DISCUSSION: Hawthorn is considered the most important herb in the treatment of ischaemic heart disease and was shown to increase the force of myocardial contraction and coronary blood flow while reducing oxygen demand. The herb also has hypotensive and anti-arrhythmic activity. Clinical trials have shown that Hawthorn is effective for the treatment of cardiac insufficiency and can relieve the symptoms associated with heart failure.

Main Applications
As reported by literature:
• Cardiovascular health. 
• Supports and maintains healthy blood pressure.

Source
Crataegus oxyacantha berries.

Pregnancy / Nursing
Do not take.

Cautions
Do not use for children under 12 years of age, if you are pregnant or breastfeeding. May cause hypotension when used with beta-blockers and may potentiate the effects of cardiac glycosides.

*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

Medical science is no longer obsessed only with finding newer and better drugs. Now, a lot of research is being done on old medicines, those that were traditionally passed down as remedies, but were never scientifically validated. Sometimes these experiments are surprisingly successful; other times the old stories turn out to be just that: stories. The story of hawthorn, though, is a success story.

Hawthorn (in scientific jargon crategus oxycantha or C. monogyna) is a small thorny tree originally from Europe. For thousands of years, folk medicine has prescribed hawthorn for a variety of uses, from a sore throat to a troubled heart. Now, though, the evidence is in and it seems that, much as some of the stories said, hawthorn has overwhelmingly positive effects for the cardiovascular system.

It's Just So Much Chemistry
One thing science allows us to do is discover the molecular makeup of a plant, and then to predict some of its effects based on the plant's chemical composition. Hawthorn is a powerhouse of chemicals shown to help heart health. One such group of chemicals is the flavonoids found within hawthorn. Flavonoids are an unique type of health-giving substance found in plants. More and more science is suggesting that many of the benefits of a diet high in fruits and vegetables may derive from flavonoids, and not just the vitamins and minerals you get in such a diet.

The flavonoids in hawthorn have been shown to possess three distinct and significant effects that are particularly important to those worried about their heart health. Not only do they increase the resiliency of small blood vessels (important in reducing the risk of "bleeding" strokes), but these flavonoids also reduce atherosclerotic deposits and inhibit the activity of the angiotensin-converting enzyme (which increases blood pressure and is consequently targeted by heart drugs called "ACE inhibitors").

Apart from these valuable flavonoids, hawthorn also contains a number of other substances that have been indicated for improved heart health, such as amines, like o-methyloxyphenynylethylamine, phenethylamine, and isobutylamine, and triterpene acids, such as ursolate, oleanolate, and crategoleate. They may sound complicated and obscure, but some evidence, while not conclusive, suggests that they may be part of hawthorn's heart-healthy, herbal mixture.

Tried, Tested, and Effective
Hawthorn doesn't just contain heart-protective ingredients, it's also been tested extensively in human subjects. Chemistry is a complicated science and, without actual tests in humans, it can be difficult to discover if a substance that is useful by itself is also useful in a complicated formula, food, or herb. In humans, though, hawthorn's effects are just as promising as its chemical makeup indicates.

Researchers have discovered several properties of hawthorn of extreme importance to anyone concerned about the health of their heart. First among these is hawthorn's power to lower cholesterol. The liver is central to cholesterol circulation and hawthorn causes the liver to bind more LDL cholesterol, preventing it from reentering the blood stream, and to synthesize less LDL cholesterol in the first place. It also increases the excretion of cholesterol in the bile, causing lower levels of cholesterol in the blood where it can buildup into blood-flow-blocking deposits. At the same time, hawthorn extract has also been shown to prevent the accumulation of high blood lipids and fatty deposits in the liver and aorta, a key factor in atherosclerosis and a result of high cholesterol diets. Hawthorn is also well tolerated, has no known drug interactions, and has extremely low toxicity. All in all, hawthorn shows great potential for the safe and effective treatment of chronic heart failure.

Over a thousand patients with mild congestive heart failure (an inefficient heart, usually caused by years of high blood pressure, that leads to a buildup of fluid in the lungs) taking standardized hawthorn extract for six months experienced lower blood pressure and resting pulse rate, an increase in maximum exercise performance, and a decrease in depressed ST segments (an indicator of oxygen starvation) and arrhythmia. The researchers in this study found that hawthorn increased what is called ejection fracture, a measure of how fully the heart chambers are emptying themselves of blood with each beat. It also reduced nocturia (nighttime bathroom trips –a common, distressing symptom associated with CHF because of hypertension-induced kidney damage) and shin edema, also a classic symptom of congestive heart failure.

Other controlled trials have also shown that hawthorn has clear therapeutic benefits. One double-blind, placebo-controlled trial of hawthorn in subjects with mild CHF found that those receiving hawthorn showed improved exercise tolerance, fewer subjective symptoms, reductions in blood pressure (systolic and diastolic), and a healthier heart rate. Another trial comparing hawthorn with the blood-pressure lowering drug Captopril found similar significant improvements in exercise tolerance, reduced shin edema, and a large reduction in fatigue and shortness of breath.

Hawthorn has long been prescribed as a folk medicine. Now we have a probable explanation for this: because it works. Many traditional herbs and remedies are debunked when analyzed by science. However, hawthorn has gained notoriety as it is researched more for one simple reason; it's effective. If you want a natural approach to maintaining a healthy heart, then hawthorn is for you.

Hypotensive effects of hawthorn for patients with diabetes taking prescription drugs: a randomised contolled trial.
Br J Gen Pract. 2006 Jun;56(527):437-43. 
Walker AF, Marakis G, Simpson E, Hope JL, Robinson PA, Hassanein M, Simpson HC.

BACKGROUND: Hawthorn (Crataegus laevigata) leaves, flowers and berries are used by herbal practitioners in the UK to treat hypertension in conjunction with prescribed drugs. Small-scale human studies support this approach.
AIM: To investigate the effects of hawthorn for hypertension in patients with type 2 diabetes taking prescribed drugs.
DESIGN OF STUDY: Randomised controlled trial.
SETTING: General practices in Reading, UK.
METHOD: Patients with type 2 diabetes (n = 79) were randomised to daily 1200 mg hawthorn extract (n = 39) or placebo (n = 40) for 16 weeks. At baseline and outcome a wellbeing questionnaire was completed and blood pressure and fasting blood samples taken. A food frequency questionnaire estimated nutrient intake.
RESULTS: Hypotensive drugs were used by 71% of the study population with a mean intake of 4.4 hypoglycaemic and/or hypotensive drugs. Fat intake was lower and sugar intake higher than recommendations, and low micronutrient intake was prevalent. There was a significant group difference in mean diastolic blood pressure reductions (P = 0.035): the hawthorn group showed greater reductions (baseline: 85.6 mmHg, 95% confidence interval [CI] = 83.3 to 87.8; outcome: 83.0 mmHg, 95% CI = 80.5 to 85.7) than the placebo group (baseline: 84.5 mmHg, 95% CI = 82 to 87; outcome: 85.0 mmHg, 95% CI = 82.2 to 87.8). There was no group difference in systolic blood pressure reduction from baseline (3.6 and 0.8 mmHg for hawthorn and placebo groups, respectively; P = 0.329). Although mean fat intake met current recommendations, mean sugar intake was higher and there were indications of potential multiple micronutrient deficiencies. No herb-drug interaction was found and minor health complaints were reduced from baseline in both groups.
CONCLUSIONS: This is the first randomised controlled trial to demonstrate a hypotensive effect of hawthorn in patients with diabetes taking medication.