Hawthorn

Botanical names: Crataegus laevigata, Crataegus oxyacantha, Crataegus monogyna

Parts used and where grown

Hawthorn is commonly found in Europe, western Asia, North America, and North Africa. Modern medicinal extracts primarily use the leaves and flowers. Traditional preparations use the fruit.

Hawthorn has been used in connection with the following conditions (refer to the individual health concern for complete information):

Science Ratings	Health Concerns
	Congestive heart failure (early-stage)
	Angina Cardiomyopathy (if congestive heart failure is also present)
	Cardiac arrhythmia Cardiomyopathy (if congestive heart failure is not present) Hypertension
Reliable and relatively consistent scientific data showing a substantial health benefit. Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit. For a herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support and/or minimal health benefit.

Historical or traditional use (may or may not be supported by scientific studies)

Dioscorides, a Greek herbalist, reportedly used hawthorn in the first century A.D. Although numerous passing mentions are made for a variety of conditions, support for the heart is the main benefit of hawthorn.

Active constituents

The leaves, flowers, and berries of hawthorn contain a variety of bioflavonoids that appear to be primarily responsible for the cardiac actions of the plant. Flavonoids found in hawthorn include oligomeric procyanidins (OPCs), vitexin, vitexin 4’-O-rhamnoside, quercetin, and hyperoside. These compounds are often standardised in leaf and flower extracts, which are widely used in Europe.

Hawthorn is thought to exert many beneficial effects on the heart and blood vessels. These include improved coronary artery blood flow and strengthening of the contractions of the heart muscle.¹ Hawthorn may also improve circulation to the extremities by lowering the resistance to blood flow in peripheral blood vessels.² The bioflavonoids in hawthorn are potent antioxidants.³ Hawthorn extracts may mildly lower blood pressure in some people with high blood pressure but should not be thought of as a substitute for cardiac medications for this condition.

Clinical trials have confirmed that hawthorn leaf and flower extracts are beneficial for people with stage II (early-stage) congestive heart failure.⁴ ⁵ ⁶ ⁷ ⁸ People with congestive heart failure taking 160–900 mg of hawthorn extract per day for eight weeks showed improved quality of life including greater ability to exercise without shortness of breath and exhaustion. Congestive heart failure is a serious medical condition that requires expert management rather than self-treatment. One study has shown that hawthorn leaf and flower extract may also help those with stable angina.⁹

How much is usually taken?

Extracts of the leaves and flowers are most commonly used in modern herbal medicine. Hawthorn extracts standardised for total bioflavonoid content (usually 2.2%) or oligomeric procyanidins (usually 18.75%) are often suggested. Many doctors recommend 80–300 mg of the herbal extract in capsules or tablets two to three times per day.¹⁰ If traditional berry preparations are used, the recommendation is at least 4–5 grams per day or a tincture of 4–5 ml three times daily. However, this form has not been clinically studied. Hawthorn is slow acting and may take one to two months for maximum effects to be seen. However, it appears to be safe and should be considered a long-term therapy.

Are there any side effects or interactions?

Hawthorn is safe for long-term use. People taking prescription cardiac medications should consult with their doctor before using hawthorn-containing products. Reports of hawthorn interacting with digitalis to augment its effects have not been confirmed in clinical trials. There are no apparent restrictions to use of hawthorn during pregnancy or breast-feeding.

Are there any drug interactions?
Certain medicines may interact with hawthorn. Refer to drug interactions for a list of those medicines.

References
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1. Weikl A, Noh HS. The influence of Crataegus on global cardiac insufficiency. Herz Gefabe 1993;11:516–24.

2. Loew D. Pharmacological and clinical results with Crataegus special extracts in cardiac insufficiency. ESCOP Phytotelegram 1994;6:20–6.

3. Bahorun T, Trotin F, Pommery J, et al. Antioxidant activities of Crataegus monogyna extracts. Planta Med 1994;60:323–8.

4. Weihmayr T, Ernst E. Therapeutic effectiveness of Crataegus. Fortschr Med 1996;114:27–9 [in German].

5. Schmidt U, Kuhn U, Ploch M, Hübner W-D. Efficacy of the Hawthorn (Crataegus) preparation LI 132 in 78 patients with chronic congestive heart failure defined as NYHA functional class II. Phytomed 1994;1:17–24.

6. Leuchtgens H. Crataegus special extract WS 1442 in heart failure, NYHA II. A placebo-controlled randomized double-blind study. Fortschr Med 1993;111:352–4.

7. Weikl A, Assmus KD, Neukum-Schmidt A, et al. Crataegus special extract WS 1442: Objective proof of efficacy in patients withy cardiac insufficiency (NYHA II). Fortschr Med 1996;114:291–6.

8. Tauchert M, Ploch M, Hübner W-D. Effectiveness of hawthorn extract LI 132 compared with the ACE inhibitor Captopril: Multicenter double-blind study with 132 patients NYHA stage II. Münch Med Wochenschr 1994;132(suppl):S27–33.

9. Hanack T, Brückel M-H. The treatment of mild stable forms of angina pectoris using Crataegutt (R) Novo. Therapiewoche 1983;33:4331–3 [in German].

10. Brown DJ. Herbal Prescriptions for Better Health. Rocklin, CA: Prima Publishing, 1996, 139–44.

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The information presented in Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or chemist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires March 2007.