
The weight mean difference (MD) between the ephedrine-containing product group and the placebo group was −1.97 kg (95% confidence interval (CI): −2.38, −1.57; p < 0.00001; I2 = 80%) (Figure 2)
In terms of total cholesterol (TC), there was no significant intergroup difference, but the ephedrine-containing product group had a lower mean TC concentration (MD: −3.00; 95% confidence intervals (CIs): −8.84, 2.83; p = 0.31; I2 = 0%, Figure 4D)
In this systematic review and meta-analysis, we demonstrated the effects of ephedrinecontaining products on weight loss, blood pressure (BP), heart rate, and lipid profiles in obese or overweight patients
Summary
Obesity is a pathological condition in which excess fat in the body accumulates due to metabolic imbalance [1]. Obesity is recognized as one of the most important challenges facing public health and economies [2]. The prevalence of obesity has been continuously increasing. According to National Health and Nutrition Examination Survey (NHANES). Data, over 40% of the American population is obese [1]. Obesity can lead to various diseases, such as diabetes mellitus, cardiovascular or musculoskeletal diseases, cancers, and psychiatric disorders [3,4,5,6]
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