Chinese Hawthorn Berry Extract
Also known as: Chinese hawthorn berry, Shan Zha, Crataegus spp., Crataegus pinnatifida
Overview
Chinese hawthorn berry extract, derived from the fruit of *Crataegus pinnatifida*, is a traditional herbal supplement widely used in traditional Chinese medicine (TCM) for its cardiovascular and digestive benefits. Its primary applications include lipid lowering, cardiovascular protection, and digestive aid. The extract is rich in bioactive compounds such as flavonoids and oligomeric procyanidins, which contribute to its antioxidant and vasodilatory properties. Research on Chinese hawthorn berry extract is moderately mature, with several high-quality randomized controlled trials (RCTs) and meta-analyses, predominantly from East Asia and Europe, supporting its efficacy. However, heterogeneity in study designs and formulations is a noted limitation in the current body of evidence.
Benefits
Chinese hawthorn berry extract offers several evidence-based benefits, primarily in cardiovascular health and lipid management. A systematic review and meta-analysis of 12 trials demonstrated significant improvement in lipid profiles (total cholesterol, triglycerides, LDL, HDL) in dyslipidemic patients, showing a clinical effectiveness odds ratio of 2.55 (95% CI [1.82, 3.57]) compared to controls. This indicates its potential in managing dyslipidemia. The extract also provides cardiovascular protection by improving coronary blood flow, exerting positive inotropic effects on the myocardium, and enhancing endothelial function through vasodilation. Its anti-atherosclerotic effects are attributed to lipid lowering, antioxidation, anti-inflammation, and vascular endothelial protection, supporting its role in preventing atherosclerosis. Emerging evidence also suggests potential anticancer effects on gastrointestinal tumors, mediated by bioactive flavonoids like quercetin and epicatechin, although clinical data in this area are currently limited.
How it works
Chinese hawthorn berry extract exerts its therapeutic effects primarily through its rich content of flavonoids and procyanidins. These bioactive compounds scavenge free radicals, thereby reducing oxidative stress. They also inhibit neutrophil elastase and increase the bioavailability of nitric oxide (NO), leading to vasodilation and improved blood flow. The extract's molecular targets include the inhibition of phosphodiesterase, prevention of LDL oxidation, and inhibition of platelet aggregation. Furthermore, it modulates inflammatory pathways, contributing to its anti-inflammatory and anti-atherosclerotic properties. The moderate oral bioavailability of flavonoids and procyanidins is enhanced by standardization of extracts, such as WS 1442, which ensures consistent levels of active compounds.
Side effects
Chinese hawthorn berry extract is generally considered safe, with most patients experiencing only mild adverse effects. Common side effects, reported in over 5% of users in some trials, include mild gastrointestinal discomfort, headache, and dizziness. Uncommon side effects, occurring in 1-5% of individuals, may include transient increases in LDL cholesterol and blood pressure, which have been linked to dietary factors in certain populations. Allergic reactions are rare, occurring in less than 1% of users. Caution is advised regarding potential drug interactions, particularly with cardiovascular medications, due to possible additive effects. Its platelet inhibition properties suggest caution with anticoagulants. Contraindications are not well-established, but due to a lack of safety data, it is recommended to exercise caution during pregnancy and lactation. Further research is needed to fully understand its effects in elderly patients and those with severe cardiac conditions.
Dosage
The optimal dosage of Chinese hawthorn berry extract varies depending on the extract's standardization and the intended purpose. For heart failure studies, a common standardized extract, WS 1442 (standardized to 18.75% oligomeric procyanidins), is typically used at 160-180 mg twice daily. For lipid-lowering and general cardiovascular benefits, optimal dosage ranges generally fall between 250 mg to 1,000 mg daily of a standardized extract. The maximum safe dose has not been definitively established, but higher doses are generally well tolerated with appropriate monitoring. It is usually recommended to administer the extract with meals to enhance absorption and minimize potential gastrointestinal side effects. Extracts standardized to specific flavonoid or procyanidin content are preferred for consistent efficacy. Bioavailability can be improved by co-administration with food, and gut microbiota may influence flavonoid metabolism. No specific cofactors are required, but antioxidants like vitamin C may offer synergistic effects.
FAQs
Is Chinese hawthorn berry extract safe for long-term use?
Generally, it is considered safe for long-term use with mild side effects, but extensive long-term randomized controlled trial data are still limited.
Can it replace conventional lipid-lowering drugs?
No, it should not replace prescribed medications like statins. It may serve as an adjunctive therapy but not a substitute for conventional lipid-lowering drugs.
When are effects seen?
Lipid and cardiovascular benefits are typically observed within 4-8 weeks of consistent daily use.
Does it interact with blood thinners?
Yes, there is a potential for interaction due to its platelet aggregation inhibition properties. Caution is advised, and consultation with a healthcare provider is recommended.
Research Sources
- https://pmc.ncbi.nlm.nih.gov/articles/PMC10928487/ – This systematic review and meta-analysis of 12 RCTs found significant improvement in lipid profiles (TC, TG, LDL, HDL) with hawthorn-containing TCM in dyslipidemic patients. It concluded that hawthorn is clinically effective in dyslipidemia management, with an OR of 2.55 for clinical effectiveness, despite some heterogeneity among studies.
- https://journals.sagepub.com/doi/10.1177/15593258241303136 – This RCT crossover meta-analysis involving 5577 patients with mild hyperlipidemia reported mild adverse events, including transient increases in LDL and blood pressure, which were linked to calorie intake. It noted no significant long-term harm but highlighted limitations such as lack of dietary intake control and potential carry-over effects.
- https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2020.00118/full – This narrative review comprehensively summarizes the mechanisms of action of hawthorn, including lipid lowering, antioxidation, anti-inflammatory effects, and endothelial protection. It provides a detailed overview of how hawthorn's bioactive compounds contribute to its cardiovascular benefits.
- https://www.aafp.org/pubs/afp/issues/2010/0215/p465.html – This source discusses hawthorn extracts' ability to improve coronary blood flow, exert positive inotropic effects on the myocardium, and enhance endothelial function via vasodilation. It highlights the cardiovascular protective properties of hawthorn.
- https://mednexus.org/doi/10.1016/j.cpt.2023.02.001 – This source discusses the potential anticancer effects of hawthorn, particularly on gastrointestinal tumors, mediated by bioactive flavonoids like quercetin and epicatechin. It notes that while promising, clinical data in this area are still limited.
