# Cratageus monogyna (Hawthorn)

**Canonical URL:** https://ingredients.hermeticasuperfoods.com/ingredients/cratageus-monogyna
**Data Source:** Hermetica Superfoods Ingredient Encyclopedia
**Updated:** 2026-04-02
**Evidence Score:** 2 / 10
**Category:** Other
**Also Known As:** Crataegus monogyna, Common Hawthorn, English Hawthorn, Single-seed Hawthorn, May Tree, Whitethorn, Mayflower, One-seed Hawthorn, Oneseed Hawthorn, Quickthorn, Haw, May Blossom

## Overview

Crataegus monogyna (Hawthorn) is a thorny shrub whose standardized leaf and flower extracts contain oligomeric proanthocyanidins (OPCs) and vitexin rhamnoside as primary bioactives. These compounds inhibit phosphodiesterase and ACE activity while enhancing coronary and peripheral vasodilation, supporting [cardiovascular](/ingredients/condition/heart-health) function.

## Health Benefits

• Reduces [blood pressure](/ingredients/condition/heart-health): Meta-analysis of 8 RCTs showed reductions of 4-5 mmHg systolic and 3 mmHg diastolic blood pressure (moderate evidence)
• Improves heart failure symptoms: Multiple RCTs (n=100-300) demonstrated improved exercise tolerance and ejection fraction in NYHA class II-III patients (moderate evidence)
• Enhances [sleep quality](/ingredients/condition/sleep): One RCT reported improved sleep alongside blood pressure reduction with 250 mg twice daily (preliminary evidence)
• Supports cardiovascular function: Provides positive inotropic effects and coronary vasodilation based on traditional use and mechanistic studies (traditional evidence)
• May modulate [immune function](/ingredients/condition/immune-support): Animal studies showed increased T/B lymphocyte subsets, though human data lacking (preliminary evidence)

## Mechanism of Action

Hawthorn's oligomeric proanthocyanidins (OPCs) and flavonoids, particularly vitexin-2-rhamnoside, inhibit phosphodiesterase III and IV, increasing intracellular cAMP and improving myocardial contractility. These compounds also inhibit angiotensin-converting enzyme (ACE), reducing peripheral vascular resistance and lowering [blood pressure](/ingredients/condition/heart-health). Additionally, hawthorn polyphenols upregulate endothelial nitric oxide synthase (eNOS), promoting vasodilation and improving coronary blood flow.

## Clinical Summary

A meta-analysis of 8 randomized controlled trials demonstrated that standardized hawthorn extract (WS 1442 or LI 132) reduced systolic [blood pressure](/ingredients/condition/heart-health) by 4-5 mmHg and diastolic by approximately 3 mmHg compared to placebo. Multiple RCTs involving 100-300 participants with NYHA class II-III heart failure showed improved exercise tolerance and ejection fraction with doses of 450-900 mg/day of WS 1442. The large SPICE trial (n=2,681) found no mortality benefit over 24 months in patients with reduced ejection fraction, though a post-hoc subgroup with ejection fractions above 25% showed possible benefit. Overall evidence is moderate for symptomatic heart failure and mild-to-moderate hypertension, with most studies using proprietary standardized extracts rather than raw herb.

## Nutritional Profile

Hawthorn (Crataegus monogyna) is primarily consumed as a berry, leaf, or flower extract rather than as a macronutrient food source. **Bioactive compounds (primary pharmacological relevance):** • **Oligomeric proanthocyanidins (OPCs):** 1–3% in berries, 2–6% in leaves/flowers; key cardioactive constituents including procyanidin B2 and epicatechin oligomers. Standardized extracts (e.g., WS 1442) are typically standardized to 18.75% OPCs. • **Flavonoids:** 1–2.5% in berries, up to 4% in leaves/flowers; major compounds include hyperoside (quercetin-3-O-galactoside, ~0.5–1.2%), vitexin (apigenin-8-C-glucoside, ~0.2–0.8%), vitexin-2″-O-rhamnoside (~0.3–1.0%), rutin (~0.1–0.4%), and quercetin glycosides. • **Triterpenic acids:** Ursolic acid (~0.2–0.5%) and oleanolic acid (~0.1–0.3%) in berries. • **Phenolic acids:** Chlorogenic acid (~0.3–0.8%), caffeic acid, and ferulic acid. **Macronutrient profile of fresh berries (per 100 g):** • Carbohydrates: ~15–20 g (predominantly sugars: fructose, glucose, sorbitol ~2–4 g). • Dietary fiber: ~5–8 g (significant pectin content ~2–4 g). • Protein: ~1–2 g. • Fat: ~0.5–1 g. • Calories: ~60–90 kcal. **Micronutrients (per 100 g fresh berries):** • Vitamin C: ~15–100 mg (varies widely by cultivar and ripeness; some reports up to 150 mg). • Vitamin A (as carotenoids, primarily β-carotene): ~0.5–2 mg. • Potassium: ~150–300 mg. • Calcium: ~30–50 mg. • Magnesium: ~15–25 mg. • Iron: ~0.5–1.5 mg. • Phosphorus: ~20–40 mg. **Bioavailability notes:** OPC bioavailability is relatively low (estimated 5–10% absorption of intact oligomers); monomers and dimers are better absorbed than higher-order polymers. Flavonoid glycosides such as hyperoside undergo hydrolysis to aglycones (quercetin) in the gut, with quercetin bioavailability ~2–5%. Vitexin (C-glycoside) is more resistant to hydrolysis and relies partly on colonic microbial [metabolism](/ingredients/condition/weight-management). Standardized extracts (WS 1442 at 900 mg/day or LI 132 at 600 mg/day) deliver clinically relevant doses of OPCs (~170–340 mg) and flavonoids (~50–100 mg). Co-administration with food may modestly improve flavonoid absorption.

## Dosage & Preparation

Clinically studied doses for hypertension: 250-500 mg/day of standardized extract (250 mg capsules twice daily). For heart failure adjunctive therapy: 160-1800 mg/day of standardized leaf/flower extracts (standardized to 18.75% oligomeric procyanidins or 2.2% flavonoids) over 8-24 weeks. Maximum studied duration is 6 months. Consult a healthcare provider before starting any new supplement.

## Safety & Drug Interactions

Hawthorn is generally well tolerated; reported side effects include mild nausea, dizziness, and gastrointestinal upset at doses above 900 mg/day. Clinically significant drug interactions include potentiation of digoxin and other positive inotropes, as well as additive hypotensive effects with antihypertensive medications including ACE inhibitors and beta-blockers. Hawthorn may enhance the vasodilatory effects of nitrates and PDE5 inhibitors such as sildenafil, increasing hypotension risk. Safety in pregnancy and lactation has not been established, and use is not recommended in these populations per WHO monograph guidance.

## Scientific Research

A meta-analysis of 8 randomized placebo-controlled trials (n>500 total) demonstrated hawthorn's significant effects on hypertension, reducing systolic [blood pressure](/ingredients/condition/heart-health) by 4-5 mmHg and diastolic by 3 mmHg over 10 weeks to 6 months. Additional meta-analyses cite RCTs for adjunctive use in left ventricular dysfunction (PMID 12597258), showing standardized extracts improved exercise tolerance and ejection fraction over 8-16 weeks. A recent safety analysis (PMID 39598401) reviewing 37 clinical studies confirmed minimal adverse events.

## Historical & Cultural Context

Hawthorn has been used in European traditional medicine since ancient Greece and Rome, formalized in 16th-19th century herbalism for [cardiovascular](/ingredients/condition/heart-health) disorders including angina, hypertension, and heart failure. It was also employed as a mild sedative for stress and sleep disorders, with WHO/EMA monographs now endorsing its use for mild heart failure (NYHA I-II).

## Synergistic Combinations

Coenzyme Q10, Magnesium, Garlic extract, Omega-3 fatty acids, L-Arginine

## Frequently Asked Questions

### What is the recommended dosage of hawthorn extract for heart failure?

Clinical trials for NYHA class II-III heart failure have used standardized extracts WS 1442 or LI 132 at doses of 450-900 mg per day, typically divided into two or three doses. These extracts are standardized to 18.75% oligomeric proanthocyanidins (WS 1442) or 2.2% flavonoids (LI 132), so raw herb preparations are not considered equivalent. Most trials ran for 8-16 weeks before significant improvements in exercise tolerance were documented.

### Can hawthorn interact with heart medications like digoxin?

Yes, hawthorn can potentiate the inotropic effect of digoxin because both share mechanisms involving intracellular calcium and cAMP, potentially increasing the risk of digoxin toxicity. It also has additive hypotensive effects with beta-blockers, ACE inhibitors, and calcium channel blockers, which may require dose adjustments. Patients on antiarrhythmic drugs or nitrates should consult a physician before using hawthorn due to compounded cardiovascular effects.

### How long does it take for hawthorn to lower blood pressure?

Based on the meta-analysis of 8 RCTs, significant reductions of 4-5 mmHg systolic and approximately 3 mmHg diastolic were observed after a minimum of 3-4 weeks of consistent supplementation at 500-1,200 mg/day of standardized extract. Effects appear to be gradual and cumulative, with most studies measuring endpoints at 8-16 weeks. Hawthorn is not appropriate as an acute antihypertensive intervention and should be considered an adjunct rather than a replacement for prescribed medications.

### What part of the hawthorn plant is used in supplements?

The WHO monograph for Crataegus monogyna specifies the dried leaf with flower (Folium cum Flore) as the official herbal preparation, which contains the highest concentration of bioactive oligomeric proanthocyanidins and flavonoid glycosides including vitexin-2-rhamnoside. Berries (Fructus Crataegi) are also used traditionally and contain similar but quantitatively different polyphenol profiles. Most clinically validated extracts such as WS 1442 are derived from leaves and flowers, not berries, so label verification of plant part is important when selecting a supplement.

### Is hawthorn safe to take long-term?

Long-term safety data up to 24 months is available from the SPICE trial (n=2,681), which found WS 1442 at 900 mg/day to be safe with no significant increase in adverse events compared to placebo over two years. Common long-term complaints are mild and include gastrointestinal discomfort and dizziness in less than 5% of users. However, long-term use in individuals with pre-existing cardiac conditions should occur under medical supervision due to potential interactions with prescribed cardiovascular therapies.

### What does the clinical research show about hawthorn's effectiveness for heart health?

Multiple randomized controlled trials demonstrate that hawthorn extract improves symptoms in heart failure patients (NYHA class II-III), with studies showing enhanced exercise tolerance and ejection fraction improvements. Meta-analyses reveal moderate evidence for blood pressure reduction of 4-5 mmHg systolic and 3 mmHg diastolic. However, while results are promising, most studies involve moderate sample sizes (100-300 participants), indicating further large-scale research could strengthen the evidence base.

### Who should avoid taking hawthorn supplements?

Hawthorn should be avoided or used with caution in patients taking cardiac glycosides like digoxin due to potential interactions that could amplify effects on heart function. Pregnant and nursing women should consult healthcare providers before use, as safety data in these populations is limited. Those with severe heart conditions should use hawthorn only under medical supervision, as it may affect blood pressure and heart rate.

### What form of hawthorn extract provides the best clinical results?

The clinical trials demonstrating effectiveness typically use standardized hawthorn leaf and flower extracts, which are preferred over berry-only preparations due to higher concentrations of active compounds like flavonoids and proanthocyanidins. Liquid extracts and standardized dry extracts have shown comparable efficacy in research studies. The quality and standardization of the extract matter more than the form itself, so products should specify the plant part used and standardization percentage.

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