Hawthorn extract for treating chronic heart failure

source extracted confidence: high 2026-04-09
#chronic-disease #crataegus #heart-failure #humans #phytotherapy

Hawthorn extract for treating chronic heart failure

Pittler et al., 2008 | Cochrane Database Syst Rev | Meta Analysis

Citation

Pittler M H, Guo R, Ernst E. Hawthorn extract for treating chronic heart failure. Cochrane Database Syst Rev. 2008-Jan-23;2008(1):CD005312. doi:10.1002/14651858.CD005312.pub2

Abstract

BACKGROUND: Hawthorn extract is advocated as an oral treatment option for chronic heart failure. Also, the German Commission E approved the use of extracts of hawthorn leaf with flower in patients suffering from heart failure graded stage II according to the New York Heart Association. OBJECTIVES: To assess the benefits and harms as reported in double-blind randomised clinical trials of hawthorn extract compared with placebo for treating patients with chronic heart failure. SEARCH STRATEGY: We searched CENTRAL on The Cochrane Library (issue 2, 2006), MEDLINE (1951 to June 2006), EMBASE (1974 to June 2006), CINAHL (1982 to June 2006) and AMED (1985 to June 2006). Experts and manufacturers were contacted. Language restrictions were not imposed. SELECTION CRITERIA: To be included, studies were required to state that they were randomised, double-blind, and placebo controlled, and used hawthorn leaf and flower extract monopreparations. DATA COLLECTION AND ANALYSIS: Two reviewers independently performed the selection of studies, data extraction, and assessment of methodological quality. Data were entered into RevMan 4.2 software. Results from continuous data were reported as weighted mean difference (WMD) with 95% confidence interval (CI). Where data were suitable for combining, pooled results were calculated. MAIN RESULTS: Fourteen trials met all inclusion criteria and were included in this review. In most of the studies, hawthorn was used as an adjunct to conventional treatment. Ten trials including 855 patients with chronic heart failure (New York Heart Association classes I to III) provided data that were suitable for meta-analysis. For the physiologic outcome of maximal workload, treatment with hawthorn extract was more beneficial than placebo (WMD (Watt) 5.35, 95% CI 0.71 to 10.00, P < 0.02, n = 380). Exercise tolerance were significantly increased by hawthorn extract (WMD (Watt x min) 122.76, 95% CI 32.74 to 212.78, n = 98). The pressure-heart rate product, an index of cardiac oxygen consumption, also showed a beneficial decrease with hawthorn treatment (WMD (mmHg/min) -19.22, 95% CI -30.46 to -7.98, n = 264). Symptoms such as shortness of breath and fatigue improved significantly with hawthorn treatment as compared with placebo (WMD -5.47, 95% CI -8.68 to -2.26, n = 239). No data on relevant mortality and morbidity such as cardiac events were reported, apart from one trial, which reported deaths (three in active, one in control) without providing further details. Reported adverse events were infrequent, mild, and transient; they included nausea, dizziness, and cardiac and gastrointestinal complaints. AUTHORS' CONCLUSIONS: These results suggest that there is a significant benefit in symptom control and physiologic outcomes from hawthorn extract as an adjunctive treatment for chronic heart failure.

Key Findings

Fourteen trials met all inclusion criteria and were included in this review. In most of the studies, hawthorn was used as an adjunct to conventional treatment. Ten trials including 855 patients with chronic heart failure (New York Heart Association classes I to III) provided data that were suitable for meta-analysis. For the physiologic outcome of maximal workload, treatment with hawthorn extract was more beneficial than placebo (WMD (Watt) 5.35, 95% CI 0.71 to 10.00, P < 0.02, n = 380). Exercis

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population chronic heart failure
Sample Size 380
Age Range See abstract
Condition See abstract

MeSH Terms

  • Chronic Disease
  • Crataegus
  • Heart Failure
  • Humans
  • Phytotherapy
  • Randomized Controlled Trials as Topic

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Meta-Analysis, Systematic Review
  • Vertical: hawthorn

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09