Source: Amy Bigus, Deanna Massengil, and Christy Walker

Hawthorne Berries

General Description

• Crataegus oxyacantha from the greek Kratos (meaning hardness of the wood), Oxus (meaning sharp), & Akantha (meaning a thorn.
• Other species of Crataegus (C. Monogyna and C. Pentagyna) have similar pharmacological actions and may be suitable alternatives.
• Common names: hawthorn, haw, may bush, whitethorn
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Chemical Composition

• Hawthorn berries, leaves and blossoms contain biologicaly active flavonoid compounds: (1) anthocyanidins and (2) proanthocyanidins (also known as biflavans or procyanidins).
• Flavonoids are responsible for the red to blue colors of the Hawthorne berries.
• Crataegus extracts also contain

1. Cardiotonic amines: phenylethlamine, tyramine, isobutylamine, o-methoxyphenylethylamine
2. Choline and acetylcholine
3. Purine derivatives: adenosine, adenine, guanine and caffeic acid
4. Amygdalin
5. Pectins
6. Triterpene acids (ursolic, oleonic, & crategolic acids)

History and Folk Use

• Crataegus flowers & berries have been utilized as cardiac tonics and mild diuretics used in organic and functional heart disorders.
• Also utilized for their astringent qualities for relief of discomfort of sore throats.
• North American Indians use it to treat stomach aches, as a diuretic for kidney & bladder ailments, to stimulate appetite, and to improve circulation.

Pharmacology

• Centers on its flavonoid components
• The proanthocyanidins are largely responsible for the cardiovascular activities
• Flavonoids have strong "Vitamin P" activity (note: Vitamin P was renamed flavonoids in 1950).
• Have ability to:

• Increase intracellular Vitamin C levels
• Stabilize Vitamin C by protecting it from oxidation
• Decrease capillary permeability & fragility

• Have significant collagen stabilizing action

1. Collagen = body protein responsible for maintaining the integrity of ground substance, tendons, ligaments & cartilage
2. Affect collagen metabolism

• Crosslinks collagen fibers to reinforce the collagen matrix of connective tissue.
• Prevent free radical damage.
• Inhibit enzymatic cleavage by enzymes secreted by leukocytes during inflammation
• Prevents synthesis and release of compounds that promote inflammation (histamines, serine proteases, prostaglandins, leukotrienes

Clinical Applications

Hawthorn berries are used to treat a wide variety of inflammatory conditions, but primary use is generally the treatment of hypertension, atherosclerosis, congestive heart failure and arrhythmias.

Cardiovascular Effects

Hawthorn preparations have been shown to:

1) Inhibit arrhythmia, 2) dilate coronary blood vessels, 3) reduce serum cholesterol & triglyceride levers, 4)reduce symptoms of angina, 5) have hypotesive action due to peripheral dilation of blood vessels (relaxes vascular smooth muscle, 6) be useful in the prevention & treatment of arteriosclerosis, 7) manage early stages of CHF, 8)treat diminished cardiac performance – to lower a sensation of pressure or anxiety in the heart area, 9) improve efficiency of blood pumping and aid in toning the contractions of the heart muscles, 10) improve symptoms of angina pectoris, 11) aid long-term recovery from heart attack, 12) slow tachycardia, 13) have indication for mitral valve insufficiency in young women

• By inhibiting phosphodiesterase, Hawthorn's flavans have a positive effect on the myocardium's calcium metabolism to increase contractile power and promote normal rhythm
• Inhibits ACE
• Cardiac Improvement is due to an increase in blood & oxygen supply to the myocardium and due to flavonoic enzyme interactions which inhibit cyclic AMP Phosphodiesterase.
• Results in raised levels of cAMP within the myocardium to lead to a positive inotropic effect

Clinical Trials (9 available with 8 case studies from PubMed)

Euphytose (mixture of Crataegus, Ballota, Passiflora, Valeriana, Cola and Paullinia) reduced anxiety more than placebo in a double blind study with 182 patients Bourin 1997

Extract WS 1442 benefited patients with NYHA stage II cardiac insufficiency in a double blind study with 136 patients treated with extract WS 1442 or placebo for 8 weeks. There was improvement in heart rate, blood pressure, shortness of breath and edema Weikl 1996

Exercise blood pressure and pulse were improved by 8 weeks of extract WS 1442 compared with placebo in a trial with 30 patients with stage NYHA II cardiac insufficiency Leuchtgens 1993

Crataegus can be used for cardiological indications for which digitalis is not (yet) indicated. The effects, mainly from the flavonoids, indicate a simultaneous cardiotropic and vasodilatory action, as confirmed clinically in controlled studies Blesken 1992

Therapeutic effect of Crataegus pinnatifida on 46 cases of angina pectoris--a double blind study. Weng 1984

Observational Studies /Case Reports

Crataegus oxyacantha and heart failure. Gildor 1997