Background
- Hawthorn, a flowering shrub of the rose family, has an extensive history of use in cardiovascular disease, dating back to the 1 Century. Flavonoids and other compounds found in hawthorn may synergistically improve performance of the damaged heart muscles, and further, may prevent or reduce symptoms of coronary artery disease.
- 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 effective, 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.
References
Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to . Selected references are listed below.
- Bodigheimer K, Chase D. [Effectiveness of hawthorn extract at a dosage of 3x100mg per day]. Munch Med Wschr 1994;136 Suppl 1:s7-s11.
- Degenring FH, Suter A, Weber M, et al. 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):363-369.
View Abstract - Holubarsch CJ, Colucci WS, Meinertz T, et al. Survival and prognosis: investigation of Crataegus extract WS 1442 in congestive heart failure (SPICE)--rationale, study design and study protocol. Eur J Heart Fail 2000;2(4):431-437.
View Abstract - Iwamoto M, Sato T, Ishizaki T. The clinical effect of Crataegus in heart disease of ischemic or hypertensive origin. A multicenter double-blind study. Planta Med 1981;42(1):1-16.
View Abstract - Koller M, Lorenz W, Aubke W, et al. Crataegus special extract WS 1442 in the treatment of early stages of CHD-associated heart failure MMW Fortschr Med. 2006;148(6):42.
View Abstract - Leuchtgens H. [Crataegus Special Extract WS 1442 in NYHA II heart failure. A placebo controlled randomized double-blind study]. Fortschr Med 1993;111(20-21):352-354.
View Abstract - Pittler MH, Schmidt K, Ernst E. Hawthorn extract for treating chronic heart failure: meta-analysis of randomized trials. Am J Med 2003;114(8):665-674.
View Abstract - Pittler MH, Guo R, Ernst E. Hawthorn extract for treating chronic heart failure. Cochrane Database Syst Rev 2008 Jan 23;(1):CD005312.
View Abstract - Schmidt U, Kuhn U, Ploch M, et al. Efficacy of the hawthorn extract LI 132 (600mg/d) during eight weeks' treatment. Placebo-controlled double-blind trial with 78 NYHA stage II heart failure patients. Munch Med Wochenschr 1994;136(suppl 1):s13-s19.
- Schmidt U, Albrecht M, Schmidt S. [Effects of an herbal crataegus-camphor combination on the symptoms of cardiovascular diseases]. Arzneimittelforschung 2000;50(7):613-619.
View Abstract - Tankanow R, Tamer HR, Streetman DS, et al. Interaction study between digoxin and a preparation of hawthorn (Crataegus oxyacantha). J Clin Pharmacol 2003;43(6):637-642.
View Abstract - Tauchert M, Ploch M, Hubner WD. Effectiveness of hawthorn extract LI 132 compared with the ACE inhibitor Captopril: Multicenter double-blind study with 132 NYHA Stage II. Munch Med Wochenschr 1994;136(suppl. 1):S27-S33.
- Walker AF, Marakis G, Simpson E, et al. Hypotensive effects of hawthorn for patients with diabetes taking prescription drugs: a randomised controlled trial. Br J Gen Pract 2006;56(527):437-43.
View Abstract - Weng WL, Zhang WQ, Liu FZ, et al. Therapeutic effect of Crataegus pinnatifida on 46 cases of angina pectoris--a double blind study. J Tradit Chin Med 1984;4(4):293-294.
View Abstract - Zapfe JG. Clinical efficacy of crataegus extract WS 1442 in congestive heart failure NYHA class II. Phytomedicine 2001;8(4):262-266.
View Abstract