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Hawthorn can help improve the pumping ability of the heart


Crataegus spp Rosaceae

Several species of hawthorn or mayflower are used to provide a remedy that is a firm favourite among practitioners for anxiety-related heart problems, symptoms associated with atherosclerosis ("hardening of the arteries"), and hypertension (high blood pressure).

Sustainability Status

Sustainability status

Not currently on risk lists but complete data may be missing on the status of the species. Read more about our sustainability guide.

Key benefits
  • Palpitations
  • Low-level heart and circulatory problems
  • Moderate high blood pressure
  • How does it feel?

    The qualities of hawthorn can best be introduced by making a strong tea with the leaves and flowers. This gives off a mild aromatic almost earthy aroma. When tasted the aromatic quality is almost vanilla-like, very low key, with gentle bitterness coming through quite quickly, followed by astringency, and finally a gentle sweet aftertaste. Eating the fruit in late summer, quite commonly done in rural areas, will provide a similar taste profile with a little extra mucilaginous quality.

    The overall hawthorn sensory profile is of a plant with several complementary properties, supportive rather than potent.

  • What can I use it for?

    Many of the traditional uses of hawthorn should only now be applied by trained health care practitioners who can navigate the complexities of heart problems and their conventional treatment. However in relatively mild heart and circulation conditions, particularly where stress is a key factor, hawthorn can be a very helpful home remedy.

    Along with good breathing exercises consider using it for palpitations (this is not usually a problem of the heart, rather the effect of tension clamping the muscles of the rib cage and diaphragm and creating a sounding chamber in the chest), for hyperventilation and other local symptoms of stress.  If your blood pressure is moderately high regular hawthorn tea can be a safe and effective companion to most blood pressure medicines.

  • Into the heart of hawthorn

    Probably best described as a heart tonic, hawthorn was used as an overall restorative and strengthening remedy, not only to alleviate symptoms, but also to aid recovery and prevent progression of illness.

    The flowers and berries have similar actions, but the berries are thought to be more useful in the lowering of blood pressure and the flowers at improving circulation to the peripheries. It is particularly beneficial for reductions of function due to old age, as opposed to the onset of any particular pathology.

    Hawthorn can also help to relieve anxiety and resulting palpitations or raised blood pressure.

  • Traditional uses

    Artwork by Fiona Owen

    Humans have venerated the hawthorn from ancient times, and the use of the plant as a medicine is almost as extensive. In Europe, ‘mayflower’ was long regarded as a sacred and magical tree. It was at the centre of numerous folk beliefs and rituals celebrating renewal of life in springtime, fertility, and matters of the heart.

    Traditional folk use of hawthorn notably included fever management, to steady fluctuating body temperatures. In 1640, the English herbalist and author Parkinson noted that the remedy was applied for dropsy (an old term for fluid accumulation caused by heart failure). Over the ensuing centuries the therapeutic potential of hawthorn emerged more strongly, and herbalists found that its greatest benefit truly was for “matters of the heart”.

    Early American herbalists found it helpful in cases of inflammation in the cardiovascular system (endocarditis, myocarditis, and pericarditis), irregular heart beat, and more severe heart malfunctions. It was considered gentle enough for elderly patients with difficult breathing linked to ‘weak heart’.

    In Asian traditions, the fruits of local species were applied for astringent effects and for general digestive complaints, including dyspepsia (indigestion) and diarrhoea; it was sometimes charred for use as intestinal charcoal. Similar digestive applications were found among Native American tribes for the flowering shoots and flowers of their local species, particularly in the north and northwest. Native Americans also had gynaecological and obstetric uses for the plant.

    All over the world, hawthorn fruits have been widely eaten as foods.

  • Traditional actions

  • Traditional energetic actions

    Herbal energetics are the descriptions Herbalists have given to plants, mushrooms, lichens, foods, and some minerals based on the direct experience of how they taste, feel, and work in the body. All traditional health systems use these principles to explain how the environment we live in and absorb, impacts our health. Find out more about traditional energetic actions in our article “An introduction to herbal energetics“.

  • What practitioners say

    Cardiovascular system: Among trained Western herbal practitioners, hawthorn is a strong favourite for the management of heart and coronary symptoms, as well as issues presenting in the circulatory system.

    As it is a tonic, hawthorn has a reputation for use in both hypertension and hypotension as it normalises cardiovascular function. Other symptoms that may indicate the use of hawthorn are mild angina (chest pain), intermittent episodes of tachycardia (fast heartbeat), benign arrhythmia (irregular heartbeat).

    Hawthorn may also be indicated to assist with peripheral circulation such as in the case of chilblains, atherosclerosis, and Raynaud syndrome.

    It is often combined with other herbs such as motherwort (Leonorus cardiaca) for tachycardia and arrythmias, or linden flowers (Tilia spp) for anxiety related symptoms or hypertension.

    Nervous system: Herbalists may prescribe Hawthorn in cases of anxiety and sleeplessness, especially if symptoms present with palpitations or other heart symptoms and sensations.

    Hawthorn is also helpful in supporting the emotional heart much like its cousin, rose (Rosa spp). Like rose, Hawthorn can be an aid in the processing of grief and loss.

  • Research

    In a meta-analysis of ten well-conducted clinical trials including 855 patients with chronic heart failure (New York Heart Association classes I to III – in which there is slight limitation of physical activity) standardised preparations of hawthorn leaf and flowers show good clinical evidence of benefit, including increased heart capacity and tolerance to exercise (1). Other reviews for a particular standardised preparation support these conclusions (2, 3). Studies of its mechanism of action suggest that hawthorn helps improve the ability of the heart muscle to contract combined with an increase in coronary blood flow; the most important constituents for this activity appear to be flavonoids (4). Oligomeric procyanidins (OPCs) are also likely to contribute benefit (5,6). Some types of hawthorn extracts steady variable heart rate. There is also a significant hypotensive (blood pressure lowering) effect (7). 

    A Chinese hawthorn Crataegus pinnatifida has been used in Asia for the treatment of high cholesterol and various cardiovascular diseases. There is evidence that this species can be helpful in the case of ‘metabolic syndrome’ in which overweight, high blood sugar, high blood pressure or high blood lipid levels occur simultaneously, raising the risk for diabetes mellitus and cardiovascular diseases (8).  

    Hawthorn is a gentle tonic herb that is considered very safe when used as recommended. The fruit has been eaten as a food for centuries and was sometimes referred to as the ‘bread-and-butter-plant’. However, some traditional uses for this remedy make it unsuitable for self-medication, as heart conditions require expert diagnosis, monitoring, and treatment. Thus, the main risk associated with its use is that it might be taken in place of proper medical diagnosis and treatment of conditions that are potentially life-threatening. 

    There is also a theoretical possibility of interactions with conventional medicines for the heart, (although there is specific evidence that it does not interact with digoxin) and hawthorn should not be taken if there is already prescriptions for heart problems without expert supervision (9).

    In one systematic review of safety in clinical trials involving over 5,000 patients with heart problems, adverse events were reported infrequently and were mostly mild, such as dizziness, digestive upsets, headache, and palpitation. 

    There is no evidence that hawthorn has harmful effects in human pregnancy, although such evidence is limited. There is no evidence of harmful effects in animal studies. Hawthorn is probably compatible with breastfeeding. Nevertheless, any use of this remedy during pregnancy and lactation should be undertaken only with expert advice.

  • Did you know?

    In one story, Joseph of Arimathea, a metal merchant and the apocryphal uncle of Jesus who donated him his tomb, after the resurrection travelled back to Glastonbury in England, then an ancient metal trading hub and surrounded by the sea. He was said to have marked the site of the first Christian church by plunging his hawthorn staff into the ground, whereupon it burst into life and survived as a tree into Victorian times. Cuttings of this tree are found throughout England as the ‘Glastonbury thorn’.

Additional information

  • Botanical description

    Leaves, flowers, and fruit of various species of hawthorn are used interchangeably. They are deciduous, shrubby trees with thorny shoots. The leaves are characteristically 3-lobed, and as with all plants of the rose family have appendages (stipules) found at the base of leaves. Small white or pink flowers with 5 petals are borne in clusters. These give way to the characteristic red spherical berries that contain a single seed each. The plant flowers in May and bears fruit in September.

    Flowers smell faint, often slightly fishy due to the trimethylamine content.

    Alternate botanical names:

    • Crataegus laevigata (aka C. oxyacantha)
    • C. monogyna and other species.
    • Crataegus pinnatifida is the main remedy used in China
  • Common names

    • Mayflower
    • Whitethorn
    • Maybush
    • Hedgethorn
    • Bread and cheese
    • Red Haw (Eng)
    • Weißdorn (Ger)
    • Hagendorn (Ger)
    • Aubépine (Fr)
    • Epine blanche (Fr)
    • Blancospino (Ital)
    • Espino blanco (Sp)
  • Safety

    Hawthorn is a gentle tonic herb that is considered very safe when used as recommended. The fruit has been eaten as a food for centuries and was sometimes referred to as the ‘bread-and-butter-plant’. However, some traditional uses for this remedy make it unsuitable for self-medication, as heart conditions require expert diagnosis, monitoring, and treatment. Thus, the main risk associated with its use is that it might be taken in place of proper medical diagnosis and treatment of conditions that are potentially life threatening.

  • Dosage

    1.5–3.5g of dried flower, leaf or berry per day, as infusion or decoction.

  • Constituents

    • Oligomeric procyanidins or OPCs up to 4% mainly procyanidin B-2
    • Flavonoids (1–2%) including quercetin glycosides (hyperoside, rutin) and flavone-C-glycosides (vitexin)
    • Terpenoids sesquiterpenes and triterpenes

    The flowers contain the highest levels of flavonoids and the leaves contain the highest levels of OPCs.

hawthorn illustration
  • Recipe

    Brave Heart Tea

    This Brave Heart tea is a therapeutic recipe for nourishing your heart, both the physical and emotional.


    • Hawthorn berry 4g
    • Hawthorn leaf and flower 2g
    • Limeflower 2g
    • Cinnamon bark 2g
    • Motherwort 1g
    • Saffron 5 strands
    • Rose flower 1g
    • Pomegranate juice a glug (or 1 tbsp) per cup

    This will serve 2 cups of a very heartloving tea.


    • Put all of the ingredients in a pot (except for the pomegranate juice).
    • Add 500ml (18fl oz) freshly boiled filtered water. Leave to steep for 10–15 minutes, then strain.
    • Add a glug of pomegranate juice to each cup.

    This recipe is from Cleanse, Nurture, Restore by Sebastian Pole

  • References

    1. Pittler MH, Guo R, Ernst E. (2008) Hawthorn extract for treating chronic heart failure. Cochrane Database Syst Rev. 2008;(1):CD005312.
    2. Holubarsch CJF, Colucci WS, Eha J. (2018) Benefit-Risk Assessment of Crataegus Extract WS 1442: An Evidence-Based Review. Am J Cardiovasc Drugs. 18(1): 25–36
    3. Zorniak M, Szydlo B, Krzeminski TF. (2017) Crataegus special extract WS 1442: up-to-date review of experimental and clinical experiences. J Physiol Pharmacol. 68(4): 521–526
    4. Rigelsky JM, Sweet BV. (2002) Hawthorn: pharmacology and therapeutic uses. Am J Health Syst Pharm. 59(5): 417–422 
    5. Jurikova T, Sochor J, Rop O, et al. (2012) Polyphenolic profile and biological activity of Chinese hawthorn (Crataegus pinnatifida BUNGE) fruits. Molecules. 17(12): 14490–14509 
    6. Rechciński T, Kurpesa M. (2005) [Oligomeric procyanidins from hawthorn extract as supplementary therapy in patients with left ventricle systolic dysfunction – Article in Polish]. Przegl Lek. 62(4): 243–244
    7. Walker AF, Marakis G, Simpson E, et al. (2006) Hypotensive effects of hawthorn for patients with diabetes taking prescription drugs: a randomised controlled trial. Br J Gen Pract. 56(527): 437–443 
    8. Dehghani S, Mehri S, Hosseinzadeh H. (2019) The effects of Crataegus pinnatifida (Chinese hawthorn) on metabolic syndrome: A review. Iran J Basic Med Sci. 22(5): 460–468
    9. Tankanow R, Tamer HR, Streetman DS, et al. (2003) Interaction study between digoxin and a preparation of hawthorn (Crataegus oxyacantha). J Clin Pharmacol. 43(6): 637–642
An ‘aromatic’ remedy, high in volatile essential oils, was most often associated with calming and sometimes ‘warming’ the digestion. Most kitchen spices and herbs have this quality: they were used both as flavouring and to ease the digestion of sometimes challenging pre-industrial foods. Many aromatics are classed as ‘carminatives’ and are used to reduce colic, bloating and agitated digestion. They also often feature in respiratory remedies for colds, chest and other airway infections. They are also classic calming inhalants and massage oils, and are the basis of aromatherapy for their mental benefits.
Astringent taste
The puckering taste you get with many plants (the most familiar is black tea after being stewed too long, or some red wines) is produced by complex polyphenols such as tannins. Tannins are used in concentrated form (eg from oak bark) to make leather from animal skins. The process of ‘tanning’ involves the coagulation of relatively fluid proteins in living tissues into tight clotted fibres (similar to the process of boiling an egg). Tannins in effect turn exposed surfaces on the body into leather. In the case of the lining of mouth and upper digestive tract this is only temporary as new mucosa are replenished, but in the meantime can calm inflamed or irritated surfaces. In the case of open wounds tannins can be a life-saver – when strong (as in the bark of broadleaved trees) they can seal a damaged surface. One group of tannins, the reddish-brown ‘condensed tannins’ are procyanidins, which can reduce inflammation and oxidative damage.
Bitters are a very complex group of phytochemicals that stimulate the bitter receptors in the mouth. They were some of the most valuable remedies in ancient medicine. They were experienced as stimulating appetite and switching on a wide range of key digestive functions, including increasing bile clearance from the liver (as bile is a key factor in bowel health this can be translated into improving bowel functions and the microbiome). Many of these reputations are being supported by new research on the role of bitter receptors in the mouth and elsewhere round the body. Bitters were also seen as ‘cooling’ reducing the intensity of some fevers and inflammatory diseases.
Blue-purple colouring
Any fruits with a blue-purple colouring contain high levels of the polyphenols known as anthocyanins. These work 1) on the walls of small blood vessels, helping to maintain capillary structure to reduce a key stage in inflammation, and improving the microcirculation to the tissues; 2) to improve retinal function and vision; 3) to support connective tissue repair around the body.
Traditional ‘cold’ or cooling’ remedies often contain bitter phytonutrients such a iridoids (gentian), sesiquterpenes (chamomile), anthraquinones (rhubarb root), mucilages (marshmallow), some alkaloids and flavonoids. They tend to influence the digestive system, liver and kidneys. Cooling herbs do just that; they diffuse, drain and clear heat from areas of inflammation, redness and irritation. Sweet, bitter and astringent herbs tend to be cooling.
Traditional ‘hot’ or ‘heating’ remedies, often containing spice ingredients like capsaicin, the gingerols (ginger), piperine (black or long pepper), curcumin (turmeric) or the sulfurous isothiocyanates from mustard, horseradich or wasabi, generate warmth when taken. In modern times this might translate as thermogenic and circulatory stimulant effects. There is evidence of improved tissue blood flow with such remedies: this would lead to a reduction in build-up of metabolites and tissue damage. Heating remedies were used to counter the impact of cold, reducing any symptoms made worse in the cold. .
Mucilages are complex carbohydrate based plant constituents with a slimy or ‘unctuous’ feel especially when chewed or macerated in water. Their effect is due simply to their physical coating exposed surfaces. From prehistory they were most often used as wound remedies for their soothing and healing effects on damaged tissues. Nowadays they are used more for these effects on the digestive lining, from the throat to the stomach, where they can relieve irritation and inflammation such as pharyngitis and gastritis. Some of the prominent mucilaginous remedies like slippery elm, aloe vera and the seaweeds can be used as physical buffers to reduce the harm and pain caused by reflux of excess stomach acid. Mucilages are also widely used to reduce dry coughing. Here the effect seems to be by reflex through embryonic nerve connections: reduced signals from the upper digestive wall appear to translate as reduced activity of airway muscles and increased activity of airway mucus cells. Some seed mucilages, such as in psyllium seed, flaxseed (linseed) or guar bean survive digestion to provide bulking laxative effects in the bowel. These can also reduce rate of absorption of sugar and cholesterol. .
New-mown hay aroma
The familiar country odour of haymaking, of drying grass and other plants, is largely produced by coumarins (originally isolated from tonka beans – in French coumarou) and widely used in perfumery. They are chemically categorised as benzopyrone lactones and are important phytochemicals, with strong antioxidant activity in the laboratory and likely effects in modulating inflammation. They were most often associated with the calming effect linked to their use in stuffing mattresses and pillows and plants, high In coumarins were commonly used for these properties.
Resins are most familiar as tacky discharges from pine trees (and as the substance in amber, and rosin for violin bows). They were most valued however as the basis of ancient commodities like frankincense and myrrh (two of the three gifts of the Three Wise Men to the baby Jesus) and getting access to their source was one benefit to Solomon for marrying the Queen of Sheba (now Ethiopia). Resins were the original antiseptic remedies, ground and applied as powders or pastes to wounds or inflamed tissues, and were also used for mummification. With alcohol distillation it was found that they could be dissolved in 90% alcohol and in this form they remain a most powerful mouthwash and gargle, for infected sore throats and gum disease. They never attracted much early research interest because they permanently coat expensive glassware! For use in the mouth, gums and throat hey are best combined with concentrated licorice extracts to keep the resins in suspension and add extra soothing properties. It appears that they work both as local antiseptics and by stimulating white blood cell activity under the mucosal surface. They feel extremely effective!
The salty flavour is immediately distinctive. A grain dropped onto the tongue is instantly moistening and a sprinkle on food enkindles digestion. This easily recognisable flavour has its receptors right at the front of the tongue. The salty flavor creates moisture and heat, a sinking and heavy effect which is very grounding for the nervous system and encourages stability. People who are solid and reliable become known as ‘the salt of the earth'.
The sharp taste of some fruits, and almost all unripe fruits, as well as vinegar and fermented foods, is produced by weak acids (the taste is generated by H+ ions from acids stimulating the sour taste buds). Sour taste buds are hard-wired to generate immediate reflex responses elsewhere in the body. Anyone who likes the refreshing taste of lemon or other citrus in the morning will know that one reflex effect is increased saliva production. Other effects are subjective rather than confirmed by research but there is a consistent view that they include increased digestive activity and contraction of the gallbladder.
In the days when most people never tasted sugar, ‘sweetness’ was associated with the taste of basic foods: that of cooked vegetables, cereals and meat. In other words sweet was the quality of nourishment, and ‘tonic’ remedies. Describing a remedy as sweet generally led to that remedy being used in convalescence or recovery from illness. Interestingly, the plant constituents most often found in classic tonics like licorice, ginseng are plant steroids including saponins, which also have a sweet taste.

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