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LETTER
Drug therapy in chronic heart failure
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  1. M H Pittler,
  2. E Ernst
  1. Complementary Medicine, Peninsula Medical School, 25 Victoria Park Road, Exeter EX2 4NT, UK; M.H.Pittlerex.ac.uk

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      We welcome McKenzie and Cowley’s update on drug therapy in chronic heart failure.1 Interestingly, they fail to mention hawthorn (Crataegus) extract as a possible additional treatment option for this condition. We would like to draw readers’ attention to our recent meta-analysis, which suggests a significant increase in maximal workload and an improvement of heart failure related symptoms compared with placebo in New York Heart Association stage II patients.2 Hawthorn extract seems to be safer than many other drugs for this indication. Trial patients reported only mild and infrequent adverse events even on very high doses of hawthorn extract. This implies that its therapeutic window is relatively wide.

      References

      1. ↵
        McKenzie DB, Cowley AJ. Drug therapy in chronic heart failure. Postgrad Med J2003;79:634–42.
        OpenUrlAbstract/FREE Full Text
      2. ↵
        Pittler MH, Ernst E. Hawthorn extract for treating chronic heart failure: meta-analysis of randomized trials. Am J Med2003;114:665–74.
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