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Hawthorn

Its traditional and clinical use as a botanical support for cardiovascular health and heart failure management.

Evidence · Grade B
Human trial evidenceTraditional useInteraction risk

Hawthorn is a plant-based nutraceutical studied for its potential health benefits in patients with heart failure. Research focuses on its role as a complementary addition to standard cardiovascular care.

Last reviewed June 13, 2026 · AI-assisted, human-reviewed
Hawthorn (Crataegus species) is a flowering shrub or tree in the rose family that has been historically utilized in traditional medicine practices. In contemporary clinical research, hawthorn extracts are primarily investigated as complementary nutraceutical interventions for cardiovascular conditions. As a pharmacologically active substance derived from plant sources, it is often categorized alongside other nutraceuticals evaluated for their potential role in managing physiological aspects of cardiac health. Scientific literature frequently assesses its application in supporting heart function, particularly in the context of chronic heart failure. While some guidelines incorporate evidence regarding its use, it is often considered an adjunct to standard pharmacological treatments rather than a primary therapy.

Quick answer

What it is: Hawthorn (Crataegus species) is a flowering shrub or tree in the rose family that has been historically utilized in traditional medicine practices.

May support:Heart Failure

Evidence:Evidence · Grade B

Evidence Summary

Evidence · Grade B

Clinical reviews and systematic evaluations, such as those informing the Australian Guidelines for the management of heart failure, have identified Hawthorn as a nutraceutical with evidence suggesting potential benefits for patients diagnosed with heart failure. These reviews categorize it as a substance that may influence health outcomes when administered as part of a structured clinical approach.

Last reviewed · Jun 2026

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Why It Works

As a nutraceutical, Hawthorn contains pharmacologically active compounds that may interact with cardiovascular pathways to produce health benefits in patients with heart failure.

How it works in more detail

Hawthorn's potential cardiovascular effects are attributed to its flavonoid and proanthocyanidin content. These compounds are believed to possess antioxidant properties, which may help reduce oxidative stress in the cardiovascular system. Proposed mechanisms include vasodilation, potentially by influencing nitric oxide production or inhibiting angiotensin-converting enzyme (ACE), and positive inotropic effects, which could improve heart muscle contraction. However, these mechanisms are largely theoretical or derived from in vitro and animal studies, and their direct relevance and significance in human physiology require further investigation.

How to use

Always consult a qualified clinician.

Editorial guidance

Suggested dosage
Standardized extracts are typically dosed at 160-900 mg daily, divided into two or three doses. Dosage should be determined in consultation with a healthcare professional, especially given co-existing heart conditions and medications.
Research dosage range
No research dosages can be provided due to the lack of specific studies.
Typical onset
The onset of effects, if any, is not well-established due to limited research.
Typical forms
Capsule, Tablet, Tincture, Tea, Liquid extract
Quality markers
When purchasing hawthorn products, look for standardized extracts, often specifying the content of flavonoids or proanthocyanidins. Reputable brands that provide third-party testing for purity and potency are preferable. Check for clear labeling of the plant part used (e.g., leaf and flower, berry).
Medication interactions
  • Cardiac glycosides (e.g., digoxin)
  • Beta-blockers
  • Calcium channel blockers
  • Nitrates
  • Anticoagulants
  • Antiplatelet drugs
  • Blood pressure medications
Avoid if
  • Pregnant
  • Breastfeeding
  • Undergoing surgery (discontinue prior to surgery)

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Suggested dosage

Standardized extracts are typically dosed at 160-900 mg daily, divided into two or three doses. Dosage should be determined in consultation with a healthcare professional, especially given co-existing heart conditions and medications.

General guidance — discuss specifics with a clinician.

Active medicinal compounds

Flavonoids (e.g., hyperoside, vitexin, rutin), proanthocyanidins (oligomeric proanthocyanidins or OPCs), triterpenic acids (e.g., ursolic acid, oleanolic acid).

Traditional use

Hawthorn has a long history of traditional use in European and Chinese herbal medicine. Historically, it was used to treat various heart-related complaints, including irregular heartbeat, chest pain, and high blood pressure. In traditional European folklore, it was also associated with protection and fertility. Its use for 'strengthening the heart' has persisted for centuries, often in the form of teas, tinctures, or extracts made from the berries, leaves, and flowers.

Safety

Safety warnings

Patients should exercise caution regarding potential drug-herb interactions, as users often do not disclose herbal use to their clinicians. It is essential to screen for interactions between Hawthorn and conventional cardiovascular medications. Consultation with a healthcare provider is necessary before beginning use, especially for those with pre-existing heart conditions.

Avoid if

  • Pregnant
  • Breastfeeding
  • Undergoing surgery (discontinue prior to surgery)

Medication interactions

  • Cardiac glycosides (e.g., digoxin)
  • Beta-blockers
  • Calcium channel blockers
  • Nitrates
  • Anticoagulants
  • Antiplatelet drugs
  • Blood pressure medications

Reported side effects

  • Nausea
  • Dizziness
  • Fatigue
  • Headache
  • Stomach upset

General guidance — discuss specifics with a clinician.

Evidence ecosystem

Scientific literature, clinical guidance, government sources, ongoing research, traditional use, and lived experience — grouped by source type and quality.

Overall grade (B)

Clinical reviews and systematic evaluations, such as those informing the Australian Guidelines for the management of heart failure, have identified Hawthorn as a nutraceutical with evidence suggesting potential benefits for patients diagnosed with heart failure. These reviews categorize it as a substance that may influence health outcomes when administered as part of a structured clinical approach.

Observational Studies(2)

Cohort, case-control, and cross-sectional human studies.

Moderate Quality

  • Nutraceuticals in Patients With Heart Failure: A Systematic Review.

    Hopper I, Connell C, Briffa T, De Pasquale CG, Driscoll A, Kistler PM · Journal of cardiac failure · 2020 · n=50

    Nutraceuticals are pharmacologically active substances extracted from vegetable or animal food and administered to produce health benefits. We recently reviewed the current evidence for nutraceuticals in patients diagnosed with heart failure as part of the writing of the Australian Guidelines for the prevention, diagnosis, and management of heart failure. A systematic search for studies that compared nutraceuticals to standard care in adult patients with heart failure was performed. Studies were included if >50 patients were enrolled, with ≥6 months follow-up. If no studies met criteria then studies <50 patients and <6 months follow-up were included. The primary outcomes included mortality/survival, hospitalization, quality of life, and/or exercise tolerance. Iron was not included in this review as its role in heart failure is already well established. Forty studies met the inclusion criteria. The strongest evidence came from studies of polyunsaturated fatty acids, wh

    Observational StudyPubMedLow Quality

  • Herbal medicinals: selected clinical considerations focusing on known or potential drug-herb interactions.

    Miller LG · Archives of internal medicine · 1998

    Herbal medicinals are being used by an increasing number of patients who typically do not advise their clinicians of concomitant use. Known or potential drug-herb interactions exist and should be screened for. If used beyond 8 weeks, Echinacea could cause hepatotoxicity and therefore should not be used with other known hepatoxic drugs, such as anabolic steroids, amiodarone, methotrexate, and ketoconazole. However, Echinacea lacks the 1,2 saturated necrine ring associated with hepatoxicity of pyrrolizidine alkaloids. Nonsteroidal anti-inflammatory drugs may negate the usefulness of feverfew in the treatment of migraine headaches. Feverfew, garlic, Ginkgo, ginger, and ginseng may alter bleeding time and should not be used concomitantly with warfarin sodium. Additionally, ginseng may cause headache, tremulousness, and manic episodes in patients treated with phenelzine sulfate. Ginseng should also not be used with estrogens or corticosteroids because of possible additive effects. Since the

    Observational StudyPubMedLow Quality

Limitations: While systematic reviews exist, the precise efficacy of Hawthorn can vary across studies. Furthermore, the integration of such nutraceuticals into formal clinical guidelines depends on the quality and consistency of human trials, which may be limited by sample sizes or variations in extract standardization.

This page is educational. Statements use phrases like "may support" and "has been studied for"because no remedy here is approved to cure, treat, or reverse any condition. Discussion happens on the ailment pages — community statistics here are derived from those reports. Always consult a qualified clinician.

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