Cardiovascular Effects of Ginkgo Biloba

Mechanism of Action and Efficacy

Ginkgo biloba contains flavonoids and terpine trilactones (ginkgolides) that decrease red blood cell aggregation, reduce blood viscosity, and inhibit platelet activating factor 1
Ginkgolide B specifically displaces platelet-activating factor from binding sites, decreasing coagulation 2

Systematic review of 8 placebo-controlled trials showed patients receiving 120-160mg daily for 12-24 weeks had a weighted mean difference in pain-free walking distance of 34 meters compared to placebo 1
No single well-powered study has definitively established efficacy for intermittent claudication, though meta-analysis suggests modest benefit 1
May be considered as an alternative therapy for intermittent claudication, but outcomes are likely to be of marginal clinical importance 1

Multiple guidelines warn against combining ginkgo with medications affecting coagulation 2
Patients with pre-existing bleeding disorders or those taking anticoagulants/antiplatelet drugs are at particularly high risk 2
Herbal medicines like ginkgo may alter drug pharmacokinetics through inhibition of cytochrome P450 system, potentially affecting the metabolism of other medications 3

Clinical trials for cardiovascular effects typically used doses of 120-160mg daily 1
The specific 200mg dose has not been extensively studied in the provided evidence, but falls within the range of doses commonly used in research 1