English Hawthorne
Also known as: Crataegus monogyna, English Hawthorn, hawthorn, thornapple, Crataegus oxyacantha
Overview
English Hawthorn, derived from the leaves, flowers, and berries of *Crataegus* species, is a traditional herbal remedy primarily used for cardiovascular health. It is known for its potential in treating hypertension and chronic heart failure (CHF). The plant contains key active compounds such as antioxidant flavonoids and oligomeric procyanidins, which are believed to improve heart function and vascular tone. Research on hawthorn is moderately mature, with several randomized controlled trials (RCTs) and meta-analyses supporting its use, particularly for blood pressure regulation and heart failure management. While the quality of evidence varies, rigorous systematic reviews have been conducted. Hawthorn is typically consumed as an herbal supplement and is recognized for its potential to offer clinically relevant benefits, often comparable to mild antihypertensive drugs, though effects usually manifest after weeks to months of consistent use.
Benefits
English Hawthorn offers several evidence-based cardiovascular benefits. A 2025 meta-analysis of six RCTs involving 428 participants demonstrated a statistically significant reduction in systolic blood pressure (mean difference −6.65 mmHg) after 2–6 months of supplementation (250–1200 mg/day), indicating its antihypertensive effects. While diastolic pressure reduction was not statistically significant, a downward trend was observed. For chronic heart failure (CHF), systematic reviews and RCTs suggest that hawthorn extract can improve exercise tolerance and alleviate symptoms in individuals with mild to moderate CHF, exhibiting a favorable safety profile. Some limited studies also propose that hawthorn may help prevent orthostatic hypotension, although these findings are inconsistent. The observed blood pressure reductions are clinically relevant, comparable to those achieved by mild antihypertensive medications. Benefits typically become apparent after several weeks to months of continuous use, and the strength of evidence for its use in hypertension and CHF is considered moderate to high quality, with well-designed studies supporting these claims.
How it works
Hawthorn's cardiovascular benefits stem from its rich content of polyphenolic compounds, including flavonoids and oligomeric procyanidins. These compounds possess antioxidant, vasodilatory, and positive inotropic properties. The mechanism involves enhancing endothelial nitric oxide production, which leads to improved vascular relaxation and a reduction in peripheral resistance, thereby contributing to lower blood pressure. Furthermore, hawthorn extracts are thought to improve myocardial energy metabolism and contractility, which is particularly beneficial for individuals with heart failure. The oral bioavailability of hawthorn varies depending on the extract type, with standardized extracts (e.g., WS® 1442) being utilized in clinical trials to ensure consistent delivery of active compounds and predictable therapeutic effects.
Side effects
Hawthorn is generally well tolerated, with a safety profile in clinical trials comparable to that of a placebo. Common side effects, occurring in more than 5% of users, are rare but may include mild gastrointestinal discomfort. Uncommon side effects, affecting 1–5% of users, can include dizziness or headache. Rare adverse events, occurring in less than 1% of users, are not well documented but appear to be minimal. It is crucial to note that hawthorn may interact with certain cardiovascular medications, such as digoxin and antihypertensives. Caution is advised when combining hawthorn with these drugs to avoid additive hypotensive effects, which could lead to excessively low blood pressure. Contraindications include known hypersensitivity to hawthorn. Due to limited safety data, caution is also recommended during pregnancy and breastfeeding. Patients on existing cardiovascular medications should consult a healthcare professional before starting hawthorn supplementation to prevent potential drug interactions and ensure safe use.
Dosage
Effective doses of standardized hawthorn extract, as observed in randomized controlled trials, typically range from 250 to 1200 mg per day. This daily dose is often divided into two or three smaller doses. The optimal dosage can vary depending on the specific extract standardization and the intended therapeutic indication. For instance, in the management of heart failure, standardized extracts like WS® 1442 are commonly used at a dose of 900 mg per day. While maximum safe doses are not firmly established, doses up to 1200 mg per day have been administered in studies without significant adverse effects. Consistency in daily dosing is recommended to achieve and maintain sustained therapeutic effects. The timing of administration is flexible, and absorption may potentially be enhanced when taken with food. Utilizing standardized extracts is important to ensure a consistent and predictable content of bioactive compounds.
FAQs
Is hawthorn safe for long-term use?
Clinical trials have shown good safety for up to 6 months of hawthorn use, but comprehensive data on very long-term safety are currently limited.
Can hawthorn replace prescription heart medications?
No, hawthorn should not replace prescribed heart medications. It may be used as an adjunct therapy but only under medical supervision.
How soon will blood pressure improvements occur?
Significant blood pressure improvements with hawthorn typically become noticeable after several weeks to a few months of consistent daily use.
Are all hawthorn supplements equally effective?
No, the efficacy of hawthorn supplements can vary. It largely depends on the extract's standardization and the specific dosage used.
Research Sources
- https://pmc.ncbi.nlm.nih.gov/articles/PMC12298042/ – This meta-analysis of six RCTs (n=428) found that hawthorn supplementation significantly reduced systolic blood pressure by -6.65 mmHg over 2-6 months, with a good safety profile. It highlights hawthorn's potential as an antihypertensive agent, though heterogeneity in study designs was noted.
- https://www.drugs.com/npp/hawthorn.html – This source provides a general overview of hawthorn, including its uses, potential side effects, and drug interactions. It notes hawthorn's traditional use for cardiovascular conditions and advises caution regarding interactions with medications like digoxin and antihypertensives.
- https://onlinelibrary.wiley.com/doi/full/10.1016/j.ejheart.2008.10.003 – This review and synthesis of RCTs indicates that hawthorn extract can improve exercise tolerance and symptoms in patients with mild to moderate chronic heart failure, demonstrating a favorable safety profile. It supports hawthorn as a beneficial adjunct therapy for CHF.
- https://www.ncbi.nlm.nih.gov/books/NBK69639/ – This Cochrane Review (2004) concluded that hawthorn extract is beneficial as an adjunct therapy in chronic heart failure, helping to reduce symptoms and improve quality of life. While an older review, it provides a high-quality assessment of hawthorn's efficacy in CHF.
