Hawthorn, English hawthorn, harthorne, haw, hawthorne, Crataegus laevigata, Crataegus oxyacantha, and Crataegus
monogyna

BACKGROUND

Crategus (hawthorn, or thornapple or hawberry) is a genus of shrubs and trees in the family Rosaceae. The name,
hawthorn, was originally applied to the species, esp. C. monogyna, in northern Europe, but now, it is also applied to the
entire genus, and also to the Asian genus Rhaphiolepis. [Wikipedia]

Hawthorn is a spiny, flowering shrub or small tree of the rose family, a fruit-bearing shrub. Hawthorn is found in Europe,
western Asia, North America, and North Africa.

Traditionally, hawthorn was used for ailments, dyspnea, kidney stones, and cardiovascular disorders. According to
National Center for Complementary and Alternative Medicine (NCCAM D344; April 2012), hawthorn fruit has been used
for heart disease since the first century. More recently, hawthorn leaf and flower have been used as folk or traditional
remedies for heart failure, a weakness of the heart muscle that prevents the heart from pumping enough blood to the
rest of the body, which can lead to fatigue and limit physical activities. However, the results are conflicting. Hawthorn is
also used for other heart conditions, including symptoms of coronary artery disease (such as angina).

Hawthorn is believed to be able to increase the integrity of the blood vessel wall and improve coronary blood flow. It is
rich in procyanidins, flavonoids and flavonols and these chemicals are postulated to account for its benefits. [9] These
chemicals or ingredients of hawthorn is able to decrease the resistance to blood flow in peripheral blood vessels,
improve coronary artery blood flow and strengthen of the contractions of the heart muscle. Consequently, they support
normal blood flow. It is also believed that hawthorn may have benefits on lipid profiles. But, more studies are needed to
prove this argument.

ACTIVE INGREDIENTS

Hawthorn contains a variety of bioflavonoids that may be responsible for its cardiac actions. Its flavonoids include
oligomeric procyanidins (OPCs), vitexin, vitexin;-O-rhamnoside, quercetin, and hyperoside.
_____________________________________________________________________________________________

HAWTHORN BENEFICIAL EFFECTS

Hawthorn may have many health benefits, such as preventing cardiovascular diseases via lowering blood pressure,
and cholesterol levels, consequently lowering the risk of congestive heart failure.  [10]

Congestive Heart Failure
Congestive heart failure happens when the heart muscle is unable to pump blood as efficiently as is needed. Its
symptoms include breathlessness, fatigue, and accumulation of fluid in the lungs or the veins (primarily in the legs) or
both. Hawthorns exert their beneficial effects probably via improving coronary artery blood flow and strengthens the
heart muscle contraction [1]. Further, hawthorns may also decrease the resistance to blood flow in peripheral blood
vessel [2] and mildly lower the blood pressure in some people.

In a study people with congestive heart failure taking 160-900 mg of hawthorn extract per day for eight weeks showed
improved their ability to exercise without shortness of breath and exhaustion. [3- 7]. Some other studies also show
similar results in patients with heart failure and in animals, [12, 13] however, people with congestive heart failure require
expert management rather than self-treatment.

Myocardial Damage
In a study of rats,  isoproterenol significantly increased the release of lactate dehydrogenase, creatine kinase in serum,
decreased the antioxidant status in the heart along with an increase in lipid peroxidation. Nitritive stress and apoptosis
were seen in isoproterenol-induced rat heart. Pre-treatment with alcoholic extracts of the berries of Crataegus
oxyacantha for 60 days had a significant effect on all the above factors and maintained near normal status. [A14]

Diabetes
Jouad H et al [Morocco] concluded that an aqueous extract of hawthorn leaves exhibited a potent anti-hyperglycemic
activity in STZ rats, but not in normal rats, without affecting basal plasma insulin concentrations. [11]
_____________________________________________________________________________________________
RECOMMENDED DAILY DOSE

The recommended daily dose of hawthorn (flowers or leaves)  water-ethanol extract is 160-900 mg or any dose
equivalent to 30-169 mg of epicatechin or 3.5-19.8 mg of flavonoids. [8]
_____________________________________________________________________________________________
HAWTHORN SIDE EFFECTS

Side Effects
Hawthorn is considered safe for most adults when used for short periods of time. Side effects are rare and can include
upset stomach, headache, and dizziness. [NCCAM] Its side effects can also be serious. Even at therapeutic dose
range, hawthorn may lead to side effects such as a mild rash, headache, sweating, dizziness, palpitations, sleepiness,
agitation, and gastrointestinal symptoms.

Drug Interaction
Hawthorn may potentiate or inhibit other drugs' actions for heart failure, hypertension, angina, and arrhythmias. [8]
Users should consult their medical doctors before taking hawthorn or its supplments.
_____________________________________________________________________________________________
HAWTHORN EXTRACTS

The standardized total bioflavonoid content is usually 2.2% and that for oligomeric procyanidins is 18.75%. And, most
people take 80-300 mg of the herbal extract three times in a day [8]. Though hawthorn may take 1-2 months to show its
maximum effects but it appears to be safe.
Hawthorn side effects and benefits                            2013
Potential Health Benefits
Hawthorn Berry / Fruit
Hawthorn Leaf
Hawthorn Flower
Antioxidant Activity
A4 Rats, A6 In vitro
In vitro, A1
A13 in vitro
Anti-inflammation (acute
myocardial ishemia)
A4 Rats Colitis A7 Mice
A2, Dogs Acute myocardial
ishemia
no support
Glucose Metabolism
no support
A3, in vivo
no support
Triglyceride lowering
A9 Mice
A3, in vivo
no support
Anti-cancer Activities
A5, Human MCF-7 breast
cancer cells
no support
no support
Cholesterol lowering
A9 Mice
A10 Larval zebrafish
A11 diabetic subjects with
chronic coronary heart disease
A10 Larval zebrafish
A11 diabetic subjects with
chronic coronary heart
disease
Chronic heart failure
-
A 12 human neutrophils
A12 human neutrophils
_____________________________________________________________________________________________
HAWTHORN BERRY, FRUIT, LEAF AND FLOWER COMPARISONS

Different parts of Hawthorn contain different compounds, Hawthorn Flowers reveal the highest tocopherols and
ascorbic acid contents, and also the best n-6/n-3 fatty acids ratio. Over ripened fruits showed the highest levels of
carbohydrates, sugars and SFA. Unripe fruits presented the highest PUFA contents with the best PUFA/SFA ratio, as
also the highest levels of phenolics and the most promising antioxidant properties [A8] The following is a brief
comparison of the potential health benefits among hawthorn berry / fruit, hawthorn leaf and hawthorn flower:
Please  note that "no support" means "no supportive research studies have been found". "No support" does not
mean the item has no such potential benefits. However, most studies were done in animals or in vitro, it is unclear if
hawthorn extracts are effective in human body. Further, all supplements can not be used as a replacement for
medicine. Please, consult with your medical doctors for any questions.
_________________________________________________________________________________________
RELATED ARTICLE

Crataegus pinnalifida (Shanzha)

__________________________________________________________________________________________
REFERENCE

Reference for Table Comparison of Hawthorn Berry, Hawthorn Leaf and Hawthorn Flower:
A1 In vitro Włoch A et al, Activity of hawthorn leaf and bark extracts in relation to biological membrane. J Membr Biol.
2013 Jul;246(7):545-56. A2. Dog Fu JH et al, Hawthorn leaves flavonoids decreases inflammation related to acute
myocardial ischemia/reperfusion in anesthetized dogs. Chin J Integr Med. 2013 Aug;19(8):582-8. A3. Wang T et al,
Regulation effects of Crataegus pinnatifida leaf on glucose and lipids metabolism. J Agric Food Chem. 2011 May 11;
59(9):4987-94 A4 Malekinejad H et al, Comparative protective effect of hawthorn berry hydroalcoholic extract,
atorvastatin, and mesalamine on experimentally induced colitis in rats. J Med Food. 2013 Jul;16(7):593-601. A5 Li T,
et al, Differential effects of polyphenols-enriched extracts from hawthorn fruit peels and fleshes on cell cycle and
apoptosis in human MCF-7 breast carcinoma cells. Food Chem. 2013 Nov 15;141(2):1008-18. A6 Simirgiotis MJ.
Antioxidant capacity and HPLC-DAD-MS profiling of Chilean peumo (Cryptocarya alba) fruits and comparison with
German peumo (Crataegus monogyna) from southern Chile. Molecules. 2013 Feb 5;18(2):2061-80 A7 Shin IS, et al,
An extract of Crataegus pinnatifida fruit attenuates airway inflammation by modulation of matrix metalloproteinase-9
in ovalbumin induced asthma. PLoS One. 2012;7(9):e45734 A8 Barros L et al, Comparing the composition and
bioactivity of Crataegus Monogyna flowers and fruits used in folk medicine. Phytochem Anal. 2011 Mar-Apr;22(2):
181-8. A9 Xu H et al, A study of the comparative effects of hawthorn fruit compound and simvastatin on lowering
blood lipid levels. Am J Chin Med. 2009;37(5):903-8. A10 Littleton BMC Complement Altern Med. 2012 Jul 23;12:105.
RM et al,Whole plant based treatment of hypercholesterolemia with Crataegus laevigata in a zebrafish model. BMC
Complement Altern Med. 2012 Jul 23;12:105 A11 Dalli E, et al, Crataegus laevigata decreases neutrophil elastase
and has hypolipidemic effect: a randomized, double-blind, placebo-controlled trial. Phytomedicine. 2011 Jun 15;18(8-
9):769-75. A13 García-Mateos R, et al, Flavonoids and antioxidant activity of flowers of Mexican Crataegus spp. Nat
Prod Res. 2013;27(9):834-6. [A14] Vijayan NA et al, Mol Cell Biochem. 2012 Aug;367(1-2):1-8]

_________________________________________________________________________________________
REFERENCE

Reference for The Text
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. Weihmayr T, Ernst E. Therapeutic effectiveness of Crataegus. Fortschr Med 1996;
114:27-9 [in German]. 4. 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. 5. 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. 6. 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. 7. 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. 8. Brown DJ. Herbal Prescriptions for Better Health. Rocklin, CA: Prima
Publishing, 1996, 139-44.[9] Rigelsky JM Hawthorn: pharmacology and therapeutic uses. Am J health Syst Pharm.
2002 mar 1;59(5):417-22. [10] Chang WT et al, Hawthorn: potential roles in cardiovascular disease. Am J Chin Med.
2005;33(1):1-10. [11] J Herb Pharmcother. 2003;3(2):19-29.
[12] Forsch Komplementarmed Klass Naturheilkd. 2004 Aug;11 Suppl 1:36-9.
[13] J Pharm Pharmacol. 2004 Jul;56(7):921-6.