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The best-known herb for the heart in western herbalism is hawthorn, which is a small tree or shrub that grows throughout the northern hemisphere. The fruits, flowers, and leaves are processed into tinctures and other kinds of extracts available in capsules or tablets in the U.S. and other parts of the world.

The comely hawthorn is a dense tree with small, sharp thorns growing to 25 feet. It has small white flowers with rose-like petals and bright red berries containing one or two large seeds. Hawthorns are native to Europe, North America and Asia.

Dioscorides, the most reliable of the ancient authors on plant medicines, called Crataegus “Oxuakantha”, which was retained by Linnaeus in the name C. oxyacantha, an old name for C. laevigata. Although many botanical and herbal writers from the 15th through the 17th centuries took this plant to be a kind of Crataegus, Parkinson (1640) determined that it was likely a Pyracantha–common ornamental shrubs with small red berries. It is listed as C. pyracantha in Gunther’s edition of Dioscorides (1933). The genus Pyracantha, is not particularly lauded for its healing properties. Galen’s “Oxyacanthus” is also certainly a Pyracantha, Pyrus (pear) or Mespilus (medlar). The latter three genera are closely allied and until the 17th century were likely to be poorly distinguished from Crataegus (Parkinson).

Gerard (1633), one of the best-known of the Renaissance herbalists, called hawthorn oxyacanthus, white thorne, or hawthorn tree. The latter two, and the name “May-Bush,” are still common in England. In Germany hawthorn is now called weifdorn, while in France it is referred to as l’epine noble (the noble thorn) because it was supposedly used for Christ’s crown of thorns.

In both the East and West, hawthorn has been used for millennia as both a food and a medicine. The current use of hawthorn for heart conditions dates back to the 17th century, according to the French doctor, Leclerc. Green, an Irish doctor, is known to have used it extensively—though secretly—for heart ailments. After his death in 1894, his daughter revealed the famous cure to be a tincture of the ripe berries of Crataegusoxycanthus. In Europe, both homeopathic and allopathic doctors used the herb for various heart and cardiovascular ailments from the late 19th through the early 20th centuries—and with great clinical success. Hawthorn had entered American clinical practice by 1896—only to fade from use in the 1930s.

Over the centuries legends about hawthorn have abounded in England and Europe. The poets, too, have sung its praises, as in Chaucer’s phrase:

Marke the faire blooming of the Hawthorne tree
Who finely cloathed in a robe of white,
Fills full the wanton eye with May’s delight.

Goldsmith, in his “Deserted Village,” penned these well-known lines:

The Hawthorn-bush with seats beneath the shade,
For talking age and whispering lovers made.

Assmann, a German homeopathic doctor from the late 1800s, said the following regarding hawthorn’s use as a cardiac medicine:

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Crataegus is no panacea, but for the handling of chronic illness, it is much more suitable than digitalis [foxglove] and strophanthus, because it has no unpleasant side-effects and no cumulative effects. Its success can be achieved if the tincture of the fresh ripe fruit in a suitable dose (3X daily 10-20 drops after meals) is prescribed.

Today, hawthorn is an official drug in the Pharmacopoeias of Brazil, China, Czechoslovakia, France, Germany, Hungary, Russia, and Switzerland. As a measure of its lasting popularity, it is an ingredient of 213 commercial European herbal formulas, which are mostly for the treatment of heart and cardiovascular ailments.

I have a special affection for this herb, because it helped my father strengthen his heart and significantly increase the quality of his circulation. Twenty-six years ago he had a heart attack and has been taking hawthorn in extract form for over 15 years with excellent results.

The extract of hawthorn can increase blood flow to the heart muscle itself, helping to counteract one of the most common modern causes of death in industrial countries—heart attack due to lack of blood flow to the heart. In pharmacological tests on both animals and humans, hawthorn has been shown to improve the contractility of the heart muscle (which can lead to a stronger pumping action of the heart), increase cardiac performance and output, lower the peripheral vascular resistance (reducing the workload of the heart), steady the heartbeat (antiarrhythmic effect), as well as increasing the heart’s tolerance to oxygen deficiency, such as might happen during stress or excitement, or in diseases where the arteries are partially blocked.

In Europe, thousands of doctors prescribe hawthorn to prevent cardiovascular disease or to help alleviate symptoms of mild to moderate problems. It is considered so safe that it is sometimes prescribed concurrently with heart medications such as digitalis. Hawthorn is also considered a mildly calming herb for the nervous system—an appropriate bonus considering that stress and nervousness often accompany cardiovascular problems.

In my own experience, it is the first herb, besides garlic, that should be added to one’s daily dietary regimen when there is any suspicion of problems of cardiovascular disease. If one has a family member who has heart or vascular problems, or for people eating a diet that includes moderate to high levels of fat (especially from dairy products or red meat), or who are stressed or using stimulants (such as coffee), hawthorn is an excellent protector.

Initially, hawthorn berries were the only part of the plant used in making extracts but eventually the flowers and leaves were added, as they were shown to have significant concentrations of the active flavonoids as well. The extract can be taken long-term, is very safe, and will not interfere with any medications, according to the official European Community monograph (ESCOP) on hawthorn. The daily dose is 2-4 droppersful of the tincture, or 1-2 tablets of the standardized extract, morning and evening.

Since the late 19th century, hawthorn has been used successfully for various diseases of the cardiovascular system, including angina pectoris, functional heart disease, arrhythmia, early manifestations of circulatory insufficiency of advanced age, and as a heart tonic to regulate circulation.

One of hawthorn’s primary applications is to support the effect of digitalis and to serve as a substitute where digitalis cannot be tolerated or where side effects need to be avoided (Madaus).

One view of the scope of hawthorn’s application is represented by this excerpt from a recent German monograph drafted by Commission E:

Hawthorn Poisoning

• reduction in heart function (NYHA stages I or II)
• uneasiness and oppressed feeling of the heart
• not yet digitalized heart (not taking digoxin)
• light forms of bradycardic arrythmia

Hawthorn works slowly, like all herbal tonics. It should be taken for at least 3 months, up to several years or longer, if needed. It is safe to use concurrently with allopathic drugs such as digoxin and may even allow a person to reduce the dose of this commonly prescribed, but highly toxic medicine.

With long-term use, hawthorn can safely help to strengthen and nourish the heart. Here is a summary of the important clinical effects of hawthorn:

1. It dilates the arteries that supply the heart muscle itself with blood, oxygen, and fuel, providing a better supply of these essential nutrients. This results, with continued use, in a stronger, more efficient heart beat.
2. It acts as a powerful free-radical scavenger, protecting the heart against the harmful effects of lessened oxygen—a common result of vascular disease, such as atherosclerosis.
3. It can help steady the heartbeat, if it is irregular and does not lead to dependence.
4. It has mild sedative activity, which may be useful where mild heart disease is combined with nervousness, hypochondria, etc., in which case it can be combined with lavender or lemon balm.

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In this modern age with its times of stress and anxiety, it is reassuring that nature has provided such a gentle yet effective cardiovascular protector as hawthorn.