Hawthorn extract proved beneficial for congestive heart failure patients

Hearts and Flowers

If you had a heart ailment during Shakespeare’s era your doctor might have given you an extract of hawthorn, a flowering shrub that grows wild throughout Europe. In fact, hawthorn was probably the statin drug of its day – automatically prescribed to improve heart health.

Over the past four centuries, scientists have shown that hawthorn extract is rich in flavonoids, which help dilate arteries, improve blood flow, and lower blood pressure.

These actions clearly benefit the heart, but could hawthorn help treat patients with a health challenge as severe as chronic heart failure? That’s a tall order, but a new study shows that hawthorn is up to the task.

Symptom control

Last year, in the e-Alert “Relaxed and Flexible” (4/9/07), I told you about a 2003 study in which more than 200 patients with chronic congestive heart failure (CHF) were divided into three groups to receive either 900 mg or 1,800 mg of hawthorn extract daily or placebo. After 16 weeks, maximum exercise tolerance increased significantly in the high-dose group compared to the other two groups, and heart failure symptoms improved in both of the extract groups, but not the placebo group.

That study was probably included in an Exeter University meta-analysis of clinical trials in which hawthorn was tested on hundreds of patients.


  • Researchers combed through five medical databases looking for randomized, double-blind, placebo controlled trials in which extracts of hawthorn leaf and flower were tested on CHF patients
  • Fourteen trials, which included more than 1,100 subjects, met the criteria for inclusion
  • In most of the trials hawthorn was used as a complementary treatment along with conventional drug treatments for CHF
  • As in the trial mentioned above, exercise tolerance was significantly improved by hawthorn intervention, as was maximal workload and pressure-heart rate product (an index of cardiac oxygen consumption)
  • Analysis showed that CHF symptoms such as shortness of breath and fatigue also

In the most recent issue of the Cochrane Database of Systematic Reviews, the Exeter team writes: “These results suggest that there is a significant benefit in symptom control and physiologic outcomes from hawthorn extract as an adjunctive treatment for chronic heart failure.”

Adverse side effects were described as “infrequent, mild, and transient.”

Working daily miracles

Some heart specialists would have you believe that the Exeter results are of no

In a MedPage Today report about the trial, Gregg Gonarow, M.D., director of the heart failure program at UCLA described hawthorn as safe but “not particularly helpful.” He based his assessment on a large, two-year trial that I told you about in “Relaxed and Flexible.” In that study, more than 2,600 subjects with advanced CHF were given either 900 mg of hawthorn daily or a placebo. Results showed that the extract didn’t prevent death associated with cardiac events and didn’t prevent non-fatal cardiac events.

Do you get the feeling Dr. Gonarow is missing the point?

The Exeter study shows that hawthorn extract may improve quality of life measures for CHF patients. Granted, hawthorn may not actually save the lives of gravely ill patients, but many CHF patients will likely find the extract to be “particularly helpful” in coping with the day-to-day challenges of their disease.

It should also be noted that at the 18-month follow up assessment in the 2007 study, patients who were taking the extract had a 20 percent reduced risk of CHF-related death compared to placebo – a difference that equaled four additional months of survival time.

Talk to your doctor before adding hawthorn to your daily regimen. CHF patients might want to consult with an experienced herbalist to make sure they receive a potent, high-quality hawthorn extract.

“Hawthorn Extract for Treating Chronic Heart Failure” Cochrane Database of Systematic Reviews, 2008 Issue 1, mrw.interscience.wiley.com
“Herbal Remedy Deemed Safe and Seemingly Effective in Heart Failure” John Gever, MedPage Today, 1/23/08, medpagetoday.com
“Effect of Vitamins in Soda Questioned” United Press International, 2/11/08, upi.com
“Makers of Sodas Try a New Pitch: They’re Healthy” Andrew Martin, The New York Times, 3/7/07, nytimes.com