Open Source Apothecary At Home / The herbs

Hawthorn

Genuine heart-failure trial evidence — as an adjunct, never as a replacement. — Crataegus monogyna, C. laevigata

remedy

Hawthorn (Crataegus) is the herb with the best-established cardiovascular evidence in this handbook: randomised trials in chronic heart failure have shown improvements in symptoms and exercise tolerance, generally as an adjunct to conventional treatment.

The word "adjunct" is load-bearing. Hawthorn is not a replacement for heart-failure medication, and stopping cardiac medication to take hawthorn is dangerous. It is also used traditionally for blood pressure and angina, where the evidence is weaker.

Flower and berry are both used, and the leaf-with-flower preparation is what most trials used.

It makes an excellent boundary hedge — dense, thorny, tolerant, long-lived — and it is worth planting for that reason alone. Harvest flowers in spring and berries in autumn.

Interactions matter here because the people taking it are usually on cardiac drugs: hawthorn may add to the effect of cardiac glycosides, beta-blockers and vasodilators.

What the studies found

Growing it

| | | |---|---| | Life | Thorny deciduous shrub/tree; decades | | Propagation | Bare-root in dormancy; or seed (slow, double-dormant) | | Light | Full sun | | Soil | Any; very tolerant | | Spacing | 2-4 m; excellent hedge | | Harvest flowers | Spring, at full flower | | Harvest berries | Autumn, fully coloured | | Dry | Flowers shade/ambient; berries warm | | First harvest | 2-3 years after planting |

Preparation

Berries — dried, in tea or decoction; 1 teaspoon per cup, simmered.

Leaf and flower — the preparation most trials used; tea or standardised extract.

Tincture — the conventional form.

Syrup or jam — traditional culinary uses for the berries.

Do not change cardiac medication to take hawthorn.

Cautions and interactions

• An adjunct to cardiac care, never a replacement. Never stop heart medication to take hawthorn.
• May interact with cardiac glycosides, beta-blockers, vasodilators and antihypertensives.
• Avoid in pregnancy and breastfeeding without advice.
• Do not self-treat heart failure, chest pain or palpitations with an herb.

When this is not a self-care problem — get help

• Chest pain, breathlessness at rest, fainting or palpitations — emergency care.
• Rapid weight gain with ankle swelling — urgent assessment; possible heart failure decompensation.

Known interactions

• Additive with cardiac glycosides, beta-blockers, calcium channel blockers and vasodilators.

Related

• Heart failure and cardiac support: hawthorn, CoQ10 and the limits
• Woody medicinals, and the plants that need a pot
• Blood pressure: the dietary interventions with real numbers
• Herb-drug interactions: the ones with numbers behind them
• Tinctures: matching the solvent to the compound

Sources

1. Hawthorn extract for treating chronic heart failure. The Cochrane database of systematic reviews 2008; doi:10.1002/14651858.CD002901.pub2 PubMed 18254076
2. Hawthorn extract for treating chronic heart failure: meta-analysis of randomized trials. The American journal of medicine 2003; doi:10.1016/s0002-9343(03)00131-1 PubMed 12798455
3. Adverse-event profile of Crataegus spp.: a systematic review. Drug safety 2006; doi:10.2165/00002018-200629060-00005 PubMed 16752934
4. Crataegus laevigata decreases neutrophil elastase and has hypolipidemic effect: a randomized, double-blind, placebo-controlled trial. Phytomedicine : international journal of phytotherapy and phytopharmacology 2011; doi:10.1016/j.phymed.2010.11.011 PubMed 21242072
5. Hawthorn Extract Randomized Blinded Chronic Heart Failure (HERB CHF) trial. European journal of heart failure 2009; doi:10.1093/eurjhf/hfp116 PubMed 19789403
6. The effect of Crataegus oxycantha Special Extract WS 1442 on clinical progression in patients with mild to moderate symptoms of heart failure. European journal of heart failure 2008; doi:10.1016/j.ejheart.2008.04.008 PubMed 18490196