Hawthorn

Other common names: English hawthorn; May tree; white
thorn
Latin name: Crataegus laevigata (Poir.) DC. and C. monogyna
Jacq. as well as other species [Rosaceae]
Latin synonyms: Crataegus oxyacantha L. = C. laevigata
Plant parts: Leaf, flower


Hawthorn, a tall shrub that grows throughout Europe, was first
documented as having medical use in the first century A.D., but the
plant’s use as a heart medicine can only be traced back to the 1600s.
The two primary species are Crataegus laevigata (Poir.) DC. and C.
monogyna Jacq. However, other species have been used medicinally,
and to make matters more complex, the two primary species are
known to hybridize (Upton, Graff, Williamson, et al., 1999). Therapeutic
efficacy has been documented most reliably for the leaves and
flowers. The dried, berrylike fruits have also been used, either alone
or in combination with the leaves and flowers. The main constituents
of hawthorn are identified as procyanidins, flavonoids, triterpenoids,
catechins, aromatic carboxylic acids, and amino and purine derivatives.
For quality control purposes, the flavonoid content and/or the
oligomeric procyanidin content are determined. The leaves and flowers
contain approximately 1 percent flavonoids and 1 to 3 percent
oligomeric procyanidins (Schulz, Hänsel, and Tyler, 2001).

Hawthorn has been studied for its clinical use in the treatment of
early stage heart failure, which is also called cardiac insufficiency.
Heart failure is defined as the inadequate supply of oxygen and nutrients
to the body as the result of heart disease. Animal studies indicate
that hawthorn preparations increase the contraction of the heart muscle,
increase the integrity of the blood vessel wall, and improve the
flow of blood to the heart without changing heart rate or aggregation
of red blood cells (Loew, 1997).

The New York Heart Association (NYHA) has classified heart
failure in four stages. Patients with Class I heart failure have cardiac
disease but are able to conduct ordinary physical activity without limitation.
Class II is defined as a slight limitation of ordinary physical
activity due to fatigue, palpitation, dyspnea, or anginal pain. Class III
is defined as marked limitation of physical activity even on light exertion.
Patients with Class IV heart failure are unable to carry on any
physical activity without discomfort—they may experience symptoms
of congestive heart failure even at rest (Cochran Foundation,
1997). Many of the clinical studies using hawthorn have been conducted
on patients with Class II disease.


The American Herbal Pharmacopoeia (AHP) lists hawthorn leaf
and flowers for the treatment of Class I and II cardiac insufficiency,
hypertonic heart with and without signs of coronary insufficiencies,
myocardial insufficiencies, arrhythmia, cerebral insufficiency, mild
hypertension, and patients with a history of myocardial infarction. It
is also distinguished as having the ability to potentiate the effects of
cardiac glycosides. The actions listed by the AHP include: increases
coronary and myocardial perfusion, lowers peripheral resistance, and
has economizing action with respect to oxygen and energy consumption;
it is positively inotropic, positively dromotropic, negatively
chronotropic, and negatively bathmotropic; and hawthorn is considered
to be an antiarrhythmic, an antioxidant, a diuretic, a hypocholesterolemic,
a hypotensive, and a sedative (Upton, Graff, Williamson,
et al., 1999). The AHP has also published a monograph on hawthorn
berry with similar indications (Upton, Graff, Bencie, et al., 1999).