A meta-analysis of previous studies concluded that there is evidence of potential benefit for an extract in treating chronic heart failure. A 2010 review cites the need for further study of the best dosages and concludes that although "many different theoretical interactions between Crataegus and orthodox medications have been postulated ... none have been substantiated.
Several pilot studies have assessed the ability of hawthorn to help improve exercise tolerance in people with NYHA class II cardiac insufficiency compared to placebo. One experiment, at (300 mg/day) for 4 to 8 weeks, found no difference from placebo. The second study, including 78 subjects (600 mg/day) for 8 weeks, found "significant improvement in exercise tolerance" and lower blood pressure and heart rate during exercise. The third, including 32 subjects (900 mg/day) for 8 weeks, found improved exercise tolerance as well as a reduction in the "incidence and severity of symptoms such as dyspnea" and fatigue decreased by approximately 50%.
In the HERB-CHF (Hawthorn Extract Randomized Blinded Chronic HF Study) clinical study, 120 patients took 450 mg of hawthorn extract twice daily for 6 months in combination with standard therapy and a standardized exercise program. "No effects of hawthorn were seen on either quality-of-life endpoint (Tables 1 and 2), or when adjusted for LVEF".
One research program, consisting of 1,011 patients taking one tablet (standardized to 84.3 mg procyanidin) twice daily for 24 weeks, found "improvements in clinical symptoms (such as fatigue, palpitations, and exercise dyspnea), performance and exercise tolerance test, and ejection fraction".
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