Hawthorn Berry

Crataegus oxyacantha

Hawthorn flowers and berries have been used primarily as heart and circulatory tonics and mild diuretics for heart disorders including congestive heart failure, angina, and hypertension. The pharmacology of hawthorn centres on its flavonoid components, the proanthocyanidins (OPCs).

CARDIOVASCULAR TONIC - Hawthorn berries have been traditionally used to treat heart problems, including hypertension, angina, elevated cholesterol, coronary artery disease, cardiac arrhythmia, myocardial weakness, and the prevention of arterial disease caused by atherosclerosis. The beneficial effects of hawthorn are due to several factors including:
1. Improvement of blood supply due to dilation of coronary vessels (relaxes smooth muscle).
2. Increase in functional abilities of the heart - increased force of contraction, and elimination of rhythm disturbances. Flavonoid components in hawthorn have been shown to inhibit cAMP phosphodiesterase - thus increasing available cAMP to the heart tissue.
3. Inhibition of angiotensin-converting enzyme (ACE) - ACE inhibiting compounds reduce constriction of blood vessels. The proanthocyanidins appear to exert this effect.
4. Increased energy production and oxygen utilisation in the heart.
Hypertension - Hawthorn exerts a mild blood-pressure lowering effect. These effects are gradual and may take up to two weeks to take effect. The hypotensive effects only cause slight effects in those with normal blood pressure.

Hypotension - The cardiotonic properties of hawthorn have been shown to raise low blood pressure.

Congestive Heart Failure - Hawthorn has traditionally been used alongside other herbs such as digitalis, however evidence suggests that is most effective in the early stages of CHF. Hawthorn potentiates the action of cardiac glycosides.

Atherosclerosis - Hawthorn has been shown to lower cholesterol levels and reduce the size of existing atherosclerotic plaques.
COLLAGEN STABILISING - The flavonoids in hawthorn are known to have protective effects on collagen and thus help support tendons, ligaments, and cartilage. The various flavonoids in hawthorn help prevent collagen destruction caused by free-radical induced inflammatory processes e.g. arthritis, periodontal disease.
ANTIOXIDANT - The OPCs in hawthorn increase and stabilise intracellular vitamin C levels by protecting it from destruction or oxidation. Potent protective antioxidant components found in hawthorn include; quercetin, procyanidin B-2, Epicatechin, catechin, and rutin.

Dosage

One to three capsules daily, or as recommended. Many doctors recommend 80-300 mg of the herbal extract in capsules or tablets two to three times per day. A meta-analysis reviewing eight clinical trials from 1989 to 1994 found standardised hawthorn extract to be effective over the entire daily dosage range of 160mg-900mg. In tincture form 4-5ml three times daily is recommended. Hawthorn is slow acting and may take one to two months for maximum effects to be seen. However, it appears to be safe and should be considered a long-term therapy.

Potential applications

Cardiovascular disorders - hypertension / hypotension, palpitations, congestive heart failure, atherosclerosis, angina, capillary congestion, cardiac arrhythmia. Hawthorn has been shown to exert anti-inflammatory effects by reducing acne and improving skin hydration in seborrhoeic conditions. Known to be useful in peripheral circulatory disorders such as arteritis and Raynaud's disease. Can help reduce blood levels of pyruvic and lactic acids.

Known contraindications

There are no apparent restrictions to use of hawthorn during pregnancy or breast-feeding.

Interactions

No adverse effects from ingestion of hawthorn are expected. Hawthorn may act in synergy with digitalis glycosides and beta blockers. Modification of drug dosage may be required. Although adverse effects are not generally anticipated from this interaction it is advisable to seek physician guidance.

Use in conjunction with

Hypertension - potassium with magnesium, Coenzyme Q10, multi-phytonutrient complex, ester-C, flax seed oil.

Note

Anthocyanidin compounds found in hawthorn are closely related to that of grape seed, pine bark, and many fruits such as berries e.g. bilberry, blueberry, and cranberry.

REFERENCES

Simon Mills & Kerry Bone. Principles and Practice of Phytotherapy. Modern Herbal Medicine. 2000.
Michael Murray. The Healing Power of Herbs. 2nd Edition. 1995.
Melvyn R. Werbach & Michael T. Murray. Botanical Influences on Illness. A source book of clinical research. 1994
Brown DJ. Herbal Prescriptions for Better Health. Rocklin, CA: Prima Publishing, 1996, 139-44.
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.
Fong HH, Bauman JL. Hawthorn. Program for Collaborative Research in the Pharmaceutical Sciences, Department of Medicinal Chemistry and Pharmacognosy, College of Pharmacy, University of Illinois at Chicago, USA. J Cardiovasc Nurs 2002 Jul;16(4):1-8
Walker AF, Marakis G, Morris AP, Robinson PA. Promising hypotensive effect of hawthorn extract: a randomized double-blind pilot study of mild, essential hypertension. Phytother Res 2002 Feb;16(1):48-54

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