Terminalia arjuna (Arjuna standardised extract)

Tier 3 — weak evidence · Cardiovascular · Heart failure · Angina

Ayurvedic cardiotonic bark used for over 2,500 years. Contains arjunolic acid and arjunic acid with proven cardioprotective effects. The canonical Indian cardiology trials (Bharani 1995 and 2002 in heart failure; Dwivedi 2007 in angina) found standardised Arjuna extract significantly improved ejection fraction in heart failure patients and reduced angina episodes. Caution: may potentiate antihypertensive and cardiac medications.

Dose: 500 mg twice daily standardised bark extract (25% arjunic acid); take under medical supervision if on cardiac medications