Hawthorn

Crataegus monogyna and Crataegus laevigata

Common & Folk Names

• Common Hawthorn (C. monogyna)
• Midland Hawthorn (C. laevigata)
• English Hawthorn
• May Tree
• Whitethorn
• Mayblossom
• Quickthorn
• Haw
• Thornapple

Plant Family

Rosaceae

Geographic Location

Crataegus monogyna and C. laevigata are native to Europe, North Africa, and western Asia. Now naturalised in temperate regions worldwide including North America, Australia, New Zealand, and parts of South America. Numerous other Crataegus species exist globally, particularly in North America, with similar medicinal properties. Thrives in temperate climates with distinct seasons.

Habitat

Naturally grows in hedgerows, woodland edges, scrubland, and open forests. Tolerates a wide range of conditions from coastal areas to upland regions. Prefers well-draining soil with full sun to partial shade. Found in hedgerows throughout rural Britain and Europe, where it has been planted for centuries as stock-proof hedging.

Growing Conditions

Sun: Full sun to partial shade; flowers and fruits best in full sun

Soil: Adaptable to most soil types including clay, loam, or sandy soils; tolerates both acidic and alkaline conditions; pH 5.0-8.0; prefers well-draining soil but tolerates various moisture levels

Propagation: Grow from seed (requires stratification and can take 18 months to germinate); take hardwood cuttings in winter; layering possible

Care: Water during establishment; once established, very hardy and drought-tolerant; prune to shape or maintain as hedge; thorny branches require careful handling; generally pest and disease-free; slow-growing initially, moderate growth after establishment; long-lived (can survive several hundred years)

NZ Planting Calendar

Sowing (seed): Autumn (March-May); seeds require cold stratification over winter and may not germinate until second spring

Propagation (cuttings/division): Take hardwood cuttings in winter (June-August); layering in spring

Planting: Autumn (March-May) or early spring (August-September); plant bare-root or containerised stock whilst dormant

Growth: Deciduous shrub or small tree; slow initial growth, moderate growth after establishment; can reach 5-10 metres depending on variety and conditions

Flowering: Spring (October-November in NZ) with abundant white or pink flowers in clusters

Harvest: Flowers and leaves harvested during flowering (October-November); berries (haws) harvested when ripe in autumn (March-May); harvest from second year onwards for established plants

Note: Naturalised in NZ and common in hedgerows, parks, and gardens; grows well throughout NZ; particularly common in rural areas; flowers profusely in spring with characteristic May blossom; berries ripen in autumn; very hardy and adaptable to NZ conditions; can become weedy in some areas; thorny branches provide excellent stock-proof hedging

Harvesting Guidelines

Flowers and Leaves: Harvest in spring when flowers are fully open (October-November in NZ). Select fresh, fully opened flowers along with young leaves. Collect flowers and leaves together in the traditional manner, or separately if desired. Harvest in dry weather after morning dew has evaporated. Dry quickly in well-ventilated area out of direct sunlight at temperatures not exceeding 40°C to preserve delicate constituents. Properly dried flowers and leaves retain good colour and should have a pleasant, mild scent. Store in airtight containers away from light and moisture.

Berries (Haws): Harvest when fully ripe in autumn (March-May in NZ). Ripe berries are deep red and slightly soft. Collect berries in bunches or individually. Use fresh or dry for later use. To dry, spread berries in thin layers in well-ventilated area; drying can take several days to weeks. Properly dried berries are dark red to brownish and somewhat shrivelled. Store dried berries in airtight containers.

High-quality hawthorn should come from trees in full health, harvested at peak ripeness for flowers and berries. The characteristic pleasant scent of fresh hawthorn flowers is distinctive.

Parts Used

• Flowers (including small leaves attached to flowering tops)
• Leaves (young leaves, often harvested with flowers)
• Berries (haws/fruits)
• Occasionally young branch tips

Constituents & their Actions

Hawthorn’s therapeutic properties, particularly its renowned cardiovascular effects, arise from flavonoids, oligomeric procyanidins (OPCs), and other compounds that work synergistically to support heart function and circulation.

Flavonoids:

These compounds are central to hawthorn’s cardiovascular effects. Some of the main flavonoids in hawthorn are:

• Vitexin
• Hyperoside
• Rutin
• Quercetin
• Vitexin-2″-rhamnoside

The main actions of these flavonoids are:

• Support coronary artery dilation, improving blood flow to heart muscle
• Exhibit antioxidant effects, protecting cardiovascular tissues
• Strengthen blood vessel walls and improve vascular integrity
• Demonstrate anti-inflammatory properties
• Support healthy blood pressure through vasodilation

Oligomeric Procyanidins (OPCs):

Complex flavonoid polymers with potent cardiovascular effects. Some of the main OPCs in hawthorn are:

• Procyanidin B-2
• Epicatechin
• Various dimeric and oligomeric procyanidins

The main actions of these OPCs are:

• Provide exceptionally potent antioxidant protection for cardiovascular tissues
• Support endothelial function (health of blood vessel linings)
• Improve coronary blood flow
• Strengthen capillary walls
• Contribute to positive inotropic effects (improved heart contractility)

Triterpene Acids:

Including various pentacyclic triterpenes.

The main actions of these compounds are:

• Support cardiovascular function
• Exhibit anti-inflammatory effects
• May contribute to blood pressure regulation

Phenolic Acids:

Including chlorogenic acid and caffeic acid derivatives.

The main actions of these compounds are:

• Provide antioxidant effects
• Support anti-inflammatory actions
• Contribute to cardiovascular protection

Actions with Mechanisms

Cardiotonic and Positive Inotrope:
Hawthorn improves the heart’s contractile force (how strongly it pumps) through multiple mechanisms. The flavonoids and OPCs enhance cardiac muscle contractility without increasing oxygen demand (unlike cardiac glycosides), which in turn improves cardiac output and circulation throughout the body. The mechanisms involve improved calcium handling in heart muscle cells, enhanced energy production in cardiac mitochondria, and sensitisation of contractile proteins. These effects improve the heart’s efficiency and pumping capacity, making hawthorn valuable for mild to moderate heart failure, reduced cardiac output, and general cardiac weakness. The improvement is gentle and sustainable rather than forcing or overstimulating the heart.

Coronary Vasodilator:
Hawthorn dilates coronary arteries (blood vessels supplying the heart muscle), which in turn increases blood flow to cardiac tissues, delivering more oxygen and nutrients whilst removing metabolic waste products. The flavonoids promote nitric oxide production and release, a key vasodilatory signalling molecule. This improved coronary circulation supports heart muscle health, reduces angina (chest pain from insufficient heart blood flow), and protects against ischaemic damage. The vasodilation extends to peripheral blood vessels as well, supporting overall circulation.

Antiarrhythmic:
Hawthorn helps regulate heart rhythm and reduce arrhythmias (irregular heartbeats) through effects on cardiac electrical activity. The mechanisms involve modulation of ion channels and improvement of cellular energy status in heart tissue, which in turn stabilises cardiac rhythm and reduces both excessively fast rhythms (tachycardia) and some irregular rhythms. Research demonstrates reduced frequency and severity of arrhythmias with hawthorn use. The antiarrhythmic effects are gentle and supportive rather than forcing rhythm changes, making hawthorn suitable for mild rhythm disturbances.

Hypotensive (Blood Pressure Lowering):
Hawthorn reduces elevated blood pressure through multiple mechanisms. The vasodilatory effects (particularly on peripheral blood vessels) reduce vascular resistance, which in turn lowers blood pressure. The herb may also affect the renin-angiotensin system (a hormonal system regulating blood pressure) and support kidney function. Additionally, hawthorn’s calming effects on the nervous system may reduce stress-related hypertension. Studies demonstrate modest but consistent blood pressure reductions with regular hawthorn use, making it valuable as part of comprehensive hypertension management.

Cardioprotective and Antioxidant:
The exceptionally potent antioxidant effects protect cardiovascular tissues from oxidative damage. The flavonoids and OPCs scavenge free radicals and reactive oxygen species in heart muscle, blood vessels, and blood, which in turn prevents lipid peroxidation (damage to fats in cell membranes and lipoproteins), protects against atherosclerosis development, and preserves cardiovascular function. Hawthorn demonstrates particular affinity for cardiovascular tissues, concentrating its protective effects where most needed. The cardioprotective properties support healthy ageing of the cardiovascular system and may slow progression of cardiovascular disease.

Anti-inflammatory (Cardiovascular):
Multiple constituents reduce inflammation in cardiovascular tissues through inhibition of inflammatory pathways. The anti-inflammatory effects protect blood vessel walls from inflammatory damage, reduce atherosclerosis development, and support overall cardiovascular health. Chronic low-grade inflammation is increasingly recognised as central to cardiovascular disease development, making hawthorn’s anti-inflammatory properties particularly valuable for prevention and as adjunctive support in cardiovascular conditions.

Anxiolytic and Nervine (Mild):
Hawthorn provides gentle calming effects on the nervous system, which in turn reduces anxiety, nervous tension, and stress-related cardiovascular symptoms. The mechanisms are not fully characterised but may involve effects on neurotransmitter systems and the herb’s traditional association with emotional heart health. Many herbalists consider hawthorn valuable for the “emotional heart”—grief, heartbreak, anxiety centred in the chest, and stress affecting cardiovascular function. The calming effects complement the cardiovascular benefits, particularly for stress-related heart complaints.

Endothelial Function Support:
The endothelium (inner lining of blood vessels) plays crucial roles in vascular health, regulating vasodilation, preventing clot formation, and resisting atherosclerosis. Hawthorn supports endothelial health through antioxidant protection, improved nitric oxide availability, and reduced inflammatory damage, which in turn maintains healthy blood vessel function and prevents cardiovascular disease development. Endothelial dysfunction is an early step in cardiovascular disease, making hawthorn’s protective effects valuable for prevention.

Main Use

Hawthorn is the premier cardiovascular tonic in Western herbal medicine, valued for supporting heart health, improving cardiac function, and preventing cardiovascular disease. The herb excels at addressing mild to moderate heart failure (chronic heart failure, congestive heart failure), where it improves cardiac output, reduces symptoms (shortness of breath, fatigue, oedema), and enhances quality of life. Clinical research demonstrates significant benefits for heart failure patients, with improvements comparable to some pharmaceutical interventions but with excellent safety and tolerability. Hawthorn is typically used long-term as part of comprehensive heart failure management under professional supervision.

For hypertension (high blood pressure), hawthorn provides modest but consistent blood pressure reductions, making it valuable as part of comprehensive blood pressure management. The herb works best when combined with lifestyle modifications (diet, exercise, stress management) and can be used alongside conventional medications under professional supervision.

Hawthorn addresses angina (chest pain from insufficient heart blood flow) through improved coronary circulation, increased oxygen delivery to heart muscle, and enhanced cardiac efficiency. The herb reduces frequency and severity of angina episodes whilst improving exercise tolerance.

For arrhythmias (irregular heartbeats), particularly mild arrhythmias like premature ventricular contractions (PVCs) or atrial fibrillation, hawthorn helps regulate rhythm and reduce symptoms. Professional supervision is essential for arrhythmias, and hawthorn is typically used adjunctively rather than as sole treatment.

As a preventive cardiovascular tonic, hawthorn supports healthy ageing of the cardiovascular system, protects against atherosclerosis development, maintains healthy blood pressure and cholesterol levels, and provides antioxidant protection to cardiovascular tissues. Long-term use (years to decades) builds cardiovascular resilience and may reduce cardiovascular disease risk.

Hawthorn addresses anxiety and stress affecting the heart—palpitations from anxiety, stress-related high blood pressure, and the “broken heart” of grief or emotional distress. The herb’s gentle, nourishing support for both physical and emotional heart makes it valuable for holistic cardiovascular care.

The herb’s safety, tolerability, and effectiveness make it suitable for long-term use in cardiovascular support and prevention, distinguishing it from many pharmaceutical cardiovascular drugs with more significant side effects.

Preparations

Infusion (Flowers and Leaves): Steep 1-2 teaspoons (2-4g) of dried flowers and leaves in 250ml freshly boiled water for 10-15 minutes; strain and drink. This is a traditional and pleasant preparation. Drink 2-3 cups daily.

Decoction (Berries): Simmer 1-2 teaspoons (3-5g) of dried berries in 250ml water for 15-20 minutes; strain and drink. Berries require longer extraction than flowers and leaves.

Tincture (1:5, 45-60% alcohol): Most common and convenient preparation. Can be made from flowers and leaves, berries, or combination. 2-5ml (40-100 drops), 2-3 times daily. Standardised tinctures ensure consistent potency.

Standardised Extract: Commercial preparations standardised to flavonoid and OPC content (typically 1.8-2% vitexin or 18% OPCs). These provide reliable, research-backed dosing. Typically 160-900mg daily in divided doses. Follow manufacturer’s instructions.

Syrup (Berries): Traditional preparation combining hawthorn berry decoction with honey or sugar. Pleasant taste makes it accessible, particularly for those who dislike alcohol-based tinctures.

Glycerite (Alcohol-Free Tincture): Hawthorn extracted in vegetable glycerine provides alcohol-free option. Less potent than alcohol tincture but suitable for those avoiding alcohol.

Combination Formulas: Hawthorn is often combined with complementary cardiovascular herbs in traditional and modern formulas.

Dosage

Dried Flowers and Leaves (infusion): 2-4g, 2-3 times daily

Dried Berries (decoction): 3-5g, 1-2 times daily

Tincture (1:5, 45-60% alcohol): 2-5ml (40-100 drops), 2-3 times daily

Standardised Extract (2% vitexin or 18% OPCs): 160-900mg daily in divided doses; common dose is 300mg three times daily

Safety & Drug Interactions

Scientific Evidence

Heart Failure: Extensive clinical research supports hawthorn’s effectiveness for chronic heart failure. Multiple randomised controlled trials and systematic reviews/meta-analyses demonstrate improvements in exercise tolerance, symptom reduction (shortness of breath, fatigue), improved quality of life, and enhanced cardiac function in mild to moderate heart failure. A Cochrane review concluded that hawthorn extract shows benefit for chronic heart failure, though more research is needed. Studies typically use standardised extracts (WS 1442 or LI 132) at doses of 900-1800mg daily. The evidence is strongest for New York Heart Association (NYHA) class II-III heart failure.

Blood Pressure: Clinical trials demonstrate modest but consistent blood pressure reductions with hawthorn use. Meta-analyses support hypotensive effects, though the magnitude varies between studies. Hawthorn appears most effective for mild hypertension and as adjunctive therapy rather than sole treatment.

Coronary Heart Disease and Angina: Research demonstrates improved coronary blood flow, reduced angina frequency, and improved exercise tolerance with hawthorn use. Studies show benefits for coronary artery disease and angina pectoris.

Antioxidant and Cardioprotective Effects: Extensive laboratory and animal research confirms potent antioxidant effects and cardiovascular protection. Studies demonstrate reduced oxidative stress markers, protection against ischaemic injury, improved endothelial function, and reduced atherosclerosis development in various models.

Mechanisms of Action: Comprehensive research characterises hawthorn’s cardiovascular mechanisms including positive inotropic effects, vasodilation, antioxidant activity, anti-inflammatory effects, and effects on cardiac energy metabolism. The mechanisms support therapeutic applications.

Safety Studies: Extensive safety research and clinical trial safety data demonstrate excellent tolerability with minimal adverse effects. Long-term use appears safe based on both traditional use and modern research.

Western Energetics

Temperature: Neutral to slightly cooling. Hawthorn’s balanced energetics make it suitable for most constitutional types. The slight cooling quality relates to its anti-inflammatory and blood pressure-lowering effects.

Moisture: Neutral to slightly moistening. Hawthorn nourishes and tonifies without being strongly drying or moistening, contributing to its broad applicability.

Tissue State: Particularly indicated for atrophy and depletion in cardiovascular tissues—weakened heart muscle, poor cardiac output, depleted cardiovascular reserves. Hawthorn excels at building and nourishing depleted heart tissue, strengthening weakened cardiac function, and restoring cardiovascular vitality. Also valuable for tension when nervous tension affects the heart (palpitations, stress-related hypertension). The gentle, nourishing approach makes hawthorn suitable for long-term rebuilding of cardiovascular health.

Taste

Flowers:

• Mildly Sweet: A gentle sweetness reflects hawthorn’s nourishing, tonifying properties. The sweet taste makes flower preparations pleasant and accessible.
• Slightly Aromatic: A delicate, pleasant aroma characterises fresh hawthorn flowers. The scent is distinctive and traditionally associated with May blossom.
• Mild Overall: The taste is gentle and unobtrusive, making hawthorn easy to take regularly.

Berries:

• Sweet-Sour: Ripe berries have a sweet-tart flavour with apple-like qualities (hawthorn is related to apples in the Rosaceae family).
• Slightly Astringent: A mild astringent quality from tannins contributes to the overall character.
• Pleasant: When fully ripe, berries are pleasant-tasting, though less appealing when under-ripe.

Plant Lore

Hawthorn holds profound cultural and spiritual significance in European traditions, where it has been revered, feared, and celebrated for thousands of years. The tree is deeply woven into folklore, mythology, and spiritual practices across Celtic, Anglo-Saxon, and broader European cultures.

In Celtic tradition, hawthorn is one of the sacred trees, associated with the fairy realm and the Otherworld. The tree was believed to mark entrances to fairy dwellings, and lone hawthorn trees (particularly those growing on fairy mounds or at crossroads) were never cut down for fear of angering the fairies. Cutting hawthorn was believed to bring misfortune, and many stories tell of disasters befalling those who disturbed sacred hawthorn trees.

The association with May (the tree flowers in May in the Northern Hemisphere) connected hawthorn with Beltane celebrations and the transition from spring to summer. Hawthorn blossom was used in May Day celebrations, though bringing the flowers indoors was often considered unlucky in British folklore. The rich symbolism included fertility, protection, and the boundary between worlds.

In Irish tradition, hawthorn (called “sceach gheal” – white thorn) is deeply respected. The famous “fairy thorn” trees of Ireland are protected, with roads and construction projects sometimes rerouted to avoid disturbing them. The respect persists into modern times, demonstrating the enduring power of hawthorn folklore.

The crown of thorns worn by Jesus Christ during the crucifixion is traditionally said to have been made from hawthorn branches, giving the tree Christian symbolism of sacrifice, suffering, and redemption. This association made hawthorn both sacred and associated with death and sorrow in medieval Christian Europe.

In British herbal tradition, hawthorn appears in medieval herbals and was recognised by physicians throughout history. The famous herbalist Nicholas Culpeper (17th century) recommended hawthorn for heart conditions, demonstrating long-standing awareness of its cardiovascular properties.

Hawthorn’s use in hedgerows dates back thousands of years in Britain and Ireland. The dense, thorny growth makes impenetrable stock-proof hedging, and hawthorn was extensively planted during the Enclosure Acts (18th-19th centuries) to divide fields. Ancient hawthorn hedgerows are now recognised as important ecosystems and cultural heritage.

The wood has been valued for making tools, walking sticks, and small wooden items. The thorns were historically used as awls, pins, and even nails. The berries provide food for wildlife and were eaten by humans in times of scarcity.

Different cultures have various traditions around hawthorn. In Traditional Chinese Medicine, a related species (Crataegus pinnatifida – Chinese hawthorn or “shan zha”) is used primarily for digestive complaints, demonstrating different applications of related plants across cultures.

The name “haw” for the berries is Old English, whilst “hawthorn” combines “haw” with “thorn,” referencing the sharp thorns. The genus name Crataegus comes from Greek “kratos” (strength), referring to the hard, strong wood.

Additional Information

Multiple Crataegus species exist globally (over 200 species, many of which are difficult to distinguish), with C. monogyna and C. laevigata being the primary European medicinal species. North American species including C. oxyacantha, C. douglasii, and others have similar properties and can be used interchangeably. The distinction between species is less important than ensuring the plant is indeed a Crataegus species.

Quality Considerations: High-quality hawthorn should have:

• Good colour (flowers should be whitish, berries deep red)
• Pleasant scent (flowers particularly)
• Proper harvest timing (flowers in full bloom, berries fully ripe)
• Proper drying and storage to preserve constituents

Standardised extracts provide consistent potency and are used in most clinical research. When purchasing, look for products standardised to flavonoid and/or OPC content.

Traditional vs. Modern Use: Traditional European herbal medicine used hawthorn for various conditions beyond cardiovascular health. Modern research has focused primarily on cardiovascular applications, where the evidence is strongest. However, traditional uses for digestive complaints, kidney stones, and other conditions reflect the herb’s broader therapeutic potential.

Hawthorn in Formulas: Hawthorn combines well with other cardiovascular herbs:

• Hawthorn + Linden (lime blossom) for gentle cardiovascular support with calming effects
• Hawthorn + Motherwort for heart palpitations and anxiety affecting the heart
• Hawthorn + Ginkgo for cerebral and peripheral circulation (caution with anticoagulants)
• Hawthorn + Garlic for cardiovascular disease prevention and lipid management

Growing Hawthorn: For home cultivation, hawthorn provides:

• Beautiful spring blossom
• Excellent wildlife habitat (flowers support pollinators, berries feed birds)
• Stock-proof hedging if desired
• Medicinal harvest opportunities
• Long lifespan (trees can live several hundred years)

The thorny branches require care during harvesting and pruning. Gloves are essential when working with hawthorn.

Sustainability: Hawthorn is abundant in hedgerows and cultivated landscapes, making sustainable harvesting straightforward. Harvest from healthy trees, taking only what’s needed, and leaving plenty for wildlife (particularly birds that depend on berries). In NZ, hawthorn’s naturalised status means abundant opportunities for ethical wild harvesting.

Culinary Uses: While less common than medicinal use, hawthorn berries can be made into jellies, jams, sauces, and beverages. The flowers can be used to make wine or infused in spirits. Proper preparation removes any bitter qualities and produces pleasant-tasting products.

Sources

Bone, K., & Mills, S. (2013). Principles and Practice of Phytotherapy: Modern Herbal Medicine (2nd ed.). Churchill Livingstone.

Mills, S., & Bone, K. (2005). The Essential Guide to Herbal Safety. Elsevier.

Hoffman, D. (2003). Medical Herbalism: The Science and Practice of Herbal Medicine. Healing Arts Press.

Pittler, M. H., Guo, R., & Ernst, E. (2008). Hawthorn extract for treating chronic heart failure. Cochrane Database of Systematic Reviews, 2008(1), CD005312.

Holubarsch, C. J., Colucci, W. S., Meinertz, T., Gaus, W., & Tendera, M. (2008). The efficacy and safety of Crataegus extract WS 1442 in patients with heart failure: The SPICE trial. European Journal of Heart Failure, 10(12), 1255-1263.

Tauchert, M. (2002). Efficacy and safety of crataegus extract WS 1442 in comparison with placebo in patients with chronic stable New York Heart Association class-III heart failure. American Heart Journal, 143(5), 910-915.

Walker, A. F., Marakis, G., Simpson, E., Hope, J. L., Robinson, P. A., Hassanein, M., & Simpson, H. C. (2006). Hypotensive effects of hawthorn for patients with diabetes taking prescription drugs: A randomised controlled trial. British Journal of General Practice, 56(527), 437-443.

Degenring, F. H., Suter, A., Weber, M., & Saller, R. (2003). A randomised double blind placebo controlled clinical trial of a standardised extract of fresh Crataegus berries (Crataegisan) in the treatment of patients with congestive heart failure NYHA II. Phytomedicine, 10(5), 363-369.

Koch, E., & Malek, F. A. (2011). Standardized extracts from hawthorn leaves and flowers in the treatment of cardiovascular disorders – preclinical and clinical studies. Planta Medica, 77(11), 1123-1128.

Edwards, J. E., Brown, P. N., Talent, N., Dickinson, T. A., & Shipley, P. R. (2012). A review of the chemistry of the genus Crataegus. Phytochemistry, 79, 5-26.

Guo, R., Pittler, M. H., & Ernst, E. (2006). Hawthorn extract for treating chronic heart failure. Cochrane Database of Systematic Reviews, 2006(1), CD005312.

Tassell, M. C., Kingston, R., Gilroy, D., Lehane, M., & Furey, A. (2010). Hawthorn (Crataegus spp.) in the treatment of cardiovascular disease. Pharmacognosy Reviews, 4(7), 32-41.

Daniele, C., Mazzanti, G., Pittler, M. H., & Ernst, E. (2006). Adverse-event profile of Crataegus spp.: A systematic review. Drug Safety, 29(6), 523-535.

Zick, S. M., Vautaw, B. M., Gillespie, B., & Aaronson, K. D. (2009). Hawthorn extract randomized blinded chronic heart failure (HERB CHF) trial. European Journal of Heart Failure, 11(10), 990-999.

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