Hawthorn

Crataegus oxyacantha L., C. laevigata (Poir.) DC, C. monogyna Jacquin, Rosaceae

Hawthorn, English hawthorn, haw, maybush, whitethorn

Crataegus is a thorny, deciduous shrub that grows to five tall.  It is found in forests of North America, Europe, North Africa and western Asia. The leaves have from three to five lobes, and the May blossoms have five petals, five sepals and numerous stamens, typical of the Rosaceae family, followed by red berries.  There are numerous indigenous species in the United States and most of them are used herbally.

The herb has been in use at least since the time of the Greeks and Dioscorides.  Indigenous species were used by at least ten Native American tribes for problems of a wide range such general debility to bladder problems.  It became popular toward the end of the 19^th century.  It is a prescription drug in Europe and Asia.

Crataegus contains flavonoids ( hyperoside, vitexin rhamnoside, rutin, vitexin, kaempferol, apigenin); oligomeric procyanidins (epicatechin, catechin); and amygdalin.  It also contains crategolic acid, saponins, polysaccharides, triterpene acid (oleanolic, ursolic, crategolic), purine, flavonoid glycosides (quercetin, quercitrin) and fruit acids (citric, crataegus and tartaric.)

 Crataegus has a high content of flavonoid compounds, particularly the oligomeric proanthocyanadins (OPCs), giving it significant antioxidant activity.  The OPCs also have considerable collagen stabilizing effects and enhance the integrity of the blood vessels¹.

Crataegus flavonoids possess vasodilatory action, particularly of the coronary blood vessels which results in reduced peripheral resistance and increased coronary circulation. It is also beneficial in myocardial ischemia.²   It can increase coronary circulation form 20% to 140% after a taking about 1 mg of dry extract.³  Crataegus also exerts mild blood pressure-lowering activity, by dilating coronary vessels, inhibiting angiotensin-converting enzyme, acting as an inotropic agent and possessing mild diuretic activity.  The German Commission E recommends its use for decreasing cardiac output as described in functional Stage II of NYHA.⁴

Crataegus has also been studied in the prevention and treatment of arteriosclerosis.  There is an up-regulation of hepatic LDL-receptors resulting in greater influx of cholesterol into the liver.  The accumulation of cholesterol in the liver is prevented with Crataegus by enhancing cholesterol degradation to bile acids, promoting bile flow and suppressing cholesterol biosynthesis.⁵

There are some sedative effects from Crataegus.  The flavonoids known as dehydrocatechins depress the central nervous system. ⁶

Crataegus is used as a tonic and phytotherapeutic with coronary heart disease, arteriosclerosis, hypertension and hypercholesterolemia.  It is used for the treatment of either high or low blood pressure, tachycardia and arrhythmias.

Flowers, leaves and fruit

Bulk herb, capsules, hydroalcoholic extract, extracts standardized to flavonoid/oligomeric procyanidin content.

Dosage will vary depending on the concentration of the product.  A typical therapeutic dose of an extract standardized to contain 1.8% vitexin-4 rhamnoside is 100 to 250 mg TID.  A standardized extract containing 18% procyanidolic oligomers is used in the range of 250  to 500 mg daily.  It may take two weeks for the effects to be felt.  Crataegus is usually taken for an extended period of time.

Monitor, Professional Level:  If conditions do not improve after 6 weeks of treatment, reevaluate the condition.  Encourage frequent follow-ups by the patient.

Warnings, Lay Person Level:  It is advised not to self-medicate heart problems.

Adverse Reactions:  It is safe at recommended dosages, but may be toxic in high doses inducing hypotension and sedation.

Interactions:  Crataegus increase the activity of cardiotonic drugs such as digitalis and cardiac glycosides including digitoxin, digoxin and g-strophanthin.⁷