Proprietary Herbal Medicines in Circulatory Disorders: Hawthorn, Ginkgo, Padma 28

Abstract

A look at the available clinical evidence of herbai preparations from hawthom (leaves, fiowers, fmits), Padma 28 (Swiss-Tibetan herbaI preparation with 20 herbai dmgs) and ginkgo (leaves) in terms of circulatory disorders shows the following: in chronic heart failure New York Heart Association (NYHA) II a meta­ analysis showed that hydroethanolic extracts from hawthorn leaves and fiowers, given at a daily dosage of 300 to 900 mg, can increase the maximum workload to up to 7 W when given concomitantly with standard therapy, The same was seen in one RCT with an extract from hawthom fmits and fiowers, The herbaI preparations seem to be well tolerated and no interaction is known so far. The data on a possible decrease on blood pressure are inconclusive. A meta-analysis on Padma 28 showed that two tablets given twice or three times a day over 16 weeks can increase the maximum walking distance by more than 100 m in patients with claudicatio intermittens. The preparation is weil tolerated and safe. Research evidence from a meta-analysis on an extract from ginkgo shows that its use in the treatment of intel1l1ittent claudication can result in a significant but clin­ ically modest improvement in pain-frce walking for distances up to 34 m given at a dosage of 160 mg per day. Despite the general evidence that ginkgo preparations are relatively safe, physicians and therapists should be cautious when anticoagulants (i.e. warfarin) are given as weil.