Abstract A look at the available clinical evidence of herbal preparations from
hawthorn (leaves, flowers, fruits), Padma 28 (Swiss-Tibetan herbal preparation with
20 herbal drugs) and ginkgo (leaves) in terms of circulatory disorders shows the
following: in chronic heart failure New York Heart Association (NYHA) II a metaanalysis
showed that hydroethanolic extracts from hawthorn leaves and flowers,
given at a daily dosage of 300 to 900 mg, can increase the maximum workload to
up to 7W when given concomitantly with standard therapy. The same was seen in
one RCT with an extract from hawthorn fruits and flowers. The herbal 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 100m
in patients with claudicatio intermittens. The preparation is well tolerated and safe.
Research evidence from a meta-analysis on an extract from ginkgo shows that its
use in the treatment of intermittent claudication can result in a significant but clinically
modest improvement in pain-free walking for distances up to 34m 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 well.
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