Crataegus monogyna ( Hawthorn) blossoms & dried berries

Hawthorn is still widely used throughout Europe, and the herb has become a popular over-the-counter supplement in the United States.

Although hawthorn has traditionally been used to treat a variety of conditions (asthma, high blood pressure, abnormal heart rhythms, anxiety, angina, heart failure, indigestion, and dyslipidemia), the best scientific evidence for its benefits derives from its use in treating the milder forms of chronic congestive heart failure (New York Heart Association classes I through III).

Hawthorn extracts are typically produced from the aerial parts of the plant – the leaves, flowers, and berries – but most clinical data supporting the plant’s cardiac benefits are based upon studies of the dried flowering parts; trials evaluating hawthorn berries are fewer in number. However, hawthorn’s leaves, berries, and flowers all contain substantial amounts of oligomeric procyanidins (OPCs) and flavonoids, the substances that are probably responsible for the plant’s medicinal properties.

The Effects of Oligomeric Procyanidins and Flavonoids on Heart Health

Whenever a portion of the heart is deprived of blood flow and oxygen – as occurs acutely during a heart attack or, more chronically, with narrowing of the coronary arteries – the muscle fibers in the deprived area are damaged. This leads to a decrease in the heart’s pumping efficiency, which is the clinical hallmark of congestive heart failure.

Much of the muscular injury caused by inadequate blood flow (ischemia) is believed to arise from free radical damage and the release of cytokines and enzymes from neutrophils.

Oligomeric procyanidins are potent free radical scavengers. Furthermore, the OPCs in hawthorn inhibit neutrophil elastase, one of the enzymes that contribute to heart damage in ischemic conditions. These two OPC properties may help to reduce cardiac injury caused by ischemia.

In addition, OPCs have demonstrated the ability to independently increase coronary blood flow, and hawthorn's OPCs improve the contractility of heart muscle, even in failing human hearts.

Flavonoids, another class of antioxidants found in plants, have been shown to improve blood flow by dilating vessels in the heart and other organ systems. Flavonoids also inhibit the oxidation of low-density lipoprotein (LDL), which is one of the major contributors to atherosclerosis. Finally, flavonoids inhibit platelet aggregation, thereby preventing inappropriate clot formation.

Among several extracts of hawthorn, two have been studied more extensively than others: WS 1442 and LI 132, standardized to concentrations of OPCs and flavonoids, respectively, have been the primary sources of information regarding hawthorn’s physiologic effects.

Clinical Use of Hawthorn for Congestive Heart Failure

Western physicians are averse to recommending any medication that hasn’t been sanctified by the US Food and Drug Administration; most doctors who practice mainstream medicine, therefore, will hesitate to utilize hawthorn in their practices when there are “proven” conventional therapies (i.e., prescription drugs) already available.

Most American-trained medical professionals will be quick to point out that, even though hawthorn exerts beneficial physiologic effects, it has yet to demonstrate that it can reduce overall mortality due to heart disease.

It should be noted, however, that many FDA-approved medications have made it to the market only to be withdrawn later due to adverse effects. Perhaps more importantly, many drugs and therapeutic protocols that are part of mainstream medical practice (e.g., tight control of insulin-dependent diabetes) have yet to show that they, too, reduce overall mortality or even improve a patient’s quality of life.

Hence (assuming the requisite studies will one day be completed) hawthorn may eventually become an acceptable alternative to physicians who treat patients with congestive heart failure…and possibly other medical conditions.

Individuals who wish to use hawthorn should take doses between 600 and 1800 mg daily, divided into two or three doses. A trial of one to two months is recommended to determine potential benefit. Persons taking other medications or supplements should not use hawthorn without consulting their physicians.