A Twin-Herbal Combination was found to have Cardio-Vascular Protection Effects after repeated RCTs on four groups of patients with Different Disease Background A Cross-Biostatical Study
Main Article Content
Abstract
Background and Objective: To perform an integrated Cross-Biostatical analysis of four randomized controlled trials (RCTs) to assess the efficacy and safety of oral administration of D&G capsule (D&G) for the maintenance of cardiovascular health.
Methods: Data from the populations of four completed RCTs were pooled for this integrated Cross-Biostatical analysis. Mean changes from baseline in IMT and lipid profile were the main lines of attention; treatment differences were compared between D&G and Placebo groups. Primary outcome was Carotid artery intima-media thickness (IMT). Secondary outcome was the lipid profile. Analyses included primary and secondary outcome measures repeated at individual time points.
Results: The pooled RCT data involved 453 subjects (245 D&G; 208 Placebo); demographic characteristics were similar between treatment groups. Taking all 4 groups together, the mean improvements in IMT from baseline to week 24 were 0.9163 to 0.8939 in D&G group, and 0.8997 to 0.8964 in Placebo group. A statistically significant improvement after treatment was observed (P < 0.001) in D&G group, not in Placebo group.
Conclusion: The integrated analysis of the pooled biostatic data further confirmed the efficacy and safety of D&G in the vascular protection effects.
Downloads
Article Details
Copyright (c) 2021 KF Cheng W, et al.

This work is licensed under a Creative Commons Attribution 4.0 International License.
Nabel EG (2003) Cardiovascular disease. N Engl J Med 349: 60‐72. Link: https://bit.ly/36g2IKm
Ross R (1986) The pathogenesis of atherosclerosis – an update. N Engl J Med 314: 488‐500. Link: https://bit.ly/3jO2Dp1
Kearney M, Whelton K, Reynolds K, Muntner P, Whelton PK, et al. (2005) Global burden of hypertension: analysis of worldwide data. Lancet 365: 217-223. Link: https://bit.ly/2Um6ZJw
Marizilli M, Merz N, Boden WE, Bonow RO, Capozza PG, et al. (2012) Obstructive Coronary Atherosclerosis and Ischemic Heart Disease. J Am Coll Cardiol 60: 951-956. Link: https://bit.ly/3qMv5JE
Almgren T , Wilhelmsen L, Samuelsson O, Himmelmann A, Rosengren A, et al. (2007) Diabetes in treated hypertension is common and carries a high cardiovascular risk: results from a 28-year follow-up. J Hypertens 25: 1311-1317. Link: https://bit.ly/36hX4at
Leung PC (2005) A critical look at traditional Chinese Medicine – Recommendation in the line of Research Approach. In PC Leung & Xue CL (Eds), Chinese Medicine – Modern Practice. World Scientific Publisher, Singapore. Link: https://bit.ly/3yqvT9x
Chan YL, Woo KS, Leung PC, Fung KP (2006) Traditional Chinese medicine Danshen and Gegen combination formula improves Atherogenic pathophysiology: an in‐vitro and ex‐vivo study. J HK Coll Cardiol 14: 68. Link: https://bit.ly/3AzOotW
Chook P, Tam WY, Chan LT, Qiao M, Cheng KF, et al. (2011) Efficacy and safety of Danshen and Gegen as adjunctive secondary prevention therapy in coronary artery disease. South China Journal of Cardiovascular Diseases 17: 48‐52. Link: https://bit.ly/2Vb8tXw
Chook P, Tam WY, Poon YK, Qiao M, Chan LT, et al. (2009) Danshen and Gegen as cardiovascular tonic in coronary patients: a novel strategy for secondary atherosclerosis prevention. South China Journal of Cardiovascular Diseases 15: 56‐64. Link: https://bit.ly/3wqEJmw
Yip TWC, Chook P, Kwong SK, Wong EML, Cheng W, et al. (2009) Adjunctive Danshen and Gegen therapy improves atherogenic process: a final report of double‐blind placebo control trial in high risk hypertension. J HK Coll Cardiol 17: 12. Link: https://bit.ly/36iVjd8
Woo KS, Yip TWC, Chook P, Kwong SK, Szeto CC, et al. (2013) Cardiovascular protective effects of adjunctive alternative medicine (Salvia miltiorrhiza and Pueraria lobata) in high‐risk hypertension. Evid Based Complement Alternat Med 2013: 132912. Link: https://bit.ly/36gXL40
Kwok TCY, Leung PC, Lam C, Ho S, Wong CK, et al. (2014) A randomized placebo controlled trial of an Innovative Herbal Formula in the prevention of atherosclerosis in postmenopausal women with Borderline hypercholesterolemia. Complement Ther Med 22: 473-480. Link: https://bit.ly/3wirSCM
Yan PY, Woo KS, Kwok CY, Leung PC (2020) Symptoms of Intermittent Claudication and Walking tolerance in patients suffering from Peripheral arterial disease can be improved with a simple herbal formula. J Integrative Cardiology. Link: https://bit.ly/3qLCzws
Leung PC, Koon CM, Lau CBS, Chook P, Cheng KF, et al. (2013) Ten years’ research on a cardiovascular tonic: A comprehensive approach – from quality control and mechanisms of action to clinical trial. Evid Based Complement Alternat Med 2013: 319703. Link: https://bit.ly/3wjsZ57
Leung PC, Koon CM, Kwok T, Woo KS, Lau CBS, et al. (2014) Development of an effective cardiovascular protective agent using evidence-based research platforms. Experimental & Clinical Cardiology 20: 4235-4250. Link: https://bit.ly/3qOKRn4
Shepherd J, Cobbe SM, Ford I, Isles CG, Lorimer AR, et al. (1995) Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia. N Engl J Med 333: 1301‐1308. Link: https://bit.ly/3yrEHfw
Down JR, Glearfield M, Weis S, Whnitney E, Shapiro DR, et al. (1998) Primary prevention of acute coronary events with lovastatin in men and women with average cholesterol levels: results of AFCAPS/TexCAPS. Air Force/Texas Coronary Atherosclerosis Prevention Study. JAMA 279: 1615‐1622. Link: https://bit.ly/3jJjqK4
Shepherd J, Blauw GJ, Murphy MB, Bollen EL, Cobbe SM, et al. (2002) Pravastatin in elderly individuals at risk of vascular disease (PROSPER): a randomized controlled trial. Lancet 360: 1623‐1630. Link: https://bit.ly/3qSzFpQ
Sever PS, Dahlof B, Poulter NR, Wedel H, Beevers G, et al. (2003) Prevention of coronary and stroke events with atorvastatin in hypertensive patients who have average or lower‐than‐ average cholesterol concentrations, in the Anglo‐Scandinavian Cardiac Outcomes Trial ‐ Lipid Lowering Arm (ASCOT‐LLA): a multicenter randomized controlled trial. Lancet 361: 1149‐1158. Link: https://bit.ly/3jMKmIT
Antithrombotic Trialists’ (ATT) Collaboratioin, Baigent C, Blackwell L, Collins R, Emberson J, et al. (2009) Aspirin in the primary and secondary prevention of vascular disease: collaborative meta‐analysis of individual participant data from randomised trials. Lancet 373: 1849‐1860. Link: https://bit.ly/3dMRDVr
Nabel EG, Braunwald E (2012) A tale of coronary artery disease and myocardial Infarction. N Engl J Med 366: 54‐63. Link: https://bit.ly/3qQE3Fu
O’Donnell CJ, Nabel EG (2011) Genomics of cardiovascular disease. N Engl J Med 365: 2098‐2109. Link: https://bit.ly/3ypWm73
European Society of Hypertension‐European Society of Cardiology Guidelines Committee (2003) European Society of Hypertension‐European Society of Cardiology guidelines for the management of arterial hypertension. J Hypertens 21: 1011‐1053.
Cucchiara BL, Messe SR (2008) Antiplatelet therapy for secondary prevention of Stroke. Link:: https://bit.ly/3dN5Gdt
Ji XY, Tan BK, Zhu YZ (2000) Salvia miltiorrhiza and ischemic diseases. Acta Pharmacol Sin 21: 1089‐1094. Link: https://bit.ly/3hkccdT
Sieveking DP, Woo KS, Fung KP, Lundman P, Nakhla S, et al. (2005) Chinese herbs Danshen and Gegen modulate key early atherogenic events in vitro. Int J Cardiol 105: 40‐45. Link: https://bit.ly/36fK853
Chiu PY, Leung HY, Leong PK, Chen N, Zhou L, et al. (2012) Danshen‐Gegen decoction protects against hypoxia/reoxygenation‐induced apoptosis by inhibiting mitochondrial permeability transition via the redox‐sensitive ERK/Nrf2 and PKC ɛ/mKATP pathways in H9c2 cardiomyocytes. Phytomedicine 19: 99‐110. Link: https://bit.ly/3hF1Ynl
Lam HM, Yam WS, Lau LK, Leung LK, Koon CM, et al. (2005) Antioxidative and vasodilative effects of Danshen and Gegen. J Mol Cell Cardiol 38: 840. Link: https://bit.ly/3qMyAzM
Ng CF, Koon CM, Cheung DW, Lam MY, Leung PC, et al. (2011) The anti‐hypertensive effect of Danshen (Salvia miltiorrhiza) and Gegen (Pueraria lobata) formula in rats and its underlying mechanisms of vasorelaxation. J Ethnopharmacol 137: 1366‐1372. Link: https://bit.ly/2Uvpb3C
Koon CM, Woo KS, Leung PC, Fung KP (2011) Salviae Miltiorrhizae Radix and Puerariae Lobatae Radix herbal formula mediates anti‐atherosclerosis by modulating key artherogenic events both in vascular smooth muscle cells and endothelial cells. J Ethnopharmacol 138: 175‐183. Link: https://bit.ly/36fGSGN
Chiu PY, Wong SM, Leung HY, Leong PK, Chen N, et al. (2011) Acute treatment with Danshen‐Gegen decoction protects the myocardium against ischemia/reperfusion injury via the redox‐sensitive PKCε/mKATP pathway in rats. Phytomedicine 18: 916‐925. Link: https://bit.ly/36eHhsW
Deng Y, Ng ES, Yeung JH, Kwan YW, Lau CB, et al. (2012) Mechanisms of the cerebral vasodilator actions of isoflavonoids of Gegen on rat isolated basilar artery. J Ethnopharmacol 139: 294‐304. Link: https://bit.ly/3weCRwY
Wong SM, Chiu PY, Leung HY, Zhou L, Zuo Z, et al. (2011) Myocardial post‐conditioning with Danshen‐Gegen decoction protects against isoproterenol‐induced myocardial injury via a PKCɛ/mKATP‐mediated pathway in rats. Chin Med 6: 7. Link: https://bit.ly/3hheNW0
Zhang Q, Yang MM (2010) DNA microarray technology and traditional Chinese medicines. Progress Nutrition 12: 6‐12. Link: https://bit.ly/3wjY8VW
Zhou L, Zuo Z, Chow MSS (2005) Danshen: an overview of its chemistry, pharmacology,pharmacokinetics, and clinical use. J Clin Pharmacol 45: 1345‐1359. Link: https://bit.ly/3wmpomC
Zhou L, Chow MS, Zuo Z (2009) Effect of sodium caprate on the oral absorptions of danshensu and salvianolic acid B. Int J Pharm 379: 109‐118. Link: https://bit.ly/36jB3Ix
Zhou L, Chow M, Zuo Z (2006) Improved quality control method for Danshen products ‐consideration of both hydrophilic and lipophilic active components. J Pharm Biomed Anal 41: 744‐750. Link: https://bit.ly/3woRJJ8
Yan PY, Woo KS, Kwok CY, Leung PC (2021) A twin herbal formula has gained sufficient clinical and laboratory evidences to be accepted as an effective cardio-vascular protective supplement. Int J Cardiol Cardiovasc Dis 1: 24-30. Link: https://bit.ly/3dPn9Sv