Medical Attributes of Crataegus sp. – Hawthorn

by Brianna Galvin
Wilkes University, Wilkes-Barre, PA

July 2017

Hawthorn, Crataegus sp, is a shrubby member of the rose family (Rosaceae). Hawthorn produces white or red white flowers, which in turn produce colorful pomes, and protects itself with thorn armature (Ehrlich, 2015). The genus Crataegus contains around two hundred species, mostly native to the north temperate zone.  Crataegus oxyacantha and Crataegus laevigata are two species recognized for their medicinal benefits by the European Pharmacopeia (Orhan, 2016).

The use of hawthorn has been documented globally for centuries (Plants Profile, 1999).   Beginning with Greek and Roman culture, herbals have discussed the edibility of Crataegus’s brightly colored pomes (Foster, 2009). In Asia, medical uses of hawthorn include the treatment of heart and blood ailments such as hypertension, arteriosclerosis, and angina pectoris. The Chinese use hawthorn to treat heart ailments as well as to treat scurvy, digestive ailments, and even to counteract certain poisonings (Foster, 2009).  Native Americans treated digestive and cardiovascular ailments, such as diarrhea, dysentery, and cramping by using the hawthorn plant (Foster 2009).

Since middle to late 20th century, hawthorn has gained recognition for its heart-healthy benefits, and its usefulness in treating circulatory disorders such as hypertension, hyperlipidemia and, congestive heart failure (Foster, 2009).  The active chemicals that benefit heart health are flavonoids, which are easy to extract as they are found in high yields, and oligomeric procyanidins (OPCs), found in the flowers and berries of hawthorn (Dickinson, 2005).  Flavonoids can dilate coronary vessels and thereby reducing blood pressure. These chemicals also contain antioxidant properties that scavenge for free radicals.  Free radicals naturally occur within the body; however, the quantity increases with environmental stresses such as radiation, UV light, air pollution.  Studies have shown that free radicals contribute to the development of cardiovascular disorders (Dickinson, 2005). Since discovering their heart-healthy benefits, scientists have focused on attempting to isolate the flavonoids as well as other potentially beneficial chemicals found within the hawthorn plant.

A recent study by Abu-Gharbieh and Ng (2017) found that 3β-O-acetyl ursolic acid taken from hawthorn leaves contains antihyperglycemic and antiperlipidemic protentional that prove effective in treating hyperglycemia. This study investigated the hypoglycemic effect of hawthorn extracts in type II diabetic (T2DM) rat model.  A 2017 study by Aierken et al., investigated the hypoglycemic effect of hawthorn extracts in Type II diabetic rats. They found that hawthorn extracts increased pancreatic plasma insulin release and decreased blood glucose levels (Aierken et al, 2017).

In a 2003 study, scientists preformed a clinical trial to determine the usefulness of hawthorn extract in treating patients with chronic heart failure. They found that symptoms such as dyspnea, or shortness of breath, and fatigue improved significantly with the hawthorn treatment when compared to the placebo results. While the hawthorn extract did not cure chronic heart failure, it can be used as an adjunctive or symptom reliever for that ailment (Pittler 2003). Holubarsch et al. (2008) investigated the efficacy and safety of an add-on treatment with Crataegus extract WS 1442 in patients with congestive heart failure. They found that WS 1442 was safe to use in patients receiving heart failure medication, and that WS 1442 had the potential to reduce the incidence of sudden cardiac death in patients with less compromised left ventricular function (Holubarsh et al, 2008).  Dalli et al. (2008) studied the effects of a dry extract of leaves and flowers of Crataegus laevigata on various functional outputs of human neutrophils in vitro. They found that C. laevigata extract inhibited various functional outputs of activated human neutrophils, such as extracellular calcium entry into calcium-depleted neutrophils, which relates to the pathophysiology of cardiac failure (Dalli et al, 2008). 

A study by Haydari et al. (2017) found that the hydroalcoholic extract of Crataegus has antihypertensive effects, which may be partly due to antioxidant and nitric oxide releasing effects. In 2016, Rastogi et al. explored the cardiovascular effects of four traditional botanicals including Crataegus oxyacantha, finding that while the mechanism of its action is unknown, there is enough evidence to support its efficacy in the treatment of cardiovascular disease.

Treatment using the hawthorn plant may result in dizziness, nausea, and other digestive symptoms (NCCIH, 2016). The overall use of Crataegus as a singular treatment of cardiovascular disorders rather than the use of conventional medicine, increases the rate death within a patient (NCCIH, 2016). Another potential risk of using hawthorn medicinally occurs with possible interactions with other medications. Some possible interactions include enhancing the effects of digoxin, which regulates irregular heartbeats.  In a laboratory study, hawthorn counteracted the effects of the vasoconstrictor phenylephrine found in nasal decongestants. Overall the risks of interactions need to be explored in more depth order to determine the safety of hawthorn as a medication (Hawkins, 2007).

While the use of hawthorn in medicine has existed for centuries, the extent of its medical benefits has yet to be fully explored. Through more experimentation and research, the medical community may gain a more complete understanding of the short and long-term benefits of this herbal medicine.  If experimentation continues pushing toward clinical trials resulting in favorable outcomes, Crataegus could become an important medicinal treatment in cardiovascular disorders.


LITERATURE CITED:

Abu-Gharbieh, E., and N.G. Shehab. 2017. Therapeutic potentials of Crataegus azarolus var. eu-azarolus Maire leaves and its isolated compounds. BMC Complementary and Alternative Medicine. 17(1):218.

Aierken, A., T. Buchholz, C. Chen, X. Zhang, and M.F. Melzig. 2017. Hypoglycemic effect of hawthorn in Type II diabetes mellitus rat model. Journal of the Science of Food and Agriculture. 10.1002.

Cratageus. 2015. Crataegus (Hawthorn) | Medicinal and Aromatic Plants | Medicinal Plants.  <http://medicinalplants.us/crataegus-hawthorn>.

Dalli, E., J. Milara, J. Cortijo, E.J. Morcillo, J. Cosín-Sales, and J.F. Sotillo, 2008. Hawthorn extract inhibits human isolated neutrophil functions. Pharmacological Research. 57(6):445-50.

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

Ehrlich. 2015. Hawthorn. University of Maryland Medical Center. <http://www.umm.edu/health/medical/altmed/herb/hawthorn>.

Foster, S. 2009. Hawthorn. Hawthorn, Chinese Hawthorn, English Hawthorn, One-seeded Hawthorn, Crataegus Laevigata Photos, Crataegus Pinnatifida Photos, Crataegus Monogyna Photos, Article by Steven Foster. <http://www.stevenfoster.com/education/monograph/hawthorn.html>.

Hawkins, E. 2007. Possible interactions with hawthorn. University of Maryland Medical Center. <http://www.umm.edu/health/medical/altmed/herb-interaction/possible-interactions-with-hawthorn>.

Haydari, M. R., M. R. Panjeshahin, E. Mashghoolozekr, and A. A. Nekooeian. 2017. Antihypertensive effects of hydroalcoholic extract of Crataegus azarolus subspecies aronia fruit in rats with renovascular hypertension: An experimental mechanistic study. Iranian Journal of Medical Sciences. 42(3):266-274.

Holubarsch, C. J., W.S. Colucci, T. Meinertz, W. Gaus, M. Tendera, and G. R. Survival. 2008. The efficacy and safety of Crataegus extract WS 1442 in patients with heart failure: The SPICE Trial. European Journal of Heart Failure. 10(12):1255-63.

NCCIH. 2016.  Hawthorn. National Center for Complementary and Integrative Health. U.S. Department of Health and Human Services NCCIH Publication No.: D344. <https://nccih.nih.gov/health/hawthorn>.

Orhan, I. E. 2016. Phytochemical and pharmacological activity profile of Crataegus oxyacantha L. (hawthorn) - A cardiotonic herb. Current Medicinal Chemistry. <https://www.ncbi.nlm.nih.gov/pubmed/27655074>.

Pittler, M. 2003. Hawthorn and Chronic Heart Failure. Science Direct. The American Journal of Medicine, <http://www.sciencedirect.com/science/article/pii/S0002934303001311>.

Plants Profile for Crataegus (hawthorn). <https://plants.usda.gov/core/profile?symbol=CRATA>.

Rastogi, S., M. Pandey, A.K. and Rawat, 2016. Traditional herbs: A remedy for cardiovascular disorders. Phytomedicine: International Journal of Phytotherapy and Phytopharmacology. 23(11):1082-9


This paper was developed as part of the BIO 368 - Medical Botany course offered at Wilkes University during the summer of 2017. 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.