Effects of Korean Medicine Treatment and a Low-Carbohydrate Diet on Weight Loss, Blood Pressure, and Safety in Patients with Angina Pectoris: A Multicenter Retrospective Study

Background and objectives: Obesity management is clinically important in patients with angina pectoris; however, the cardiovascular safety of ephedra-containing herbal medicines (HM) in coronary artery disease remains a concern. This study retrospectively evaluated the effectiveness and short-term safety of ephedra-containing HM combined with a low-carbohydrate diet (LCD) in patients with angina pectoris.Methods: This multicenter retrospective study included 51 adults treated with HM and LCD (≤50 g/day). Outcomes included body weight, body mass index (BMI), percent body fat (%BF), blood pressure (BP), heart rate (HR), HbA1c level (when available), and adverse events (AEs).Results: Body weight decreased by 7.06±5.69 kg (p<0.001), with 78.4% achieving ≥5% weight loss. BMI and %BF decreased significantly (both p<0.001). Systolic BP and HR decreased significantly, whereas diastolic BP showed no significant change. HbA1c levels decreased when available. Most AEs were mild (grades 1-2), and no serious AEs were observed.Conclusion: Ephedra-containing HM combined with LCD was associated with meaningful weight loss and favorable short-term safety signals in patients with angina pectoris.