ReviewHawthorn extract for treating chronic heart failure: meta-analysis of randomized trials
Section snippets
Methods
Systematic literature searches were conducted using the data sources MEDLINE, EMBASE, the Cochrane Library, CINAHL, CISCOM, and AMED. The search terms were hawthorn, whitethorn, Crataegus, and Weissdorn (common name for hawthorn in German). Each database was searched from its inception until June 2002. Additionally, ten manufacturers of commercial hawthorn preparations and nine experts on the subject were asked to provide published or unpublished trials (15). Hand-searches of relevant medical
Results
The literature searches identified 26 potentially relevant trials 6, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, including one unpublished study (18). Thirteen publications were excluded because they were not randomized and placebo controlled 27, 28, 29, 30, 31, 32, did not use monopreparations of extracts of hawthorn leaf with flower 33, 34, 35, 36, assessed healthy volunteers (37), were published in duplicate (38), or did not include
Discussion
Our results suggest that, compared with placebo, hawthorn extract increases the maximal workload in patients with chronic heart failure. This conclusion, however, is based on small numbers of studies and patients. Nevertheless, the secondary outcome measures support the findings and suggest that hawthorn extract is superior to placebo as an adjunctive treatment for patients with chronic heart failure.
As described in eight of the 13 trials, most patients were also treated with conventional
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