Hawthorn (Crataegus species), a member of the rose family, was hung
over the doorway in the Middle Ages to prevent the entry of evil spirits. By the
early 1800's, American physicians recognized the herb's medicinal properties and
began using it to treat circulatory disorders and respiratory illnesses.
Considered a "cardiotonic" herb, the flowers and berries of the hawthorn plant
have been used in traditional medicine to treat irregular heartbeat, high blood
pressure, chest pain, hardening of the arteries, and congestive heart failure.
Animal and laboratory studies have found that hawthorn contains active
compounds with antioxidant properties. Antioxidants are substances that scavenge
free radicals -- damaging compounds in the body that alter cell membranes,
tamper with DNA, and even cause cell death. Free radicals occur naturally in the
body, but environmental toxins (including ultraviolet light, radiation,
cigarette smoking, and air pollution) can also increase the number of these
damaging particles. Free radicals are believed to contribute to the aging
process as well as the development of a number of health problems including
heart disease. Antioxidants found in hawthorn can neutralize free radicals and
may reduce or even help prevent some of the damage they cause. Today, many
professional herbalists believe that the antioxidants in hawthorn may help
protect against heart disease and help control high blood pressure and high
Congestive heart failure Hawthorn has primarily been studied
in people with congestive heart failure (a health condition in which the heart
is unable to pump adequate amounts of blood to other organs in the body). Of six
well-designed trials, four studies concluded that hawthorn significantly
improved heart function and three found that the herb improved patients' ability
to exercise. Patients in five of the six studies reported that hawthorn
significantly improved symptoms of the disease (such as shortness of breath and
fatigue). One study found that hawthorn extract (900 mg/day) taken for 2 months
was as effective as low doses of captropril (a leading heart medication) in
improving symptoms of congestive heart failure. A large-scale international
study is currently underway to determine whether hawthorn extract reduces the
risk of death in people with this disease. Results are expected at the end of
Atherosclerosis Animal and laboratory studies demonstrate that
this herb has antioxidant properties that help protect against the formation of
plaques, which leads to a health problem known as atherosclerosis. Plaque
buildup in the vessels that supply the heart with oxygen-rich blood may cause
chest pain (angina) and heart attacks while plaque buildup in the arteries that
supply blood to the brain may result in stroke.
Chest pain Hawthorn berry preparations have been shown to
combat chest pain (angina), a health problem caused by insufficient blood flow
to the heart. In one early study, 60 angina patients were given either 180
mg/day of hawthorn berry-leaf-flower extract or placebo for 3 weeks. Those who
received the hawthorn preparation experienced improved blood flow to the heart
and were also able to exercise for longer periods of time without suffering from
High cholesterol Studies using rats suggest that a hawthorn
tincture (made from the berries) may be a powerful agent for the removal of LDL
("bad") cholesterol from the bloodstream. The tincture of hawthorn berries also
reduced the production of cholesterol in the liver of rats who were being fed a
high-cholesterol diet. Studies to determine if hawthorn will confer the same
effects in people are needed.
High blood pressure Although hawthorn has not been studied
specifically in people with high blood pressure, considerable evidence supports
the cardiovascular benefits of this herb. Studies suggest that hawthorn can be
taken safely by people with hypertension who are also taking blood pressure
Hawthorn is a common thorny shrub that grows up to five feet tall on
hillsides and in sunny wooded areas throughout the world. In May its flowers
bloom, but even though hawthorn is in the same botanical family as roses, the
flowers are not fragrant. They grow in small clusters, and are white, red, or
pink. Small berries, called haws, sprout after the flowers. They are usually red
when ripe, but they may also be black. Hawthorn leaves are shiny and grow in a
variety of shapes and sizes.
What's It Made Of?
Hawthorn contains many substances that may benefit the heart. However, it
appears that two substances in particular -- flavonoids and oligomeric
procyanidins (OPCs) -- are most likely to contribute to hawthorn's beneficial
effects on the heart. Flavonoids help dilate blood vessels, improve blood flow,
and increase heart rate. Both flavonoids and OPCs have potent antioxidant
The berries, leaves, and flowers of the hawthorn plant are used for medicinal
purposes. The leaves and flowers are believed to contain substantially more of
the active compounds than the berries.
Hawthorn is available in capsules, tinctures, standardized fluid extracts, or
solid extracts. A bitter-tasting tea can also be made from dried hawthorn
leaves, flowers, and berries.
How to Take It
There are no known scientific reports on the pediatric use of hawthorn.
Therefore, it is not currently recommended for children.
To decrease symptoms of congestive heart failure (which has been the most
studied use for hawthorn):
160 to 900 mg standardized (4 to 20 mg flavonoids/30 to 160 mg
oligomeric procyanidins) fluid crude extract daily for at least six weeks
120 to 240 mg extract standardized to 1.8% vitexin rhamnoside/10%
procyanidins three times per day for at least six
Hawthorn for heart failure or angina may require at least six weeks of use,
three times per day before an effect is noticed.
The use of herbs is a time-honored approach to strengthening the body and
treating disease. Herbs, however, contain active substances that can trigger
side effects and interact with other herbs, supplements, or medications. For
these reasons, herbs should be taken with care, under the supervision of a
practitioner knowledgeable in the field of botanical medicine.
The American Herbal Products Association (AHPA) gives hawthorn a class 1
safety rating, which indicates that it is a very safe herb with a wide dosage
range. Even so, it is always wise to follow recommended dosages. Side effects
are rare, but may include headache, nausea, and palpitations (a feeling of a
If you are pregnant or breastfeeding, do not use hawthorn.
It is extremely important for you to note any changes you feel while you are
taking hawthorn. People experiencing more pain, more angina attacks, more
exhaustion while walking or exercising should stop taking hawthorn and seek
immediate medical attention. Even if you don't experience any of these symptoms,
see your healthcare provider if your condition hasn't improved after six weeks
of hawthorn treatment. Your progress should always be monitored by your
If you are currently being treated with any of the following medications, you
should not use hawthorn without first talking to your healthcare provider:
Digoxin Hawthorn may enhance the activity of digoxin, a
medication used for irregular heart rhythms.
Phenylephrine In a laboratory study, an alcoholic extract of
hawthorn fruit counteracted the effects of phenylephrine, a medication that
constricts blood vessels and is commonly found in nasal decongestant products.
However, this interaction has not been studied in people; therefore, the
relevance of this interaction to people is unknown at this
Bahorun T, Trotin F, Pommery J, Vasseur J, Pinkas M. Antioxidant activities
of Crataegus monogyna extracts. Planta Med. 1994;60:323-328.
Blumenthal M, Goldberg A, Brinckmann J. Herbal Medicine: Expanded
Commission E Monographs. Newton, MA: Integrative Medicine Communications;
Brinker F. Herb Contraindications and Drug Interactions. 2nd ed.
Sandy, Ore: Eclectic Medical; 1998:82-83.
Foster S, Tyler VE. Tyler's Honest Herbal. 4th ed. New York: The
Haworth Herbal Press; 1999:205-207.
Fugh-Berman A. Herbs and dietary supplements in the prevention and treatment
of cardiovascular disease. Prev Cardiol. 2000;3(1):24-32.
Holubarsch CJ, Colucci WS, Meinertz T, Gaus W, Tendera M. Survival and
prognosis: investigation of Crataegus extract WS 1442 in congestive heart
failure (SPICE)--rationale, study design and study protocol. Eur J Heart
Karch SB. The Consumer's Guide to Herbal Medicine. Hauppauge, New York:
Advanced Research Press; 1999:109-111.
Mashour NH, Lin GI, Frishman WH. Herbal medicine for the treatment of
cardiovascular disease. Arch Intern Med.
Miller AL. Botanical influences on cardiovascular disease. Altern Med
Miller L. Herbal medicinals: selected clinical considerations focusing on
known or potential drug-herb interactions. Arch Intern Med.
Morelli V, Zoorob RJ. Alternative therapies: Part II. Congestive heart
failure and hypercholesterolemia. [Review]. Am Fam Physician.
Rajendran S, Deepalakshmi PD, Parasakthy K, Devaraj H., Devaraj SN. Effect of
tincture of Crataegus on the LDL-receptor activity of hepatic plasma membrane of
rats fed an atherogenic diet. Atherosclerosis. 1996;123:235-241.
Rotblatt M, Ziment I. Evidence-Based Herbal Medicine. Philadelphia,
PA: Hanley & Belfus, Inc; 2002:231-235.
Rigelsky JM, Sweet BV. Hawthorn: pharmacology and therapeutic uses.
Am J Health Syst Pharm. 2002;59(5):417-422.
Schultz V, Hansel R, Tyler V. Rational Phytotherapy: A Physician's Guide
to Herbal Medicine. Heidelberg: Springer; 1998.
Schussler M, Holzl J, Fricke U. Myocardial effects of flavonoids from
crataegus species. Arzneimittelforschung.
White L, Mavor S. Kids, Herbs, Health. Loveland, Colo: Interweave
Review Date: April 2002
Reviewed By: Participants in the review process include: Jacqueline A. Hart, MD,
Department of Internal Medicine, Newton-Wellesley Hospital, Harvard University
and Senior Medical Editor Integrative Medicine, Boston, MA; Gary Kracoff, RPh
(Pediatric Dosing section February 2001), Johnson Drugs, Natick, MA; Steven
Ottariono, RPh, Veteran's Administrative Hospital, Londonderry, NH; David
Winston, Herbalist (March 1999), Herbalist and Alchemist, Inc., Washington, NJ;
Tom Wolfe, P.AHG (March 1999), Smile Herb Shop, College Park, MD. All
interaction sections have also been reviewed by a team of experts including
Joseph Lamb, MD (July 2000), The Integrative Medicine Works, Alexandria,
VA;Enrico Liva, ND, RPh (August 2000), Vital Nutrients, Middletown, CT; Brian T
Sanderoff, PD, BS in Pharmacy (March 2000), Clinical Assistant Professor,
University of Maryland School of Pharmacy; President, Your Prescription for
Health, Owings Mills, MD; R. Lynn Shumake, PD (March 2000), Director,
Alternative Medicine Apothecary, Blue Mountain Apothecary & Healing Arts,
University of Maryland Medical Center, Glenwood, MD; Ira Zunin, MD, MPH, MBA
(July 2000), President and Chairman, Hawaii State Consortium for Integrative
Medicine, Honolulu, HI.
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regarding dosage, precautions, warnings, interactions, and contraindications
before administering any drug, herb, or supplement discussed