Hawthorn is a dense, thorny shrub that grows 5–13 ft (1.5–4 m) high. It has white flowers that look like roses and is considered one of the most beautiful of all
the shrubs that flower in the spring. A member of the rose family, it has been planted along hedges to deter trespassers since the Middle Ages. Hawthorn grows throughout the world anywhere that is moist.
Hawthorn is the common name for Crataegus oxyacantha or other Crataegus species. There are more than 300 species throughout the world. Hawthorn's flowers, leaves, and fruit (berries) are used as medicine, although the flowers have an unpleasant smell and taste slightly bitter. The hawthorn fruit is sour.
Hawthorn is one of the oldest medicinal plants known in Europe, where it has been used since the Middle Ages for heart problems. The ancient Greeks and Native Americans also recognized hawthorn's heart-healthy properties.
Hawthorn also is called Crataegus extract, mayflower, maybush, and whitethorn. Common trade names for hawthorn include Cardiplant, Hawthorn Berry, Hawthorn Formula, Hawthorn Heart, Hawthorn Phytosome, and Hawthorn Power.
Hawthorn most commonly is used to treat heart disease and to treat and prevent cardiovascular disorders. Herbalists consider hawthorn to be the world's best heart tonic. It increases blood flow to the heart by dilating the coronary arteries; lowers blood pressure and eases the heart's workload by dilating arteries in the arms and legs; and increases the force of the heart's contractions.
In Europe, scientific studies have shown that the hawthorn leaf expands the blood vessels and lets more oxygen-rich blood reach the heart muscles; increases the strength of the heartbeat and slightly increases its speed; and helps the heart by reducing resistance throughout the rest of the circulatory system. Hawthorn leaf is used for angina and weak heart. A 2001 report on a European study stated that patients using hawthorn extract reported improved exercise intolerance, fatigue, and shortness of breath.
Hawthorn also is a powerful antioxidant. There is strong evidence that antioxidants lower the risk of heart attacks, strokes, and deaths from heart diseases, but this has not been proven in studies. Antioxidants are believed to help the coronary arteries dilate and increase blood flow to the heart. They may prevent blockages from coming back after a surgical procedure called angioplasty.
Hawthorn is used, in conjunction with standard medical treatment, for heart failure classified as mild to moderate (stage II) by the New York Heart Association and to prevent angina. Mild to moderate heart failure includes patients with heart disease who do not have any limitations in their physical activities due to the heart disease. They are comfortable when resting and feel symptoms such as fatigue, palpitation, shortness of breath, or angina pain when performing ordinary physical activities.
Hawthorn has long been used in Europe to treat mild cases of heart failure. In Germany, the Federal Institute for Drugs and Medical Devices has approved the use of hawthorn leaf with flower extracts as a treatment for New York Heart Association functional stage II heart failure. The treatment also is listed in the German Pharmacopeia and approved in the German Commission E monographs. Several recent studies conducted outside the United States, primarily in Germany, have studied hawthorn's effects. In one study, patients who took hawthorn after having moderate heart attacks showed some improvement compared to patients who took a placebo; however, this study only lasted eight weeks. Other studies have shown that hawthorn can be used safely and effectively for congestive heart failure, that it can improve heart function in patients with chronic heart disease, and that it compared well with a heart drug called Captopril in treating stage II heart disease patients. Most of these studies only lasted eight weeks.
In 2003, a longer trial, consisting of 16 weeks of treatment of more than 200 patients, showed that use of hawthorn increased exercise capacity and decreased signs and symptoms on heart failure. Hawthorn was slightly more effective at a higher dose (1,800 mg per day).
Hawthorn also is taken in liquid form for insomnia and nervous conditions and is used as a gargle for sore throats. In folk medicine, hawthorn is used as a heart tonic and treatment, to regulate blood pressure, and as a
Hawthorn is most commonly used in liquid or dry extracts or as capsules. It is collected and dried at room temperature. The dosage of hawthorn varies and the manufacturer's directions should always be followed. A typical dose of hawthorn might be 160 to 900 mg of extract given in two or three doses a day or 1 gram of crushed herb taken up to five times a day. Hawthorn should be taken for at least six weeks. It should be stored in a tightly sealed container and protected from the light.
Hawthorn should only be used for diagnosed heart conditions. Women who are pregnant or breast feeding should take hawthorn only under the advice of a physician. Patients who are sensitive to other types of Rosaceae plants should not take hawthorn.
Hawthorn leaf only is useful for angina when it is used over a long period of time. It can sometimes prevent angina, but it cannot treat an angina attack.
Since hawthorn performs the same function as some nitrates, cardiac glycosides, central nervous system depressants, and medications for high blood pressure, lower doses of these medications might be needed. Consult a qualified practitioner for appropriate dosages.
Fetrow, Charles W. and Avila, Juan R. Professional's Handbook of Complementary & Alternative Medicines. Spring-house, 1999.
The PDR Family Guide to Natural Medicines & Healing Therapies. Three Rivers Press, 1999.
PDR for Herbal Medicines. Medical Economics Company, 1998.
Gaby, Alan R. "Hawthorn (Crateagus) Effective Against Heart Failure: Double-blind Study." Townsend Letter for Doctors and Patients, (May 2003): 32.
"Heart Effects of Herbal Medicine." Harvard Health Letter (March 2000): 3.
"Herbs and Drugs for Your Heart: Sorting Out What's Safe." Herbs for Health (Nov/Dec 1999):28-29.
Walsh, Nancy. "Hawthorn Extract Limits CHF, Mild Heart Ailments." Internal Medicine News (October 1, 2001):9.
onhealth. "Hawthorn Leaf." http://onhealth.com/alternative/resource/herbs/item,77150.asp
"Hawthorn for the Heart: A Cardiologist's Perspective." Heart Watch, from the publishers of The New England Journal of Medicine, http://www.allhealth.com/heartwatch/jul99/nejm/0,4802,7016_127324,00.html.
Lori De Milto
Teresa G. Odle