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Herbal remedy useful for Heart Failure
Newswise — Adding another twist to the ongoing
debate over the value of an herbal treatment
for patients with heart failure, a new
review of existing research suggests that
hawthorn extract “significantly” improves
symptoms.
“If I had chronic heart failure, I certainly
would consider (using) it,” said review
co-author Dr. Max Pittler, deputy director
of complementary medicine at Peninsula
Medical School in Exeter, England.
The review does not include results of a large
new study — unpublished to date — that
suggested hawthorn has only a limited affect
on lifespan.
At issue is heart failure, a common condition
that is both debilitating and deadly. An
estimated five million Americans suffer from
heart failure, which is often the result of
clogged arteries that put stress on the
heart by forcing it to work harder.
As a result, the heart becomes larger while
failing to effectively move blood around the
body. This causes fluids to build up in the
legs and lungs, often causing shortness of
breath and other symptoms.
Perhaps the most famous heart failure patient is
Vice President Dick Cheney, who has suffered
from a long history of cardiac problems and
has a defibrillator implanted in his chest.
According to the new review, the hawthorn bush
produces one of the most commonly used
herbal medicines in the United States. Many
believe that hawthorn extract improves heart
health, lowers cholesterol and boosts
antioxidant levels.
To determine whether hawthorn is actually an
effective treatment, Pittler and colleagues
searched the medical literature for
high-quality studies into the use of the
herb in chronic heart failure patients.
The review of the studies appears in the latest
issue of The Cochrane
Library, a publication of The Cochrane
Collaboration, an international organization
that evaluates medical research. Systematic
reviews like this one draw evidence-based
conclusions about medical practice after
considering both the content and quality of
existing medical trials on a topic.
The researchers found 14 studies that met their
criteria, several of which looked at the use
of hawthorn as an addition to conventional
medications.
The review authors combined the results of 10
studies of 855 patients into a
meta-analysis. Compared to placebo, hawthorn
extract boosted the maximum level of
physiological workload — a fact that the
review authors described as significant,
although they acknowledged they based the
finding on small numbers of studies and
patients.
The analysis found that hawthorn, as compared to
placebo, also decreased the “pressure-heart
rate product,” a measurement of how much
oxygen is used by the heart. In addition,
the analysis reports that two other
measurements — exercise tolerance, and
shortness of breath and fatigue — improved
“significantly” in patients who used
hawthorn.
Side effects were reported to be “infrequent,
mild and transient,” and included nausea,
dizziness and heart and gastrointestinal
complaints. The studies reviewed did not
examine death rates in detail, however.
Overall, the review showed a “significant benefit
in symptom control and physiologic outcomes”
in patients who took hawthorn, Pittler said.
According to him, the extract appears to
boost the strength of heart contractions,
increase blood flow through arteries and
reduce irregular heartbeats.
There are some caveats, however. Only seven of
the 14 trials specified that patients were
taking conventional drugs. In addition,
patients included in the studies had
mild-to-moderate heart failure. Pittler said
hawthorn might cause greater side effects in
patients who must take drugs that are more
powerful to control their disease.
Dr. Gregg Fonarow, director of the Heart Failure
Program at the University of California at
Los Angeles, said the larger hawthorn study
whose results were released last year
impressed him more. The study, which was not
included in the review because it thus far
remains unpublished, found only limited
benefit.
“It does indeed demonstrate that [hawthorn] is
not a harmful therapy, but it’s one that is
not particularly helpful nor that would be
recommended,” Fonarow said. “It’s naturally
attractive to think there is something over
the counter or naturally occurring that may
help improve outcome. Unfortunately, we’ve
not been able to identify that so far.”
The Cochrane Collaboration is an international
nonprofit, independent organization that
produces and disseminates systematic reviews
of health care interventions and promotes
the search for evidence in the form of
clinical trials and other studies of
interventions. Visit http://www.cochrane.org
for more information.
Pittler MH, Guo R, Ernst E. Hawthorn extract for
treating chronic heart failure. Cochrane
Database of Systematic Reviews 2008, Issue
1.
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