Khat: an emerging threat to the heart in the UK.

Khat (also called Qat) is a shrub whose leaves (figure 1A) have been chewed for their central stimulatory effect by people of East Africa and the Arabian peninsular since the time of the Islamic conquest (around 640 AD) to the present day. Its stimulatory effects have been used in preparation for battle, religious ceremonies including weddings, and simply as a social pastime. It is used by some Muslims after fasting at Ramadan and has also found use as an appetite suppressant in the obese. Khat is predominantly cultivated in Kenya, Yemen and Ethiopia. In Ethiopia it is the second biggest export after coffee. Somalia has become the biggest net importer, its own production destroyed by years of civil war. Figure 1 (A) Khat ( Catha edulis Celestrasae ) leaves, likely of Kenyan origin, where it is called Mirra. The bright green leaves are 2–4 cm in length, shiny, with serrated edges. The stems are reddish in colour. (B) A bundle of khat (around 250 g) purchased in Acton, west London, in late 2010 for £6. The leaves and stems are wrapped and secured in banana leaves to preserve their essential freshness. Its use is emerging as a threat to the cardiovascular system among the growing numbers of those in the UK who regularly indulge in its effects. Used for centuries in the countries of its origin, khat emerged in the western world …