Effect of Crataegus Usage in Cardiovascular Disease Prevention: An Evidence-Based Approach

Table 3

Randomized, controlled, double-blind trials of Hawthorn extract for cardiovascular diseases.

Study	Design^a	Target	Duration	Dose	Case/control	Primary outcome measures
Eggeling et al., 2011 [89]^b	OPC	Early chronic heart failure	156 w	900 mg, qd	372/—	Improve outcomes of MWL, LVEF, PHRPI, BP, HR, DP, and typical symptoms.
Schröder et al., 2003 [90]^e	Double-blind, Nonrandomized controlled trial	Mild cardiac insufficiency (NYHA II)	8 w	100 mL, tid	110/102	Change HR, BP, DP, symptoms, frequency of nocturnal urinations, and exercise tolerance.
Degenring et al., 2003 [91]^c	RCT, pg	Congestive heart failure (NYHA II)	8 w	2.25 mL, qd	69/74	Change BHP and maximum load.
Zapfe Jun, 2001 [92]^b	RCT, pg	Congestive heart failure (NYHA II)	12 w	240 mg, qd	20/20	Increase exercise tolerance and reduce the DP.
Schmidt et al., 1994 [93]^d	RCT, pg	Congestive heart failure (NYHA II)	8 w	600 mg, qd	50/50	Reduce the SBP, HR,; and DP.
Zick et al., 2009 [94]^b	Randomized controlled trial	Chronic; heart failure (NYHA II-III)	24 w	450 mg, bid	60/60	No symptomatic or functional benefit when given with standard medical therapy.
Holubarsch et al., 2008 [95]^b	RCT, pg	Chronic; heart failure (NYHA II/III)	48 w	900 mg, qd	1338/1343	Reduce the incidence of sudden cardiac death.
Tauchert, 2002 [87]^b	RCT, pg	Congestive heart failure (NYHA III)	16 w	900/1800 mg, qd	70/69	The treatment is safe and well tolerated.
Belz et al., 2002 [105]^e	RCT, pg	Hypertension	16 w	1200 mg, qd	39/40	Lower mean DBP.
Walker et al., 2006 [106]^e	RCT, pg	Hypertension	10 w	500 mg, qd	19/17	Lower both SBP and DBP, especially DBP.
Walker et al., 2002 [107]^e	RCT, co	Hypertension	5 min.	80 drops, qd	24/24	Lower DBP.
Asher et al., 2012 [108]^e	RCT, co	Hypertension	3 d	1000/1500/2000; mg, bid	15/6	No evidence of a dose-response effect of hawthorn extract on FMD.
Dalli et al., 2011 [109]^e	RCT, pg	Hyperlipidemia	24 w	400 mg, tid	24/21	Decrease NE and lower LDL-C.
Liang and ye, 2004 [110]^e	Randomized controlled trial	Hyperlipidemia	5 w	60 mg, tid	60/52	Decrease TC, TG, LDL-C.
Shen et al., 2000 [111]^e	Clinical controlled trial	Hyperlipidemia	4 w	5 pills, tid	120/20	Decrease TC, TG, and LP(a) and increase HDC.

aRCT: randomized, double blind, placebo-controlled trial; co: crossover; pg: parallel group; OPC: open prospective cohort study; ^bCrataegus extract WS 1442; ^cCrataegisan; ^dCrataegus extract LI 132; ^eOther extracts or preparations of Crataegus; MWL: maximal workload; LVEF: left ventricular ejection fraction; PHRPI: pressure-heart rate product increase; BHP: blood pressure-heart rate product; HR: heart rate; BP: blood pressure; DP: double product (evaluated on a bicycle ergometric test and defined as heart rate × systolic blood pressure × 10⁻² where HR is heart rate in bpm and BP blood pressure in mmHg); NYHA: New York Heart Association; SBP: systolic blood pressure; DBP: diastolic blood pressure; NE: neutrophil elastase; LDL-C: LDL cholesterol; FMD: flow mediated dilation.