Available evidence indicates that patients with heart failure may benefit from using hawthorn. One meta-analysis study suggests that in patients with heart failure, hawthorn extract results in improved maximal workload capacity, BHP and improved symptoms, compared to controls. Exercise tolerance was improved, although significance was not reached. Further research on the effect of hawthorn use in patients with heart failure is needed.

• Grade I means there is Good/Strong evidence supporting the statement;
• Grade II is Fair;
• Grade III is Limited/Weak;
• Grade IV is Expert Opinion Only;
• Grade V is Not Assignable.
• High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
• Moderate (B) means we are moderately confident in the effect estimate;
• Low (C) means our confidence in the effect estimate is limited;
• Very Low (D) means we have very little confidence in the effect estimate.
• Ungraded means a grade is not assignable.