Hawthorn berry extract
Also known as: Crataegus oxyacantha, Crataegus laevigata, Hawthorn, Hawthorn berry, Crataegus spp.
Overview
Hawthorn berry extract is derived from the fruit, leaves, and flowers of various Crataegus species, most commonly Crataegus oxyacantha and Crataegus laevigata. Traditionally used for cardiovascular conditions, it is primarily applied as an adjunct treatment for chronic heart failure (CHF) and other heart-related ailments. Its key characteristics stem from its rich content of flavonoids and oligomeric proanthocyanidins, which are believed to exert beneficial cardiovascular effects. Research on hawthorn is moderately mature, with multiple randomized controlled trials (RCTs) and meta-analyses, particularly focusing on its role in heart failure. The quality of evidence is relatively strong for its use as an adjunct therapy in CHF, demonstrating improvements in exercise capacity and symptoms. However, evidence for other cardiovascular applications is less definitive. It is available in various forms, including capsules, tinctures, and teas, with standardized extracts preferred for consistent flavonoid content.
Benefits
Hawthorn berry extract offers several evidence-based benefits, primarily as an adjunctive therapy for chronic heart failure (CHF). A meta-analysis of 8 RCTs involving 632 patients with NYHA class I-III CHF demonstrated that hawthorn extract significantly improved maximal workload by 7 Watts (95% CI: 3 to 11; p < 0.01) and reduced the pressure-heart rate product by 20 units (95% CI: -32 to -8), indicating enhanced cardiac function and efficiency. Patients also reported significant improvements in symptoms such as dyspnea (shortness of breath) and fatigue compared to placebo. These benefits are observed over weeks to months of consistent use. Preclinical studies suggest potential secondary effects, including improved coronary blood flow and anti-arrhythmic properties, though these require more robust clinical confirmation. The evidence for CHF is considered relatively strong, supporting its use to complement conventional heart failure treatments rather than replace them.
How it works
The cardiovascular effects of hawthorn extract are primarily attributed to its active compounds, flavonoids and proanthocyanidins. These compounds are believed to improve coronary blood flow through vasodilation, reducing resistance in blood vessels. They also contribute to antioxidant effects, mitigating oxidative stress in the cardiovascular system. Furthermore, hawthorn appears to enhance myocardial contractility, meaning it can improve the heart muscle's pumping efficiency. It may also modulate cardiac myocyte contraction amplitude and exhibit anti-arrhythmic properties. However, the bioavailability of these active polyphenols is limited (3-10%) due to extensive first-pass metabolism, which can affect their systemic concentrations and overall efficacy.
Side effects
Hawthorn extract is generally well tolerated, with a favorable safety profile. Common side effects, occurring in less than 5% of users, are rare and typically mild, including transient gastrointestinal symptoms such as nausea and dizziness. Uncommon side effects (1-5%) may involve mild, transient cardiac complaints. Rare side effects (less than 1%) are not well documented. While no significant drug interactions or contraindications have been conclusively identified, caution is advised when combining hawthorn with conventional cardiac medications, such as digoxin, beta-blockers, calcium channel blockers, or nitrates, due to potential additive effects on heart rate or blood pressure. Individuals with severe heart failure, pregnant or lactating women, and children should use hawthorn only under strict medical supervision. It is not a substitute for prescribed cardiovascular medications.
Dosage
Effective doses of hawthorn extract in clinical trials typically range from 160 to 1800 mg per day. An optimal dosage often cited is around 900 mg per day of a standardized extract, specifically one standardized to contain 2-3% flavonoids. The maximum safe dose has not been firmly established, but doses up to 1800 mg per day have been well tolerated in clinical studies. For optimal absorption and consistent blood levels, it is generally recommended to divide the daily dose and take it throughout the day, preferably with meals. It is crucial to use extracts standardized for their active flavonoid content to ensure consistency and efficacy, as non-standardized preparations may vary significantly in potency. Always consult a healthcare professional before starting hawthorn, especially if you are on other medications or have pre-existing heart conditions.
FAQs
Is hawthorn safe for heart failure?
Yes, hawthorn extract has demonstrated safety and efficacy as an adjunct to standard therapy for chronic heart failure, improving symptoms and exercise capacity.
When will benefits appear?
Clinical improvements from hawthorn typically manifest after several weeks of consistent daily use, with more significant benefits observed over months.
Can it replace conventional heart medications?
No, hawthorn extract is not a substitute for prescribed heart medications. It is intended to complement, not replace, conventional treatments for heart conditions.
Are there risks of interactions?
Potential interactions exist with cardiac drugs like digoxin, beta-blockers, and calcium channel blockers. Medical consultation is highly recommended before use to avoid adverse effects.
Research Sources
- https://pubmed.ncbi.nlm.nih.gov/12798455/ – This meta-analysis of 8 randomized controlled trials (n=632 CHF patients) found that hawthorn extract significantly improved maximal workload and reduced symptoms like dyspnea and fatigue in patients with chronic heart failure. The study concluded that hawthorn can be a safe and effective adjunctive treatment for CHF, highlighting its high quality due to strict inclusion criteria.
- https://pubmed.ncbi.nlm.nih.gov/11887407/ – This comprehensive pharmacological review highlighted hawthorn's cardiovascular effects and therapeutic uses, emphasizing its flavonoid content and favorable safety profile. While providing valuable insights into the mechanisms and applications of hawthorn, it was a narrative review and did not include quantitative synthesis of data.
- https://journals.sagepub.com/doi/full/10.1177/2156587213491428 – This physiological study investigated hawthorn's effects on coronary flow and cardiac myocytes in vitro and ex vivo. It demonstrated dose-dependent vasodilation and improved myocardial contractility at pharmacologically relevant concentrations, providing mechanistic insights. However, the study's limitations include the need for extrapolation from animal models to human physiology.
