Hawthorn - A Scientific Overview
Botanical Name: Crataegus spp.
Common Name: Hawthorn
Parts Used: Berries, flower and leaf
Properties: Astringent, drying
Phytochemical Constituents: Flavonoids and oligomeric procyanidins found in Hawthorn are believed to specifically support cardiovascular health.1 One study mentions that “endothelial dependent nitrous oxide induction, which triggers vasodilation, has been attributed primarily to oligomeric procyanidins. The vasorelaxant effects reduce peripheral vascular resistance and increase coronary blood flow.” 2,3,4,5 Other constituents include amines, catechins, saponins and triterpenes. 1
Hawthorn is a popular herb that has been used by various cultures and regions of the world for many centuries. It has been enjoyed as food, utilized for its medicinal properties and even considered sacred, as some believe that the thorny crown worn by Jesus Christ was made from Hawthorn.
It has documented use as a cardiovascular tonic in Europe and North America for symptoms including arrhythmias, angina, congestive heart failure, coronary artery disease, hypertension, inflammation and even hemorrhoids.1,6,7 Studies suggest that the cardiovascular benefits are the “result of positive inotropic activity, its ability to increase the integrity of the blood vessel wall, improve coronary blood flow and provide positive effects on oxygen utilization”.8
In Traditional Chinese Medicine (TCM), Hawthorn berry is called Shan-Zha and has been used for thousands of years to help treat damp spleen symptoms. It is also used to improve digestive disturbances including bloating and diarrhea. 1
Historically, Hawthorn has also been used to support and nourish the energetic, emotional heart, particularly during times of anxiety, grief, sadness, depression, or trauma that causes a person to close off or put barriers of protection around their heart. The herb gently helps to balance and support the heart chakra, allowing the person to feel more self-love and compassion, love for others and have a more positive outlook on their current circumstances as well as the future.
Effects on Arrhythmias
An animal study was performed to assess the effects of Crataegus oxyacantha on arrhythmias induced by digoxin. 12 The experimental group which was given 100 mg of Crataegus oxyacantha extract was found to have shorter durations of atrial and ventricular arrhythmias compared to the control group. 12
Effects on Blood Pressure
A 16-week randomized controlled study was performed on hypertensive, type 2 diabetic patients to evaluate effects of Hawthorn for hypertension. 13 A daily dose of Hawthorn extract at 1,200 mg was given to the first group while the second group was given a placebo. It was reported that 71% of the study population was also taking hypotensive medication. Results showed the Hawthorn group to have a greater reduction in mean diastolic pressure compared to the placebo group. 13
Reduces Angina (Chest Pain)
A study evaluating the effects of Hawthorn for angina was performed over a four-week period. 9,10 One group was given 100 mg of Hawthorn extract three times per day while the second group was given a placebo. By the end of the study 91% of the Hawthorn group reported a reduction in angina while the placebo group only reported a 37% reduction. 9,10
Reduction of Symptoms Associated with Heart Failure
A two-year study was conducted to evaluate the therapeutic benefits of Crataegus (special extract WS 1442) on patients with heart failure (NYHA II). 11 The Crataegus cohort consisted of 588 patients who either received the extract by itself or as an add-on therapy while the comparative cohort consisted of 364 patients whose therapy did not include Crataegus. At the end of the study, “palpitations, fatigue and stress dyspnea were significantly less marked in the Crataegus cohort compared to the comparative cohort”. 11
Benefits Beyond the Cardiovascular System
Other studies have discussed additional benefits of Hawthorn berry ethanol extract including gastroprotective and anti-inflammatory effects for extract doses of 50, 100 and 200 mg/kg. 14 Moderate bactericidal activity was also seen against Bacillus subtitles, Lysteria monocytogenes and Micrococcus flavus. 14
Safety Class: 1
Interaction Class: A
Adverse Events: Although Hawthorn is typically well tolerated, documented adverse effects from monopreparations ranging from 160 – 1,800 mg include gastrointestinal, headache, dizziness and palpitations. 15
Drug Interactions and Precautions:
Individuals taking Hawthorn with cardiovascular medication including digoxin, beta-blockers and calcium channel blockers are strongly advised to be closely monitored by a health care provider. 16 Hawthorn may enhance the activity and effects of these drugs which may results in adverse events.16
This research review article is sponsored by The Wise Woman Herbals® Practitioner Learning Community. The information provided is solely on behalf of the author and not Wise Woman Herbals®. The purpose of this article is to provide a summary of clinical or scientific information that has been published about this specific herb. This information has not been approved by the FDA nor is it intended to cure, treat or replace medical care. Always consult with a health care provider before starting a new wellness regimen.
Dr. Yasamine Farshad is the Practitioner Education Manager for Wise Woman Herbals® where she coordinates educational events and content for health care practitioners. Dr. Farshad received her Doctorate in Naturopathic Medicine from the Southwest College of Naturopathic Medicine in Tempe, Arizona and received her Bachelor of Science in Ecology and Evolutionary Biology from the University of Arizona. Dr. Farshad also teaches anatomy and physiology for Herbal Wisdom Institute where she received her herbalist certification. She focuses in nature cure using botanical medicine and nutrition.
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- Yance, D. R. (2013). Hawthorn. In Adaptogens in medical herbalism: Elite herbs and natural compounds for mastering stress, aging and chronic disease (pp. 473-474). Rochester, VT: Healing Arts Press.
- Tassell MC, Kingston R, Gilroy D, Lehane M, Furey A. Hawthorn (Crataegus spp.) in the treatment of cardiovascular disease. Pharmacogn Rev. 2010;4(7):32-41. doi:10.4103/0973-7847.65324
- Brixius K, Willms S, Napp A, et al. Crataegus special extract WS 1442 induces an endothelium-dependent, NO-mediated vasorelaxation via eNOS-phosphorylation at serine 1177.Cardiovasc Drugs Ther. 2006;20(3):177-184. doi:10.1007/s10557-006-8723-7
- Tsuyuki RT, McAlister FA, Teo KK. Beta-blockers for congestive heart failure: what is the current consensus?.Drugs Aging. 2000;16(1):1-7. doi:10.2165/00002512-200016010-00001
- Kim SH, Kang KW, Kim KW, Kim ND. Procyanidins in crataegus extract evoke endothelium-dependent vasorelaxation in rat aorta.Life Sci. 2000;67(2):121-131. doi:10.1016/s0024-3205(00)00608-1
- Tilgner, S. (2009). Herbal medicine: From the heart of the earth (pp. 102-103). Creswell, OR: Wise Acres.
- Hawthorn: Heart Healing from Physical to (2017, June 20). Retrieved July 1, 2020 from https://traditionalroots.org/hawthorn-heart-healing-from-physical-to-spiritual .
- Rigelsky JM, Sweet BV. Hawthorn: pharmacology and therapeutic uses. Am J Health Syst Pharm. 2002;59(5):417-422. doi:10.1093/ajhp/59.5.417
- Hudson ND, T. (july 2011). Hibiscus, Hawthorn, and the Heart Modern research supports the use of traditional plants. Natural Medicine Journal, 3(7).
- WEng W, Zhang W, Liu F, et al. Therapeutic effect of Crataegus pinnatifida on 46 cases of angina pectoris—a double blind study. J Tradit Chin Med. 1984;4(4):293-294.
- Habs M. Prospective, comparative cohort studies and their contribution to the benefit assessments of therapeutic options: heart failure treatment with and without Hawthorn special extract WS 1442. Forsch Komplementarmed Klass Naturheilkd. 2004;11 Suppl 1:36-39. doi:10.1159/000080574
- Alp H, Soner BC, Baysal T, Şahin AS. Protective effects of Hawthorn (Crataegus oxyacantha) extract against digoxin-induced arrhythmias in rats. Anatol J Cardiol. 2015;15(12):970-975. doi:10.5152/akd.2014.5869
- Walker AF, Marakis G, Simpson E, et al. Hypotensive effects of hawthorn for patients with diabetes taking prescription drugs: a randomised controlled trial. Br J Gen Pract. 2006;56(527):437-443.
- Tadić VM, Dobrić S, Marković GM, et al. Anti-inflammatory, gastroprotective, free-radical-scavenging, and antimicrobial activities of hawthorn berries ethanol extract. J Agric Food Chem. 2008;56(17):7700-7709. doi:10.1021/jf801668c
- Daniele C, Mazzanti G, Pittler MH, Ernst E. Adverse-event profile of Crataegus spp.: a systematic review. Drug Saf. 2006;29(6):523-535. doi:10.2165/00002018-200629060-00005
- Complementary and Alternative Medicine - Penn State Hershey Medical Center - Penn State Hershey Medical Center. (n.d.). Retrieved July 1, 2020, from http://pennstatehershey.adam.com/content.aspx?productid=107 .
- Gardner, Z. E., & McGuffin, M. (2013). The American Herbal Products Association Botanical Safety Handbook(pp.270-273). Boca Raton, FL: CRC Press.