Hawthorn (Crataegus laevigata, C. oxyacantha, C. monogyna, C. pentagyna)
background
Hawthorn, a flowering shrub of the rose family, has an extensive history of use in cardiovascular disease, dating back to the 1st Century. Modern day animal and in vitro studies suggest that flavonoids and other pharmacologically active compounds found in hawthorn may synergistically improve performance of the damaged myocardium, and further, may prevent or reduce symptoms of coronary artery disease.
Numerous well-conducted human clinical trials have demonstrated safety and efficacy of hawthorn leaf and flower in New York Heart Association (NYHA) Class I-II heart failure (characterized by slight or no limitation of physical activity). An international, multi-center randomized controlled trial is currently underway to investigate long-term benefits.
Hawthorn is widely used in Europe for treating New York Heart Association (NYHA) Class I-II heart failure, with standardization of its leaves and flowers. Overall, hawthorn appears to be safe and well tolerated, and in accordance with its indication, best used under the supervision of a medical professional.
The therapeutic equivalence of hawthorn extracts to drugs considered standard-of-care for heart failure (such as angiotensin converting enzyme inhibitors, diuretics, or beta-adrenergic receptor blockers) remains to be established, as does the effect of concomitant use of hawthorn with these drugs. Nonetheless, hawthorn is a potentially beneficial therapy for patients who cannot/will not take prescription drugs, and may offer additive benefits to prescription drug therapy.
synonyms
Aubepine, bei shanzha, bianco spino, bread and cheese tree, Cardiplant®, Chinese hawthorn, cockspur, cockspur thorn, crataegi flos, Crataegi folium, Crataegi folium cum flore, Crataegi fructus, Crataegi herba, Crataegisan, Crataegus azaerolus, Crataegus cuneata, Crataegus fructi, Crataegus monogyna, Crataegus nigra, Crataegus oxyacanthoides, Crataegus pentagyna, Crataegus pinnatifida, Crataegus sinaica boiss, Crataegutt®, English hawthorn, epine blanche, epine de mai, Euphytose (EUP) (combination product), Fructus oxyacanthae, Fructus spinae albae, gazels, haagdorn, hagedorn, hagthorn, halves, harthorne, haw, Hawthorne Berry®, Hawthorne Formula®, Hawthorne Heart®, Hawthorne Phytosome®, Hawthorne Power®, hawthorn tops, hazels, hedgethorn, huath, ladies' meat, LI 132, may, mayblossoms, maybush, mayhaw, maythorn, mehlbeerbaum, meidorn, nan shanzha, northern Chinese hawthorn, oneseed, oneseed hawthorn, quickset, red haw, RN 30/9, sanza, sanzashi, shanza, shan zha rou, southern Chinese hawthorn, thorn-apple tree, thorn plum, tree of chastity, Washington thorn, weissdorn, Weissdornblaetter mit Blueten, whitethorn, whitethorn herb, WS 1442.
evidence table
These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
Congestive heart failure
(Grade: A)
Extracts of the leaves and flowers of hawthorn have been reported as efficacious in the treatment of mild-to-moderate congestive heart failure (CHF), improving exercise capacity, and alleviating symptoms of cardiac insufficiency. However, the therapeutic equivalence of hawthorn extracts to drugs considered standard-of-care for heart failure (such as angiotensin converting enzyme inhibitors, diuretics, or beta-adrenergic receptor blockers) remains to be established, as does the effect of concomitant use of hawthorn with these drugs. Nonetheless, hawthorn is a potentially beneficial treatment for patients who cannot/will not take prescription drugs, and may offer additive benefits to established therapies. Further study of these issues is warranted.
Extracts of the leaves and flowers of hawthorn have been reported as efficacious in the treatment of mild-to-moderate congestive heart failure (CHF), improving exercise capacity, and alleviating symptoms of cardiac insufficiency. However, the therapeutic equivalence of hawthorn extracts to drugs considered standard-of-care for heart failure (such as angiotensin converting enzyme inhibitors, diuretics, or beta-adrenergic receptor blockers) remains to be established, as does the effect of concomitant use of hawthorn with these drugs. Nonetheless, hawthorn is a potentially beneficial treatment for patients who cannot/will not take prescription drugs, and may offer additive benefits to established therapies. Further study of these issues is warranted.
Coronary artery disease (angina)
(Grade: C)
Hawthorn has not been tested in the setting of concomitant drugs such as beta-blockers or ACE-inhibitors, which are often considered to be standard-of-care. At this time, there is insufficient evidence to recommend for or against hawthorn for coronary artery disease or angina.
Hawthorn has not been tested in the setting of concomitant drugs such as beta-blockers or ACE-inhibitors, which are often considered to be standard-of-care. At this time, there is insufficient evidence to recommend for or against hawthorn for coronary artery disease or angina.
Functional cardiovascular disorders
(Grade: C)
Two randomized trials have found efficacy of herbal combinations containing hawthorn in the treatment of functional cardiovascular symptoms. However, due to a lack of controlled information on hawthorn monotherapy, there is insufficient evidence to recommend for or against hawthorn for functional cardiovascular disorders.
Two randomized trials have found efficacy of herbal combinations containing hawthorn in the treatment of functional cardiovascular symptoms. However, due to a lack of controlled information on hawthorn monotherapy, there is insufficient evidence to recommend for or against hawthorn for functional cardiovascular disorders.
