May 31, 2006

Khat (Stimulating leaf) linked to heart disease

Stimulating leaf linked to heart disease
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Wachira Kigotho
31 May 2006
Source: SciDev.Net

Chewing khat leaves — a practice common in East Africa and the Arabian Peninsula — can cause severe heart problems, warn researchers in the June issue of the Journal of the Royal Society of Medicine.

People have chewed the leaves as a stimulant for centuries, in a social tradition that predates coffee drinking.

But according to Sagar Saha and Clare Dollery of the Heart Hospital in London, United Kingdom, long term chewing can lead to heart attacks, liver damage, tooth loss and throat cancer.

Dollery, a consultant cardiologist, says khat seems to affect blood clotting and cause spasms in the arteries supplying blood to the heart.

The findings support previous research done in Yemen that found that khat chewers were at higher risk of heart attack than people who do not chew the leaves. The practice is also popular in Ethiopia and Somalia, and among emigrant communities from these countries.

Kamran Abbasi, editor of the Journal of the Royal Society of Medicine, says there needs to be greater awareness of the dangers of chewing khat.

"Unless there is a public awareness, khat will continue to cause serious harm to the health of many people in developing countries and disadvantaged migrant communities in European countries where khat is not banned," said Kamran.

Canada, Ireland, Norway, Sweden and the United States have all banned the leaf.

The shrub (Catha edulis) from which the leaves are harvested is largely grown in East Africa and Yemen. It is a major export crop in Ethiopia.

According to Saha: "There are no guidelines on how to treat and manage khat-induced harm, which in turn affects the ability of doctors to provide holistic treatment."

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British Journal of Clinical Pharmacology
Volume 59 Page 574 - May 2005
doi:10.1111/j.1365-2125.2005.02358.x
Volume 59 Issue 5
Khat chewing is a risk factor for acute myocardial infarction: a case-control study
A. Al-Motarreb1, S. Briancon2, N. Al-Jaber1, B. Al-Adhi1, F. Al-Jailani1, M S. Salek3 & K J. Broadley3

Aim

Khat chewing is a common habit in Yemen and east African countries. Millions of people chew khat leaves daily for its euphoric and energetic effects and to increase alertness. Cathinone, the main active substance in fresh khat leaves, has sympathomimetic effects which increase heart rate and blood pressure. The aim was to examine the hypothesis that khat chewing is a risk factor for acute myocardial infarction (AMI) using a hospital-based matched case-control study.

Method

Between 1997 and 1999, we selected 100 patients admitted to the Al-Thawra teaching hospital Sana'a ICU, Yemen with acute myocardial infarction. 100 control subjects, matched to cases for sex and age, were recruited from the outpatients clinics of the same hospital. A questionnaire was completed for case and control groups covering personal history of khat chewing, smoking, hypertension, diabetes and any family history of myocardial infarction. A blood sample was collected for performing lipid profiles. Cases and controls were compared by analysis conducted using conditional logistic regression which corrected for baseline imbalances leading to less biased estimations of odds ratio (OR). The risk associated with each classical factor and khat chewing habits was then investigated. OR values greater than 2.5 indicated a significant risk factor.

Results

Khat chewing was significantly higher among the AMI case group than control group (OR = 5.0, 95% CI 1.9–13.1). A dose–response relationship was observed, the heavy khat chewers having a 39-fold increased risk of AMI.

Conclusion

This study indicates that khat chewing is associated with AMI and is an independent dose-related risk factor for the development of myocardial infarction.

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