Hawthorn Summary:

Hawthorn is considered by many to be the best known cardiovascular tonic in the plant kingdom. This is a result of hawthorns level of safety, and its broad actions on all cardiovascular functions. It is especially beneficial at improving the blood supply to the heart directly via the coronary arteries. A blockage in any of the coronary arteries will result in a heart attack. Therefore promoting an improvement in these arteries can go a long way in delaying or preventing the development of heart failure. 

Hawthorn also improves heart arrythmias and palpitations, high blood pressure, high cholesterol and high blood lipid levels, and anxiety. It is used both before a heart attack as a preventative, and after to aid recovery.  

The Greek meaning of Crataegus oxycantha  actually refers to the shape thorns and hard wood that is characteristic of the plant [3]. It tends to grow in temperate climates, and makes a great garden variety tree or shrub. 


Botanical Name

Crateagus oxycantha
Crateagus laevigata
Crateagus oxycanthoides
Crateagus monogyna

Family

Rosaceae

Part Used

Berries, flower, leaf

Specific Actions:

  • Positively inotropic
  • Positively chronotropic
  • Positively dromotropic
  • Vasodilating to the coronary arteries

Herbal Actions:

  • Cardiotonic
  • Diuretic
  • Astringent
  • Hypotensive
  • Antioxidant
  • Collagen Stabilizer
  • Anti-Arrhythmic
 

Dosage

Infusion (1:20)

Berries, flowers, leaves

xxx mL/day

Liquid Extract (1:2)

Leaf or berry

3-7 ml/day

Tincture (1:5)

17 ml/day

(Higher for hypertension)
A note on using Hawthorn for cardiovascular disease

When using Hawthorn for heart disease it should be used for a minimum of 2 months. No long term adverse affects of using this herb in the above doses have been reported and long term use has been found to be most effective for this condition. [3]. 

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Indications:

[3, 15]

  • Cardiovascular disease
    • Preventative and treatment
    • Cardiac arrhythmias
    • Heart palpitations
    • High blood pressure
    • Age related heart conditions
    • Angina pectoris
    • Tachycardia
    • Mild congestive heart failure
    • Coronary artery disease
    • Recovery from heart attacks
    • Protects heart during infections of diphtheria and pneumonia
    • Arteriosclerosis
  • Topical uses
    • Acne
    • Improve hydration to the skin and hair
  • Nervous system disorders
    • Anxiety
  • Taken as a cofactor for vitamin C intake
  • Hyperlipidaemia (mainly the berries)

Common Names:

  • Crataegus
  • Hawthorn
  • Hawthorn Berry
  • Hawthorn Leaf
  • Aubépine (France)
  • Biancospino (Italian)

Traditional Uses:

There is a lot of reference to hawthorn in older texts, and much of the indications are towards cardiac diseases and circulation. It was used in the past to treat conditions including tachycardia, hypertention, angina pectoris, and myocardial weakness. The berries were also used as an astringent for sore throats, and as a diuretic. [3]. 

In Chinese medicine, the fruit was often used to improve digestion, stimulate circulation, and treat blood stasis. [3]. 

Traditionally the berry was mainly used, however more recent findings suggest the leaves to have a stronger action medicinally [3]. 

Hawthorn has also been extensively used as a source of wood, and the berries as a flavouring of liquor. [3]. 

The British herbal pharmacopoeia lists crataegus as cardiotonic, coronary vasodilator, and hypotensive specific for cardiac failure, myocardial weakness, hypertension, arteriosclerosis, Buergers disease, and paroxysmal tachycardia [13]. 


    Botanical Description:

    Crataegus is a deciduous, thorny shrub or small tree that can grow up to 10m tall. [3]. 

    The leaves are broad, and have 3-5 lobes. [3]. 

    The flowers are white, have red anthers, and arranged in groups of 5 or 10 [3]. 

    The fruit is contained within a larger, dark red colored false fruit [3]. 

    There is extensive hybridization of Crataegus in general, which has led to some confusion with the classification of many species contained in the genus [3]. 


    Habitat Ecology, and Distribution:

    Still compiling research. 


    Harvesting Collection, and Preparation:

    Although traditionally the berries were preferred, in general it has been found that the leaves offer the most benefit towards cardiovascular disease [3]. 


    Constituents:

     

    Hawthorn Berries

    The berries of the hawthorn tree contain flavonoids, amines, catechols, carboxylic acid, and triterpene acids [3]. 

     

    Hawthorn leaves and flowers

    The leaves contain flavonoids (up to 1.78%) (including vitexin, quercetin, hyperoside, rutin), oligomeric procyanidins (1-2.4%), triterpene acids (up to 0.6%) (ursolic acid, oleanic acid, crataegolic acids), phenolic acids (caffeic, chlorogenic, and related phenocarboxyl acids), [1-3]. 

     

    A note on concentrated extracts of crataegus

    There have been multiple reports of studies using isolated constituents showing very little or no significant activity when compared to the whole herb extract. The whole extract, has been found to consistently produce noticeable, and broad actions, especially on the cardiovascular system [1]. For this reason, only the whole herb extract should be used. 


    Pharmacology and Medical Research:

     

    Cardiovascular system

    The German Federal Ministry of Health conducted a four year study on Crataegus and its activity on the cardiovascular system, which resulted with the inclusion of Crataegus as a recognized cardiac medication in Europe. [1]. 

    Much of the research on hawthorn has been aimed at its activity on the cardiovascular system. To date, evidence towards crataegus benefits on the entirety of the cardiovascular system includes:

    • Coronary artery dilation [3, 4]
    • Antioxidant activity [3]
    • Positively inotropic [3, 4]
      •  improves the availability and utilization of energy in the myocardium rather than directly impacting contractile fibers like cardiac glycosides [1]. 

     

    Coronary artery dilation

    The coronary artery dilation has been found to be through the crataegolic acid and ursolic acid content, and various flavonoids (such as vitexin-2"-)'rhamnoside, luteolin-7-glucoside, hyperoside, rutin, and vitexin), and the oligomeric procyanidins (OPCs) [4]. 

    the ability for hawthorn to improve coronary blood flow was reproduced in dogs (with oral administration) [8], 

     

    Antioxidant activity

    The antioxidant activity of crataegus is suggested to be mainly due to the flavonoids present in the leaves, flowers, and berries. These chemicals are strong antioxidant chemicals, and have also been shown to produce the ability to increase collagen cross-linkiung in the walls of vascular tissue. this strengthens the blood vessels and dcan significantly reduce the risk of cardiovascular disease. [1]. 

     

    Positively Inotropic

    The inotropic activity was found to be due to the cratagolic acid, ursolic acid, and vitexin-2"-O-rhamnoside (flavonoid) content in an older study [4]. The action was found in another study to be through an increase in the contraction amplitude of the cardiac myocytes in an in vitro study [5].

    This activity has been reproduced in several studies using standardized leaf and flower extracts [7].  

     

    Antiarrhythmic

    The antiarrhithmic activity of crataegus was shown to be attributed mainly to the isoprenaline content. Th mechanism was suggested to be likely through a prolonged refrctory period brought on by the beta-adrenergic agonist activity of this chemical [6]. 

     

    Microcirculation

    The OPC content of crataegus was shown in several studies to promote bloodflow in both the aorta and microcirculation, through nitric-oxide mediated relaxation and inhibitory action on angiotensin converting enzyme (ACE) both invitro and in vivo [9, 10, 11, 12]. 

     

    Toxicity

    There are no reported long term adverse effects with using hawthorn in the therapeutic dosage range, and long term use is recommended for cardiovascular disease with this herb [3]. 

     

    Cautions:

    Due to the action around heart function, crataegus may enhance the activity of cardiac glycosides such as digitalis, or Convellaria majalis. This may improve the effectiveness of these drugs/herbs, and allow for smaller, more effective doses. Caution is advised when using these medications. [1]. 


    Traditional Chinese Medicine:

    Still compiling research


    Synergy:

    Often used in conjunction with Tilia platyphyllos, Allium sativum, or Viburnum opulus for arteriosclerosis [1]. Their may be possible synergy here. 

    Combines well with Tilia and scutellariua for hypertension [1].

    Crataegus has been reported to have synergy with digitalis glycosides and beta-blockers. No adverse interactions have been reported with digoxin. [3]. 

    The British herbal pharmacopoeia suggests crataegus has possible synergy with Selenicereus grandiflorus , Tilia, Viscum, or Scutellaria [13]. 


    Author:

    Justin Cooke

    The Sunlight Experiment

    Updated: June 2017


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    References:

    1. Hoffmann, D. (2003). Medical herbalism: The science and practice of herbal medicine. Rochester, VT: Healing Arts Press
    2. Blumenthal, M., Brinckmann, J., & Wollschlaeger, B. (2003). The ABC clinical guide to herbs. Austin, TX: American Botanical Council.
    3. Bone K, Mills S. (2013). Principles and Practice of Phytotherapy. Elsevier health. China. (Pg. 392-398).
    4. Occhiuto, F., Circosta, C., Costa, R., Briguglio, F., & Tommasini, A. (1986). Comparative study of the cardiovascular activity of shoots, leaves and flowers of Crataegus oxyacantha: 2. Action of extracts and isolated pure active principles on the isolated rabbit heart. Plantes medicinales et phytotherapie, 20, 52-63.
    5. Petkov, E., Nikolov, N., & Uzunov, P. (1981). Inhibitory effect of some flavonoids and flavonoid mixtures on cyclic AMP phosphodiesterase activity of rat heart. Planta Medica, 43(10), 183-186.
    6. Pöpping, S., Rose, H., Ionescu, I., Fischer, Y., & Kammermeier, H. (1995). Effect of a hawthorn extract on contraction and energy turnover of isolated rat cardiomyocytes. Arzneimittel-Forschung, 45(11), 1157-1161.
    7. Trunzler, G., & Schuler, E. (1962). [Comparative studies on the effect of a Crataegus extract, of digitoxin, digoxin and gstrophanthin on the isolated mammalian heart.]. Arzneimittel-Forschung, 12, 198-202.
    8. Roddewig, C., & Hensel, H. (1977). [Reaction of local myocardial blood flow in non-anesthetized dogs and anesthetized cats to the oral and parenteral administration of a Crateagus fraction (oligomere procyanidines)]. Arzneimittel-Forschung, 27(7), 1407-1410.
    9. Kim, S. H., Kang, K. W., Kim, K. W., & Kim, N. D. (2000). Procyanidins in crataegus extract evoke endothelium-dependent vasorelaxation in rat aorta. Life sciences, 67(2), 121-131.
    10. Brixius, K., Willms, S., Napp, A., Tossios, P., Ladage, D., Bloch, W., ... & Schwinger, R. H. (2006). Crataegus special extract WS® 1442 induces an endothelium-dependent, NO-mediated vasorelaxation via eNOS-phosphorylation at serine 1177. Cardiovascular drugs and therapy, 20(3), 177-184.
    11. Anselm, E., Socorro, V. F. M., Dal-Ros, S., Schott, C., Bronner, C., & Schini-Kerth, V. B. (2009). Crataegus special extract WS 1442 causes endothelium-dependent relaxation via a redox-sensitive Src-and Akt-dependent activation of endothelial NO synthase but not via activation of estrogen receptors. Journal of cardiovascular pharmacology, 53(3), 253-260.
    12. Lacaille-Dubois, M. A., Franck, U., & Wagner, H. (2001). Search for potential angiotensin converting enzyme (ACE)-inhibitors from plants. Phytomedicine, 8(1), 47-52.
    13. British Herbal Medicine Association. (1983). British Herbal Pharmacopoeia. Bournemouth, UK: Author.
    14. Bone, K. (2003). A clinical guide to blending liquid herbs: Herbal formulations for the individual patient. Edinburgh [u.a., MO: Churchill Livingstone.
    15. Blumenthal, M., Brinckmann, J., & Wollschlaeger, B. (2003). The ABC clinical guide to herbs. Austin, TX: American Botanical Council.
     

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