Hawthorn berry (Crataegus)

Tier 2 — promising · Heart failure · Blood pressure

Studied in multiple RCTs for mild to moderate heart failure. A Cochrane review found it improved exercise tolerance and reduced breathlessness vs placebo. The large SPICE trial confirmed symptomatic improvement but found no mortality benefit. May interact with cardiac medications (digoxin, beta-blockers) — use under medical supervision.

Dose: 160–900 mg/day hawthorn extract standardised to flavonoids; use under medical supervision for heart conditions