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(Crataegus Oxyacantha)
Description

Hawthorne is a spiky bush or tree found in Europe, northwestern

Africa, and western Asia. In England it is grown as a hedge plant. The
tree reaches 13 feet in height and grows along the edges of woods and
forests. Hawthorne has smooth, gray bark and sharp thorns which grow
along the branches. The leaves are dark green with shiny, bluish-green
undersides, and have irregular tooth margins. Snow white flowers
bloom from May to June and grow in terminal corymbs. The fruits are
bright red, oval, two to three seeded, and hang down in clusters. The
medicinal parts are the flowers and the fruit.

Other common names:

English hawthorn May bush May tree

Quickset Thorn apple tree White thorn

CHEMICAL COMPOSITION

Acetylcholine Anthocyanins Caffeinic acid

Chlorogenic acid Flavonoids Hormones
Oleanolic acid Oxyacanthine Phenolic acids
Plant acids Saponins Triterpene acids
Ursolic acid

* For definition of some of the above terms see the dictionary section
of this book.

NUTRIENT COMPOSITION

Bioflavonoids Choline Lecithin

Vitamin B complex Vitamin C

PROPERTIES AND USES

Antispasmodic - an agent which relieves or prevents spasms, usually of

the smooth muscles; barbiturates and valerian are examples of
antispasmodics.

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Cardiac - a substance which stimulates heart metabolism and

strengthens contractions, and may at times cause a slowing of heart rate
due to more efficient activity.

Sedative - a class of drugs which function to quiet nervous excitement

and reduce motor activity without inducing sleep. They are used in the
management of neuroses and in the treatment of anxiety and
apprehension accompanying various disease states such as
hypertension. Sedatives commonly function to induce reversible
depression of the central nervous system. Examples of this class are
phenobarbital, secobarbital sodium, and pentobarbital.

Vasodilator - an agent which causes dilation of blood vessels.

Hawthorne berries are very effective for relieving insomnia. A poultice

of crushed leaves or fruit has strong draining powers and has been used
in England for centuries for the treatment of embedded thorns and
splinters, and some sores. The fruits are used for nervousness and also
to prevent miscarriage. It has been known for centuries as a treatment
for heart disease. Regular use increases cardiovascular health. It is an
excellent heart tonic; it dilates peripheral blood vessels, increase
metabolism in the heart muscle, dilates coronary vessels, and improves
blood supply to the heart. The herb also acts to abolish rhythm
disturbances.

Several of hawthorn's most active constituents are cholines, chlorogenic

acid, caffeinic acid, and ascorbic acid. The constituents in hawthorn
berries work together to help prevent coronary thrombosis and cardiac
arrest. The choline present in the berries is the main principle in
lecithin, which helps to control cholesterol by breaking fat into tiny
particles which can then pass very easily into the tissues of the body.

Hawthorn is hypotensive and anabolic

Compared to digitalis, it is much milder and safer to use, more a tonic

than a specific. The herb is tonic for both high and low blood pressure,
as well as tachycardia and arrhythmia. Mild anti-arteriosclerotic
principles have been identified in hawthorn; antispasmodic and sedative
properties have also been ascribed to it, but have not been
experimentally verified.

Hawthorne is an excellent cardiotonic

It functions by peripheral vasodilation; very mild dilation of coronary

vessels; increased enzyme metabolism in the heart muscle; and
increased oxygen utilization by the heart.

A noted expert in the area maintains that hawthorn drugs are

characterized by three basic healing properties which complement one
another:

1. Improvement of coronary blood supply which leads to a decreased

frequency of anginal attacks and of subjective complaints.

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2. Improvement of the metabolic processes in the myocardium, which

results in an improvement of functional heart activity.

3. Abolition of some types of rhythm disturbances.

In human patients with perfusion disorders of the coronary arteries due

to coronary sclerosis, hawthorn significantly decreased oxygen
utilization during exercise. In 40 of 52 patients, intravenous
administration of hawthorn extract for a mean period of 13.4 days
produces a noticeable decrease in the ischemia reaction in the exercise
EKG. In patients undergoing standard therapies such as CD2 partial
baths, an improvement was seen in only 25% of the cases.

In another study on human subjects with primary heart disease,

intravenous hawthorn extract produced an improvement in almost all
cases, as determined by a normalization of heart dynamics (the
mechanical efficiency of the heart muscle). In patients with secondary
heart disease the effect was not as great in terms of the number of cases
helped, but significant effects were seen in those cases that were
helped. The herb also helped patients whose heart disease was caused
by hepatitis or other liver disease. Taken together, these results suggest
a positive inotropic action.

Excellent results in a wide variety of coronary problems were obtained

utilizing a crossed, double-blind procedure. The substance used was a
German drug called Corguttin, which composed of Adonidiss,
Covallaria majalis, Hawthorn, Primula officinales, and Valerian
officinales. This product proved extremely effective in meeting the
routine, daily needs of patients with minor heart problems.

Hawthorn has vasodilatory action

It has a marked and prolonged vasodilatory action, and an ability to

lower peripheral resistance to blood flow in dogs and guinea pigs. The
extract was injected directly into the arteria coronaria. Intravenous
injection caused no change in the volume of coronary blood flow, but
still showed lowering of peripheral resistance. The blood supply of the
central nervous system was influenced in the same manner as that of
the coronary vessels, i.e., the resistance to blood flow was lowered, and
following direct injection into the carotid, the blood volume passing
through was also increased.

Hawthorne increases blood flow

In a series of experiments in dogs, aqueous solutions of

heptahydroxyflavenoglycoside, a component of hawthorn, was used to
demonstrate the herb's cardiac and circulatory actions. Intra-arterial
injections in the a. femoralis, a. femoris post. sup. (a muscle vessel),
and a. coronaria dextra, caused increased blood flow. In the a. saphena
(a skin vessel) and the a. renalis, the blood flow was lowered. Blood
pressure was raised by injection into the a. coronaria dextra and
intravenous injection. No changes in urinary excretion and respiration
were found. No definite dose-response relationship could be
determined because the degree of response was unpredictable.

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Hawthorne successfully destroys experimentally-induced blockade of

anaerobic glycolysis, a condition that typifies some forms of heart
disease cause by enzyme insufficiency.

In patients with chronic cardiac insufficiency, hawthorn has produced a

quickening of the heart beat. It increased coronary blood flow by
increasing the cardiac output and by direct influence on the smooth
muscles of the vessels. Arterial and venous blood pressure were not
affected, the EKG was not influenced, and no pulmonary damage was
observed.

Hawthorn is hypotensive

A fraction of the hawthorn extract, containing flavan polymers, had a

low toxicity in the mouse, a pronounced hypotensive activity in the cat,
and strong and prolonged cardiotonic action and detoxicating properties
in the rabbit.

Oligomeric procyanidins isolated from hawthorn extract decrease blood

pressure in cats; in mice, they decreased aggression and body
temperature, and prolonged hexobarbital narcosis.

Hawthorn versus Digitalis

It was once assumed that hawthorn and digitalis belonged to the same
class of agents. That hypothesis has been totally refuted by studies
which demonstrated that hawthorn may partly antagonize the
undesirable properties of digitalis. In addition, hawthorn enhances pulse
and positively potentiates the force of muscular contractions. It
enhances cardiac output or performance in rats as measured by stress
swimming trials. On isolated from heart, it has a tonic and normalizing
action. Unlike digitalis, hawthorn lowers blood pressure through dilation
of peripheral vessels, rather than by direct action on the heart. Thus it
preserves critical reflexive blood pressure regulation. In man, hawthorn
acts even on the healthy heart to increase cardiac activity. Hawthorn
appears to have less of an immediate effect than digitalis. After longer
periods of use, subjective betterment accompanied by objective
measurable improvement in tonus and regulation of cardiac activity are
observed with hawthorn. Unlike digitalis, hawthorn exhibits an absence
of cumulative activity; it appears to occupy a position somewhere
between digitalis and adrenaline.

Heart tissue pretreated with either Hawthorn or Digitalis becomes

sensitized to the other, so that only about half the normal dose of the
second is required to obtain normal results. This suggest a synergism
between the two substances.

Hawthorn has an anabolic effect on metabolism

After 14 hours of abstinence from food, the blood levels of free fatty
acids, free glycerol, triglyceride, glucose, lactate, and pyruvate were
measured in ten human subjects. These levels were measured again 30,
60, and 120 minutes after intravenous injection of hawthorn extracts.
Thirty and sixty minutes after injection, a significant decrease in free

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fatty acids and lactate was observed. Glucose and pyruvate also
decreased, whereas the concentration of triglycerides increased. The
observed alterations in fat and carbohydrate metabolism suggests that
hawthorn has an anabolic effect on metabolism, presumably by an
influence on the enzymatic system. In this way, a decrease in oxygen
and energy consumption would occur.

TOXICITY FACTORS

No toxicity has been attributed directly to hawthorn. However, since it

is an active cardiotonic herb, users should exercise extreme caution
when combining this herb with other cardiac drugs.

DRUG PRECAUTIONS AND INTERACTIONS

Known Interactions

The effects of hawthorn and digitalis are synergistic, such that only half
the normal dose of digitalis is required if hawthorn is also being used.

Possible Interactions

Diuretic-induced hypokalemia may increase the activity of hawthorn;

guinidine, procainamide, and propranolol may also enhance its effects.
Conversely, the effects of the herb may be reduced by propantheline,
spironolactone, and triamterene, as well as by antacids, anti-diarrheal
absorbent suspensions, neomycin, cholestyramine, and other anionic
exchange resins. Hawthorn is synergistic with parenteral calcium salts,
pancuronium, succinylcholine, rauwolfia alkaloids, ephedrine,
epinephrine, and other adrenergic agents. The inotropic action of this
herb may be reduced by propranolol; however, the effect of the two
substances on AV are additive. Cyclopropane or halogenated
hydrocarbon anesthetics may sensitize the myocardium to the
cardiotonic effects of hawthorn, although the chances of this happening
are very low.

Comments

The cardiac alkaloids in hawthorn may antagonize the action of

heparin. Certain drugs induce activity by hepatic microsomal enzymes
that metabolize cardiac glycosides. These agents probably affect the
action of hawthorn, but in an as yet unknown manner. To the extent
that hawthorn's action depends on the presence of cholinergic
substances, it will be affected by the decrease in cholinergic-receptor
stimulation produced by anticholinergics. Drugs utilized to treat angina
pectoris, such as nadolol and propanolol HDI, may reduce AV
conduction induced by this herb.

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