Hawthorn

Crataegus monogyna
Crataegus laevigata

Botanical Classification

Family: Rosaceae (Rose family)

Other Names

Maythorn, Whitethorn, Haw, Thornapple
Fruits: Hawthorn berries

Description

A deciduous shrub growing between 2 and 10 meters tall, with smooth, light gray bark. The branches bear sharp thorns and leathery, lobed leaves. The upper surface of the leaves is glossy dark green, while the underside is bluish to light green.

The mostly white (occasionally pink) flowers have a pleasant amine-like scent that attracts pollinating insects. The flowers grow in corymb clusters at the tips of the branches.

In autumn, round red fruits develop that resemble small rose hips. The fruits are yellow inside and have a mealy texture and taste.

Flowering Time

May to June

Habitat

Native throughout Europe.

Cultivation

Prefers dry soils at forest edges and in light scrubland.

Plant Parts Used

Leaves and flowers.

Taste

Slightly sweet to mildly bitter, mildly astringent.

Traditional Folk Use

In late antiquity, hawthorn was described as helpful for diarrhea and snake bites. During the Middle Ages, it largely fell into obscurity. Later, it was used to promote circulation in the extremities.

Active Compounds

  • Dimeric and oligomeric procyanidins (OPC), standardized extracts contain approx. 18.75%

  • Flavonoids (hyperoside, rutin, vitexin rhamnoside, eriodictyol glycoside)

  • Triterpenic acids (ursolic acid, oleanolic acid, 2‑α‑hydroxy‑oleanolic acid)

  • Chlorogenic acid

  • Caffeic acid

  • Aromatic amines (phenylethylamine, tyramine, 6‑methoxyphenylethylamine, aminopurines, catechins)

  • Potassium salts

Mechanism of Action

Effects of Oligomeric Procyanidins and Flavonoids

Hawthorn extracts:

  • Increase myocardial contractility (positive inotropic effect)

  • Improve electrical conduction (positive dromotropic effect)

  • Reduce excitability (negative bathmotropic effect)

  • Lower peripheral vascular resistance (afterload reduction)

These effects result in:

  • Increased cardiac output

  • Improved coronary and myocardial blood flow

  • Enhanced tolerance of the heart muscle to oxygen deficiency

  • More efficient heart rhythm and performance

Cellular and Molecular Mechanisms

The positive inotropic effect is attributed at the cellular level to:

  • Increased calcium influx

  • Enhanced intracellular calcium release

Vasodilation is likely related to modulation of potassium-dependent calcium ion channels.

At the molecular level, effects are thought to involve:

  • Inhibition of cAMP phosphodiesterase

  • Inhibition of angiotensin-converting enzyme (ACE)

  • Direct or indirect beta-sympathomimetic effects

  • Modulation of thromboxane (TXA2) and prostacyclin (PGI2) synthesis

  • Complement system inhibition

  • Antioxidant and free radical scavenging properties

Additional Pharmacological Properties

  • Vascular stabilizing (flavonoids)

  • Cardioprotective

  • Peripheral vascular effects (e.g., skeletal muscle circulation)

  • Lipid-lowering effects (increased LDL receptor expression in the liver, inhibition of cholesterol synthesis)

  • Anti-inflammatory

  • Antioxidant

Clinical Use

May be given in addition to conventional medication.
Long-term use is necessary for sustained benefit.

Indications

  • Heart failure stages I and II according to NYHA, possibly also stage III

  • Prevention of atherosclerosis

  • Cardiac arrhythmias

  • Coronary ischemia

  • Myocardial weakness after infectious diseases

  • Post-myocardial infarction recovery

NYHA Heart Failure Classification

Stage I: No symptoms, normal physical capacity
Stage II: Mild to moderate limitation (e.g., shortness of breath when climbing stairs)
Stage III: Symptoms with mild exertion (e.g., shortness of breath when walking normally), comfortable at rest
Stage IV: Symptoms at rest, bedridden

Contraindications

None known.

Side Effects

Very rare mild gastrointestinal discomfort.

Preparations

Tea, capsules, tablets, tinctures, liquid extracts.

Commercial preparations include:
Crataegutt (drops), Crataegus Verla, Craegium, and others.