Crataegus in the treatment of cardiovascular disease
Results recorded from clinical trials, experiences of professionally qualified medical herbalists, and the low/negligible incidence of side effects experienced by patients would indicate that Crataegus preparations hold significant potential as a useful remedy in the treatment of CVD.
Clinical trials have until recently been largely confined to patients presenting with NYHA stage I or II heart failure. More recently, the inclusion of patients with more advanced CVD in clinical trials might have affected outcomes, particularly where dosages were not adjusted to reflect the severity of illness.
Studies by Holusbarsch et al. would indicate efficacy of Crataegus preparations in the treatment of mild to moderate heart failure (NYHA I–II). The more seriously ill patient may need higher dosages (1800 mg) as used by Tauchert for significant improvements to be obtained. Ultimately, an examination of the data to date is encouraging but would point to the need for a more targeted approach in terms of dosage related to severity of illness. It is possible that this remedy might have limited the benefit for more seriously ill patients but, used in the early stages of disease progression, may significantly enhance prognosis.
The excellent safety profile of this remedy, coupled with the lack of herb–drug interactions detected to date in clinical trials would further support its inclusion in treatment strategies surrounding CVD, especially in the early stages of disease progression.
A robust and succinct response to a letter to the editor of the European Journal of Heart Failure, criticizing the inclusion of a clinical trial involving the use of a homeopathic Crataegus preparation in the treatment of heart failure called for more open-mindedness within the scientific community and a celebration “of the success of bringing different medical cultures together to focus on patients unmet needs.” Whole plant hawthorn remedies represent an excellent opportunity for this commendable concept to be taken forward.