Medical Attributes of Crataegus sp. – Hawthorn

by Ashley McBrearty, Jason Cao, and Chuck Yurkon
Wilkes University, Wilke-Barre, PA

July 2005

Hawthorn is a
small tree or large shrub in the genus Crataegus that is classified in the Rosaceae (the rose family).  It was described as far back as Theophrastus’s History of Plants, about 2,300 years ago (Dickinson, 2003).  Crataegus contains approximately 300 different species.  Crataegus has white or red flowers, pronounced thorns, and colorful berries.  It is often used as a hedgerow (Foster, 2000). 

Crataegus has been used medically by the Native Americans to treat a variety of disorders, including those of the digestive, renal, and cardiovascular systems (Foster, 2000).  Chinese medical uses included treatment of scurvy and digestive disorders as well as an antidote to poisoning (Foster, 2000).  The hawthorn plant received very little mention in Greek and Roman herbals, aside from the edible quality of its berries (Foster, 2000). 

Hawthorn is considered a heart tonic herb and has been found to be beneficial in the treatment of circulatory disorders such as hypertension, hyperlipidemia and in particular, congestive heart failure
(Foster, 2000).  The beneficial effects are mainly due to flavonoids and oligomeric procyanidins (OPCs) which are found in the flowers and berries of hawthorn (Dickinson, 2005).  Flavonoids and OPCs have antioxidant properties which allow them to scavenge free radicals.  While found naturally in the body, the number of free radicals increases dramatically with environmental stresses such as UV light, radiation, cigarette smoke and air pollution.  Free radicals may contribute to the aging process as well as the development of heart diseases (Dickinson, 2005). Flavonoids can dilate coronary vessels and thereby reducing blood pressure.  However, hawthorn's long-term effectiveness is still being studied (Degenring et al. 2003). 

Many studies have confirmed the use of hawthorn in treating hypertension accompanied by a weak heart, angina pectoris, and arteriosclerosis.  The cardiovascular effects of hawthorn in these studies are believed to be the result of positive inotropic activity which allows the heart muscle to contract more strongly, along with the ability to increase the durability of the blood vessel wall and improve coronary blood flow (Rigelsky and Sweet, 2002).  In a study done by Rigelsky and Sweet (2002), New York Heart Association (NYHA) functional class II congestive heart failure (CHF) patients showed a positive response of improved coronary blood flow and oxygen utilization in a clinical trial to the recommended daily dose of hawthorn (equivalent to 3.5-19.8 mg flavonoids) with few minor side effects.  In another study done by Degenring et al. (2003), a significant improvement occurred in NYHA II patients who showed a dramatic increase in exercise tolerance due to the fact that dyspnoea and fatigue did not occur until a significant wattage was reached in a bicycle exercise.  In both studies, further research is being done on the long-term effects of the hawthorn therapy with the standardized extract of fresh hawthorn berries (Degenring et al. 2003). 

In Germany, hawthorn leaves and flowers have already been approved for treating early stages of congestive heart failure, age-related heart disorders and mild arrhythmias in Germany (Foster and Duke, 2000).  However, the use of their berries has not yet been approved in treating any disorders. 

Hawthorns do not have too many harmful side effects. The biggest risk with this remedy is that the patient runs an increased risk of death if hawthorn is used instead of conventional medical treatment for serious conditions (Miller 1998). Chemicals in hawthorn have been shown to increase the force of heartbeats and on the blood vessels to relax the arteries around the heart, but they decrease the rate of heartbeats. In some rare cases, hawthorn can cause rapid or erratic heartbeat. Hawthorn also has been reported to cause dizziness, headache, insomnia, nausea, and sweating (Mashour et.al., 1998).

Hawthorn may interact with other medications. Certain foods and vitamins may also interact with hawthorn. Before taking hawthorn, patients should talk to their health care provider if these medications are also being taken: ACE inhibitors, beta blockers, digoxin, herbs that affect the heart, nitroglycerin, sedatives and tranquilizers, and vasodilators (Miller, 1998).

Although hawthorn has been used as an herbal remedy for centuries, its medical benefits are just beginning to be explored.  More experimentation is necessary to better understand the long-term effects of this herb.  If additional clinical trials prove favorable, Crataegus could become a more important therapeutic agent in the treatment of cardiovascular disorders.





LITERATURE CITED:

The Crataegus Problem. University of Toronto. http://www.botany.utoronto.ca/faculty/dickinson/CRATAEGUS2.HTML.

Degenring, F.H., A. Suter, M. Weber, & R. Saller. 2003. A randomized double blind placebo controlled clinical trial of a standardized extract of fresh Crataegus berries
(Crataegisan) in the treatment of patients with congestive heart failure NYHA II.  Phytomedicine 10: 363-369.

Dickinson, T.A. Hawthorn. University of Maryland Medical Center. http://www.umm.edu/altmed/ConsHerbs/Hawthornch.html. June 15, 2005.

Foster, S. and J.A. Duke. 2000. Medical Plants and Herbs.  Peterson Field Guide. Houghton Mifflin Company. NY, NY.

Foster, S.  2000. Hawthorn. Crataegus. Steven Foster Group. Houghton Mifflin, Co., Boston.

Mashour, N.H., G.I. Lin, & W.H. Frishman. 1998.  Herbal medicine for the treatment of cardiovascular disease. Archive of Internal Medicine. 158: 2225-2234.

Miller, L.G. 1998. Herbal medicinals
: selected clinical considerations focusing on known or potential drug-herb interactions.  Archive of Internal Medicine. 158: 2200-2211.

Rigelsky, J.M. & B.V. Sweet. 2002.  Hawthorn: pharmacology and therapeutic uses. Am J Health Systems Pharmacology. 59: 417-422.



This paper was developed as part of the BIO 368 - Medical Botany course offered at Wilkes University during the summer of 2005. Course instructor was Kenneth M. Klemow, Ph.D. (kklemow@wilkes.edu). The information contained herein is based on published sources, and is made available for academic purposes only. No warrantees, expressed or implied, are made about the medical usefulness or dangers associated with the plant species in question.

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This page posted and maintained by Kenneth M. Klemow, Ph.D., Biology Department, Wilkes University, Wilkes-Barre, PA 18766. (570) 408-4758, kklemow@wilkes.edu.