Hawthorn
Useful mainly for adults with mild-to-moderate (NYHA I-II) heart failure, as an adjunct under cardiology care.
Quick decision guide
May help most
adults with mild-to-moderate (NYHA I-II) heart failure, as an adjunct under cardiology care
Common dosing range
160–900 mg/day standardized extract, divided
When to expect effects
Weeks (6–12)
Watch out for
not a substitute for prescribed heart-failure therapy; use only under medical supervision
What is it
Hawthorn (Crataegus species, most commonly C. monogyna, C. laevigata, or C. pinnatifida) is a thorny shrub or small tree whose leaves, flowers, and berries are used in traditional and modern herbal medicine, primarily for cardiovascular support.
Is it worth it for you?
Use this as a quick fit check, not a diagnosis.
Worth considering if…
Probably skip if…
Evidence at a glance
| Goal | Effect | Best fit | Time |
|---|---|---|---|
mild to moderate heart failure (nyha i-ii) Good Evidence | Modest improvement in symptoms and exercise tolerance | NYHA I-II heart-failure patients on standard therapy | Weeks |
mild hypertension Mixed Evidence | Small (a few mmHg at most) | adults with mildly elevated blood pressure | Weeks |
mild to moderate heart failure (nyha i-ii)
- Effect
- Modest improvement in symptoms and exercise tolerance
- Best fit
- NYHA I-II heart-failure patients on standard therapy
- Time
- Weeks
mild hypertension
- Effect
- Small (a few mmHg at most)
- Best fit
- adults with mildly elevated blood pressure
- Time
- Weeks
Evidence for 2 uses
AI-assisted evidence assessment — talk to your doctor before relying on any single supplement.
mild to moderate heart failure (nyha i-ii)
Disease adjunctStandardized extracts such as WS 1442 added to standard therapy improved symptoms, exercise tolerance, and quality of life in randomized trials of mild-to-moderate heart failure. The large SPICE trial did not show a net mortality benefit and raised a subgroup signal for early sudden cardiac death, so it is symptom-supportive rather than life-prolonging.
Bottom line: A reasonable adjunct for symptoms of mild heart failure under supervision, but not shown to extend survival.
Evidence is mixed
Symptom trials are positive, yet SPICE found no mortality benefit and a possible early sudden-death signal in one subgroup, warranting caution.
mild hypertension
Biomarker supportSome small trials report modest reductions in blood pressure with hawthorn, while others show no effect. Evidence is limited and inconsistent, and any change is a blood-pressure reading rather than a demonstrated cardiovascular-event benefit.
Bottom line: At best a small, inconsistent effect on blood pressure; not a reliable antihypertensive.
Evidence is mixed
Blood-pressure results are mixed across small trials, with several showing no significant change.
How it works
How to take it
What to track
4 commercial forms
Compare the main delivery options and what they’re best suited for.
WS 1442 standardized extract
Most-studied form, used in European heart failure trials. Sold under various brand names internationally.
Standardized to 18.75% oligomeric procyanidins
Hawthorn berry extract
Common in supplements. Often standardized to procyanidin or flavonoid content.
Higher procyanidin content than leaf
Hawthorn leaf and flower extract
Used in many European phytomedicine products.
Traditional European preparation
Liquid extract / tincture
Used in traditional and modern herbalism.
Alcohol-based extraction
Safety
Know the common side effects, key cautions, and who should avoid it.
Common side effects
Serious risks
possible increased early sudden cardiac death in a heart-failure subgroup (SPICE trial)
Who should avoid it
- people self-treating suspected heart conditions
- pregnancy and breastfeeding
- those on cardiac medications without supervision
Pregnancy & breastfeeding
Avoid in pregnancy and breastfeeding due to insufficient safety data.
Interactions
may potentiate effects; requires monitoring and possible dose adjustment
additive blood-pressure lowering
additive cardiovascular effects warranting supervision
Documented interactions
Evidence-graded pair pages with sources, dosing notes, and timing guidance — a complement to the narrative section above.
Warnings (3)
+ metoprolol
moderateHawthorn (Crataegus) has mild vasodilatory and heart-supporting effects that can add to the blood-pressure and heart-rate lowering of metoprolol, modestly increasing the chance of low blood pressure, a slow pulse, dizziness, or fainting. The interaction is pharmacodynamic (it happens at the receptor and tissue level), not metabolic, so taking the doses at different times does not prevent it.
+ digoxin
moderateHawthorn (Crataegus) shares digoxin's cardiac target and can cross-react with the immunoassays used to monitor digoxin, so a serum level may read falsely high or low. Controlled testing shows little change in how much digoxin reaches the bloodstream, so the practical concerns are additive cardiac effects and confounded lab monitoring rather than altered absorption.
+ losartan
lowHawthorn modestly lowers blood pressure through vasodilation and endothelial effects. Taken with losartan, an angiotensin II receptor blocker, the two can add up and occasionally cause dizziness or lightheadedness, mainly in people who already run low or who take more than one blood pressure medication.
Beneficial pairs (2)
+ coq10
synergyHawthorn (Crataegus) flavonoids and oligomeric procyanidins act on the mechanical and vascular side of heart function, while CoQ10 supports the heart's energy metabolism in the electron transport chain. The two are sometimes combined as low-risk cardiovascular adjuncts, but the supportive human evidence is for each ingredient separately, not for the pair, so any "synergy" is extrapolated rather than demonstrated.
+ garlic
synergyGarlic and hawthorn each modestly lower blood pressure on their own, and both have mild blood-thinning activity, so taking them together can add up to a slightly larger drop in blood pressure and a small increase in bleeding tendency. There is no human trial of the two taken together, so any true 'synergy' beyond simple additive effects is unproven. The practical concern is layering them on top of antihypertensive, antiplatelet, or anticoagulant medication.
Choosing a product
What to look for on the label — and what to be skeptical of.
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Frequently asked questions
Can hawthorn replace my heart medication?⌄
No. Hawthorn is not a substitute for prescribed cardiovascular medications. It has been studied as an adjunct to standard therapy in heart failure, but stopping prescribed medication without medical guidance can be dangerous.
How long until I see effects from hawthorn?⌄
Clinical effects typically emerge gradually over 6 to 12 weeks of consistent daily use. Acute effects from single doses are minimal.
Is hawthorn safe with digoxin?⌄
Hawthorn may potentiate digoxin's effects, raising the risk of digoxin toxicity. Only use this combination under cardiology supervision with appropriate monitoring.
Which part of the hawthorn plant is best?⌄
European standardized extracts often combine leaf and flower (e.g., WS 1442). Berry extracts are common in North America. The most extensive clinical evidence comes from leaf-and-flower standardized extracts.
Can hawthorn help with high blood pressure?⌄
Some studies suggest modest reductions in mild hypertension. Effects are small and hawthorn is not a substitute for proven antihypertensive therapy if you have significant elevation.
References by claim
Track Hawthorn with Pilora
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Coming to App StoreDisclaimer: These statements have not been evaluated by the FDA. This page is educational, not a substitute for personalized medical advice. Evidence grades are AI-assisted assessments — talk to your doctor before starting any new supplement, especially if you’re pregnant, breastfeeding, on medications, or managing a chronic condition.