Hawthorn extract may have benefit as an adjunctive treatment for chronic heart failure

Clinical question: 
Is hawthorn extract effective for treating chronic heart failure (CHF)?
Bottom line: 
Those trials suitable for inclusion in a meta-analysis showed improvements in heart failure symptoms and in the function of the heart. Compared to placebo, hawthorn extract as an adjunctive treatment for CHF produced significant benefit in symptom control (e.g. shortness of breath and fatigue) and physiological outcomes (e.g. maximal workload, exercise tolerance, and cardiac oxygen consumption). Reported adverse effects were infrequent, mild and transient, and included nausea, dizziness, hot flushes, gastroenteritis, flatulence, palpitations, dyspnoea, headaches and epistaxis.
Caveat: 
The trials did not all measure the same outcomes, and several did not report what other CHF treatments patients were receiving. Data reporting on relevant mortality and morbidity, such as cardiac events, was limited to the reporting of deaths in one trial (three deaths in the active group and one in the control group).
Context: 
Hawthorn extract (made from the dried leaves, flowers and fruits of the hawthorn bush) is advocated as an oral treatment option for CHF. It is among the most popular herbal medicinal products in the USA and in Europe, where it is marketed in some countries as a prescription medicine. It has been suggested that hawthorn extract has positive inotropic effects, decreases active ventricular conduction time, and increases coronary blood flow.
Review CD#: 
CD005531
PEARLS No: 
64
Date: 
May, 2008
Authored by: 
Brian R McAvoy