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Botanicals & Herbs

Hawthorn

Also known as: Crataegus monogyna, Crataegus laevigata, Hawthorn berry, Maybush

Europe's traditional heart tonic — berry, leaf, and flower extracts with trial support for mild heart failure and blood-pressure management.

  • By IngredientWiki Editorial Team
  • Fact-checked by IngredientWiki Editorial Team
  • Updated 2026-09-26
  • 2 min read

In short

Hawthorn (Crataegus species) is a thorny shrub whose berries, leaves, and flowers have been used as a heart tonic in European and Traditional Chinese medicine for centuries. Its pharmacology centers on oligomeric procyanidins and flavonoids that modestly dilate blood vessels, mildly inhibit ACE, and improve coronary blood flow. The strongest modern evidence comes from trials of standardized leaf-flower extracts in patients with mild (NYHA class I–II) heart failure, where hawthorn improved exercise tolerance and symptoms such as shortness of breath, and from blood-pressure trials showing small reductions. It is well tolerated but interacts with cardiac medications, so heart patients should use it under supervision.

  • Traditional European heart tonic from Crataegus berries, leaves, and flowers
  • Best evidence: mild (NYHA I–II) heart failure symptoms
  • Mechanisms: mild vasodilation, ACE inhibition, antioxidant procyanidins
  • Interacts with digoxin, beta-blockers, and blood-pressure drugs

What is Hawthorn?

Few herbs carry as much cardiology credibility as hawthorn. What began as a European folk remedy for 'the heart' has been put through randomized trials — most notably in mild heart failure, where standardized leaf-and-flower extracts improved exercise capacity and reduced symptoms like breathlessness. The effect sizes are modest and hawthorn is no substitute for conventional therapy, but its pharmacology (gentle vasodilation, mild ACE inhibition, antioxidant procyanidins) makes it one of the better-evidenced herbal cardiovascular aids. The critical caveat is interaction risk with heart medications.

Where it comes from

Natural sources

  • Berries, leaves, and flowers of Crataegus species (C. monogyna, C. laevigata), native to Europe, Asia, and North America
  • Traditional European and Chinese heart tonic
  • Key actives: oligomeric procyanidins, flavonoids (hyperoside, vitexin), triterpenes

How it's made

Mostly sold as standardized extracts (typically 1.8% vitexin or 18.75% OPCs); also teas and whole-berry preparations.

What it does in products

  • Mild vasodilation and improved coronary blood flow
  • Weak ACE inhibition and afterload reduction
  • Antioxidant protection of vascular endothelium
  • Mild chronotropic and inotropic support

Benefits

Mild heart failure symptom relief

strong evidence

Multiple trials in NYHA class I–II patients found standardized hawthorn extract improved exercise tolerance, fatigue, and shortness of breath versus placebo; a large 2008 trial confirmed safety but not mortality benefit.

Blood pressure support

moderate evidence

Meta-analyses report small reductions in systolic and diastolic pressure in people with prehypertension or mild hypertension.

Anxiety and palpitations

emerging evidence

Traditional use for 'nervous heart'; small trials suggest modest benefit, but data are thinner than for heart failure.

Side effects & safety

Dizziness, nausea, and digestive upset (uncommon)Mild and usually transient; more common at higher doses.
Palpitations or excessive blood-pressure lowering (rare)More relevant in people on multiple antihypertensives.

Safety considerations

  • Insufficient safety data in pregnancy and lactation; avoid unless advised by a clinician.
  • Digoxin — hawthorn may increase effects and toxicity; avoid combining without monitoring
  • Beta-blockers, calcium-channel blockers, nitrates, and ACE inhibitors — additive blood-pressure effects
  • Sildenafil and related PDE5 drugs — additive vasodilation risk
  • Not for: Unstable or severe heart failure (NYHA III–IV) — do not replace conventional therapy
  • Not for: Scheduled surgery within 2 weeks — discontinue to avoid interactions with anesthesia

How it's used

In supplements

160–1,800 mg/day of standardized extract (18.75% OPCs or 1.8% vitexin), often divided; trial doses commonly 900 mg/day.

In skincare

Not typically used topically.

Regulatory status

  • Sold as a dietary supplement; not FDA-approved to treat any cardiovascular condition. Manufacturers may not make disease-treatment claims.
  • Not assessed for topical use.

Popular products containing Hawthorn

  • Nature's Way Hawthorn Berries — Whole-berry capsule formNature's Way · Supplement
  • Gaia Herbs Hawthorn Supreme — Liquid phyto-capsule extractGaia Herbs · Supplement
  • Solaray Hawthorn Berry — Standardized extract capsulesSolaray · Supplement

Product names and brands are shown for reference and belong to their respective owners.

What the clinical evidence shows

The landmark dataset is the SPICE trial (2008), which randomized over 2,600 heart-failure patients to hawthorn extract or placebo and found no mortality difference but confirmed safety alongside standard therapy. Earlier trials in milder disease had reported better exercise tolerance and symptom scores. For blood pressure, a 2020 meta-analysis of four trials found roughly 4–6 mmHg systolic reductions. Evidence quality is generally rated low-to-moderate because of small samples and heterogeneous preparations.

How hawthorn is thought to work

Oligomeric procyanidins relax blood vessels through endothelial nitric oxide pathways, reduce peripheral resistance, and mildly inhibit angiotensin-converting enzyme (ACE). The same compounds scavenge free radicals in vascular tissue. Unlike digoxin, hawthorn's inotropic effect is gentle, which is why it suits mild rather than severe heart failure.

Frequently asked questions

Is hawthorn safe with blood pressure medication?

It can add to your medication's effects, so blood pressure must be monitored. Some clinicians endorse it as an adjunct; others advise against self-combining. Talk to your prescriber before adding hawthorn to any antihypertensive regimen.

How long does hawthorn take to work?

Trials typically assess outcomes at 8–16 weeks. Hawthorn is a long-game supplement, not a fast-acting remedy.

Which part of the plant is used?

Modern supplements standardize leaf and flower extracts, though berries are traditional and common. Leaf-flower extracts have the strongest clinical backing.

The bottom line

Hawthorn is one of the best-evidenced herbal heart aids, with trials supporting symptom relief in mild heart failure and small blood-pressure reductions — but it belongs alongside, never instead of, conventional cardiac care, and it requires interaction screening.

References

  1. Hawthorn — Health Professional Fact Sheet. NCCIH. https://www.nccih.nih.gov/health/hawthorn
  2. Hawthorn extract for treating chronic heart failure. Cochrane Database of Systematic Reviews. https://pubmed.ncbi.nlm.nih.gov/18254076/
  3. The SPICE trial: hawthorn extract in chronic heart failure. European Journal of Heart Failure. https://pubmed.ncbi.nlm.nih.gov/19099504/