Hawthorn: The Safe Heart Tonic that Improves Blood Supply to the Heart

Long before most herbs are promoted in the United States, they are approved as medicines by the German government and are reviewed by Commission E, a group of experts and authorities responsible for the creation of monographs similar to the official summaries used to regulate drugs in the United States. Commission E monographs describe each herb, its applications, the appropriate dosage and contraindications. Hawthorn (Crataegus oxyacantha, C. monogyna) is one of these herbs, and has been prescribed by European doctors for years to treat various heart conditions including hypertension and hypotension, elevated cholesterol levels, angina, congestive heart failure, and atherosclerosis12, and to improve breathing capacity, physical performance, and general heart function.

Although there are about 280 known species of hawthorn, the plant from which medicinal extracts is obtained is a spiny shrub native to the northern wooded temperate zones of eastern North America and Europe.3

Hawthorn was initially documented by the first century Greek herbalist Dioscorides and later by the Swiss physician Paracelsus. According to Christian legend, the Crown of Thorns was believed to be made of hawthorn. Because of this, the herb was thought to possess miraculous healing properties. In ancient Greece, hawthorn was a symbol of hope and happiness, while in Rome, it was considered a potent charm.

Hawthorn berries are edible and the herb has an excellent safety record with plenty of clinical evidence to support its cardiovascular benefits. Clinical use of the herb for cardiovascular disease and heart ailments, however, didn’t begin in Europe until the nineteenth century.45

Chemical composition

Hawthorn’s health benefits are due to the active flavonoid compounds found in its leaves, berries and blossoms, particularly anthocyanidins and proanthocyanidins. These flavonoids are powerful antioxidants and are responsible for the red-to-blue colors found in hawthorn berries and also blackberries, cherries, blueberries, grapes, and flowers.6

How does hawthorn support cardiovascular health?

  • Appears to improve the metabolism of the heart, thereby increasing strength and promoting regular contractions of the heart, helping to normalize arrhythmias8
  • Has a relaxing effect that helps regulate blood pressure and treat hypertension9
  • Can be useful in the recovery period after a heart attack by strengthening the heart muscle, and improving blood flow and oxygen to the heart, and in treating congestive heart failure1011
  • Helps prevent free radical damage1213
  • Improves blood flow, oxygen and nutrients to the heart by dilating blood vessels78, and helps alleviate the pain associated with angina

Lowers blood pressure

Hawthorn is thought to lower blood pressure and strengthen heart-muscle function by relaxing and dilating blood vessels, producing a mild diuretic effect, and acting as both a natural calcium channel blocker and an ACE inhibitor.8914 ACE, short for angiotensin converting enzyme, refers to an enzyme that reduces sodium retention and blood pressure. Be patient though. Hawthorn can take two to four weeks to lower blood pressure.

Helps prevent and treat atherosclerosis

Atherosclerosis remains a major cause of death in the United States. The good new is the proanthocyanidins in hawthorn help reduce cholesterol levels and decrease the size of existing atherosclerotic plaques15, probably due to their ability to stabilize collagen, the most abundant protein in the body. Cholesterol is deposited within the artery when the collagen matrix of the artery is weakened, and scientists believe that atherosclerotic plaques will not form if the collagen matrix remains strong. Studies in which laboratory animals were fed proanthocyanidin extracts showed a decrease in serum cholesterol levels and the reversal of atherosclerotic lesions.15

Shows promise in the treatment of congestive heart failure

According to the National Heart, Lung, and Blood Institute of the National Institutes of Health, almost 5 million Americans have congestive heart failure, a progressive and lethal disease if left untreated. Half of the patients diagnosed with CHF die within five years, and there are an estimated 400,000 new cases each year. Even with existing therapies, the mortality rate remains high, and the quality of life is significantly impaired.

What is CHF?

The condition is caused by and/or exacerbated by hypertension, coronary artery disease, heart attack, and excessive alcohol consumption. Patients with CHF are unable to pump blood out of their heart efficiently, because of weak and dilated heart chambers. As a result, congestion may occur in the lungs or the circulatory system, giving rise to a variety of symptoms including edema, reduced circulation, and reduced urine output during the day and increased urine output at night. In order to compensate for insufficient circulation, the heart increases the number of contractions. This results in an enlargement of the muscle itself, a progressive thickening of the heart muscle fibers and enlarged chamber volume. The increased tissue mass increases the heart’s need for oxygen16, which is why people with CHF have difficulty breathing.

CHF is a difficult condition to treat. Hawthorn, however, has been shown to increase survival time and improve quality of life, by actually improving circulation in the heart itself.

Hawthorn has shown promise in both uncontrolled and controlled clinical trials in the treatment of New York Heart Association (NYHA) functional class II congestive heart failure-defined as “fatigue or shortness of breath during heavy exertion and possibly during normal activities.”17

A very recent double-blind study of 143 patients shows the efficacy and safety of a standardized extract of hawthorn berries in patients with cardiac failure. For eight weeks, the patients had their work output on an ergometer bicycle measured. The group taking hawthorn extract three times a day showed less fatigue and shortness of breath than the group taking the placebo. The researchers concluded that patients taking hawthorn over a period of time could expect improvement in their heart failure condition.18

A similar study of 136 patients showed an improvement in shortness of breath, ankle edema, and restricted physical performance. Patients also reported a “better sense of mental well-being.”19

When patients taking hawthorn extract were compared to patients taking the ACE inhibitor Captopril in a double-blind study, hawthorn was shown to produce similar benefits to the drug without any serious side effects.20

Produces a relaxing effect inside the arterial wall

Nitric oxide is produced by endothelial cells that line your blood vessels. It is responsible for causing all of the capillaries and little blood vessels to relax and go to their biggest open position rather than half-closed or tightly-closed position, as you would find in someone with high blood pressure. In other words, nitric oxide production is essential to allow the unobstructed flow of blood throughout your vessels.

But if the endothelial cells are damaged from free radicals, inflammation or contain heavy metals, nitric oxide production is impaired. Endothelial dysfunction, as it is called, has been linked to hypertension, high cholesterol, atherosclerosis, diabetes, blood clots, infection, and heart failure.21

A study in which hawthorn extract was given to rats, indicates that its procyanidins produce an endothelium-dependent nitric oxide-mediated relaxation in isolated rat aorta, which is good news for individuals with high blood pressure and cardiovascular disease.22


Though heart disease continues to plaque our nation as the #1 killer, hawthorn is an exceptional, safe herb for strengthening the heart muscle, and benefiting a number of heart ailments. In fact, in Eat Right for Your Type (Putnam Pub. Group, 1997), Peter D’Adamo writes, “If I had my way, extracts of hawthorn would be used to fortify breakfast cereals, just as vitamins are.”

Combined with a healthy diet, exercise, stress-reduction techniques, and other nutritional supplements, including an excellent vitamin/mineral supplement, CoQ10, and cardio-support nutrients such as taurine, folic acid, and red wine polyphenols, hawthorn may be just what you need to create a heart wellness program that will protect your heart and arteries … and give you peace of mind.


  1. Ammon HPT, Handel M. Crataegus: toxicology and pharmacology.Planta Medica 1981;43:318-22.
  2. Petkov V. Plants with hypotensive, antiatheromatous and coronary dilating action. A J Chin Med, 1979;7:197-236.
  3. British Herbal Pharmacopoeia (BHP), British Herbal Medicine Association. Exeter, U.K. 1996. pp. 98-101.
  4. Anschutz, E.P. New, Old and Forgotten Remedies. Boericke and Tafel. Philadelphia, PA, 1900.
  5. Hobbs, C. and S. Foster. “Hawthorne-a literature review.”Herbalgram,1990;22:19-33.
  6. Murray, Michael T., N.D. The Healing Power of Herbs. Prima Health. Rocklin, CA. 1995; pp. 203-204.
  7. Tyler, V.E. Herbs of Choice: The Therapeutic Use of Phytomedicines. Pharmaceutical Products Press: New York. 1994.
  8. Petkov V: Plants with hypotensive, antiatheromatuous and coronarodilating action. Am Chin Med, 1979;7,197-236.
  9. Uchida S, et al. Inhibitory effects of condensed tannins on angiotensin converting enzyme. Jpn J Pharmacol, 1987; 42,

  10. Brown, D.J. Herbal Prescriptions for Better Health. Prima Publishing: Rocklin, CA.1996.
  11. Newall, C.A.; L.A. Anderson and J.D. Phillipson. Herbal Medicines: A Guide for Health-care Professionals. The Pharmaceutical Press: London.1996.
  12. Kuhnau J: The flavonoids: A class of semi-essential food components: Their role in human nutrition. World Rev Nutr Diet, 1976; 24, 117-191.
  13. Middleton E: The flavonoids. Trends Pharm Sci 5,335-338, 1984.
  14. Ammon HPT, Handel M. Crataegus: toxicology and pharmacology.Planta Medica 1981;43:318-22.
  15. Wegrowski J, Roer AM, Moczar M: The effect of procyanidolic oligomers on the compoistion of normal and hypercholesterolemic rabbit aortas. Biochem Pharm 33, 3491-3497, 1984.
  16. Horner, R., Eaton, J. Hawthorn. Hawthorn, Nutraceuticals World, April 2002.
  17. New York Heart Association (NYHA). 1994. Revisions to Classification of functional Capacity and Objective Assessment of Patients with Diseases of the Heart.
  18. Degenring FH, Suter A, Weber M, Saller R. A randomised double blind placebo controlled clinical trial of a standardised extract of fresh Crataegus berries (Crataegisan) in the treatment of patients with congestive heart failure NYHA II. Phytomedicine. 2003;10(5):363-9.
  19. Weikl, A., et al. 1996. “Crataegus special extract WS 1442. Assessment of objective effectiveness in patients with heart failure.”Forschr Med 114(24)291-296.
  20.  Tauchert, M., M. Ploch, W.D. Hubner. 1994. “Effectiveness of hawthorne extract LI 132 compared with the ACE inhibitor Captopril: Multicenter double blind study with 132 NYHA Stage II.”Muench Med Wochenschr 136 suppl:S27-S33.
  21. Harrison, D.G. (1997) J. Clin. Invest. 100:2153.
  22. Kim SH, Kang KW, Kim KW, Kim ND. Procyanidins in crataegus extract evoke endothelium-dependent vasorelaxation in rat aorta. Life Sci. 2000;67(2):121-31.