In traditional Chinese medicine, acupuncture is considered free of harmful side effects when properly performed. Pharmacokinetics provides a valuable approach to explore how acupuncture influences drug disposition. Stimulation at specific acupoints, such as Zusanli (ST36), may modulate drug absorption and action. While most studies highlight beneficial outcomes, potential risks also deserve consideration. A systematic review was conducted to evaluate how acupuncture or electroacupuncture at ST36 affects the pharmacokinetics of various drugs. Data on changes in absorption, distribution, metabolism, and excretion, along with pharmacokinetic parameters (e.g., average plasma concentration-time curve [AUC], C _max , T _max ), were extracted and analyzed. Acupuncture at ST36 significantly influenced the pharmacokinetics of several compounds. For instance, it enhanced the absorption and plasma levels of Schisandra chinensis lignans and acetaminophen (APAP), increasing AUC and C _max while shortening T _max . Tissue distribution also shifted, with elevated concentrations observed in certain organs such as the lungs. While aspirin metabolism remained unaffected, ST36 stimulation delayed APAP clearance at higher doses, resulting in prolonged systemic exposure. In the case of triptolide, a bioactive diterpenoid, acupuncture increased its plasma levels and AUC. Some studies reported changes in biomarkers associated with liver function under elevated compound exposure, though no acute adverse effects were noted for commonly used agents. ST36 acupuncture can alter drug pharmacokinetics, potentially impacting drug exposure and clinical response. Awareness of such interactions is important when combining acupuncture with medication. Further studies are warranted to ensure the safe and effective integration of acupuncture into pharmacological treatment strategies.

Hypertensive heart disease (HHD) and ischemic heart disease (IHD) are major global burdens. High body mass index (BMI) is a key modifiable risk factor, but the global burden, trends, and inequalities of HHD and IHD attributable to high BMI remain poorly defined. We analyzed Global Burden of Disease data from 1990 to 2021 across 204 countries, estimating age-standardized mortality rates (ASMRs), disability-adjusted life-year rates (ASDRs), and annual average percentage changes (AAPCs). Additional analyses included age- and sex-specific distributions, socio-demographic index (SDI) patterns, frontier and decomposition analyses, inequality metrics, and projections to 2035 using Bayesian age–period–cohort and ARIMA models. From 1990 to 2021, global ASMR and ASDR for HHD attributable to high BMI slightly increased (AAPC: 0.014 and 0.099), whereas those for IHD declined (AAPC: −0.067 and −0.751). The highest HHD burden occurred in Southern Sub-Saharan Africa, and the greatest IHD burden in Eastern Europe. Elderly females had higher HHD mortality and DALYs, while middle-aged males bore greater IHD burden. HHD inversely correlated with SDI (r = −0.5524, P < 0.001), whereas IHD showed a unimodal relationship. Decomposition highlighted aging and population growth as major contributors. Inequalities worsened for HHD but improved for IHD. Forecasts suggest continued rises in HHD and declines in IHD by 2035. HHD and IHD attributable to high BMI show divergent global trends and inequality patterns, underscoring the urgent need for targeted weight management and cardiovascular risk reduction, particularly in low- and middle-SDI regions.