Quick Summary

Chinese Hawthorn (Crataegus pinnatifida) is a traditional medicinal plant widely used in China with a long history. It contains bioactive compounds like flavonoids, polysaccharides, saponins, and triterpenoids. Evidence from multiple systematic reviews, meta-analyses, and clinical trials suggests it may have potential benefits in several metabolic disorders including type 2 diabetes mellitus (T2DM), metabolic-associated fatty liver disease (MASLD)/non-alcoholic fatty liver disease (NAFLD), dyslipidemia, stable angina pectoris, and atherosclerosis. Clinical studies have shown improvements in lipid profiles, glucose metabolism, liver enzymes, insulin resistance, and cardiovascular function with hawthorn-containing preparations. However, the overall quality of evidence is low to moderate due to methodological limitations. Adverse effects are generally minor and infrequent, mostly gastrointestinal or occasional cardiac events. There is limited data on drug interactions, contraindications, and use during pregnancy or breastfeeding. Further high-quality research is needed to confirm efficacy and safety.

What is it?

Chinese Hawthorn (Crataegus pinnatifida) is a plant native to China, belonging to the Rosaceae family. It has been traditionally used in Chinese medicine and also serves as a food source. The plant is known for its red fruit, which contains several bioactive compounds thought to contribute to its medicinal properties.

Traditional Uses

Traditionally, Chinese Hawthorn has been used in Chinese medicine to support digestive health, improve blood circulation, and address heart-related conditions. It has been included in various formulations aimed at metabolic health and cardiovascular support.

Active Compounds

  • Flavonoids
  • Polysaccharides
  • Saponins
  • Triterpenoids

These compounds are believed to contribute to the plant’s antioxidant, anti-inflammatory, and metabolic-modulating effects.

Potential Benefits with Evidence Levels

  • Type 2 diabetes mellitus (T2DM) with metabolic-associated fatty liver disease (MASLD/NAFLD)
    Systematic reviews and meta-analyses of randomized controlled trials (RCTs) with moderate to low quality evidence suggest that traditional Chinese medicine preparations containing hawthorn may improve liver enzymes (ALT, AST), lipid profiles (TG, TC, LDL-C, HDL-C), insulin resistance (HOMA-IR), glycemic control (fasting blood glucose, 2h postprandial glucose, HbA1c), and reduce hepatic fat deposition as assessed by imaging (Controlled Attenuation Parameter – CAP).
  • Dyslipidemia
    Evidence from systematic reviews and meta-analyses of RCTs with moderate quality suggests that Chinese patent medicines including hawthorn, combined with statins, may reduce total cholesterol, triglycerides, LDL-C, and increase HDL-C without increasing adverse events.
  • Stable angina pectoris
    A prospective real-world observational study indicated that Shenxiong-Xinmaikang Decoction containing hawthorn was associated with symptomatic improvement, enhanced cardiac function (LVEF), and improved biochemical markers (LDL-C, hs-CRP, CK, cTnI) without an increase in adverse events.
  • Atherosclerosis and coronary microvascular dysfunction
    Systematic reviews, network meta-analyses, and preclinical studies show hawthorn-containing polyherbal preparations may benefit endothelial function, lipid parameters, inflammatory markers, and microvascular indices. However, the evidence quality is low with high heterogeneity.
  • Non-alcoholic fatty liver disease (NAFLD)
    Systematic reviews with evidence mapping indicate that traditional Chinese medicine including hawthorn may improve liver enzymes, metabolic parameters, and imaging biomarkers, though the evidence quality is limited by methodological flaws.

Side Effects

  • Minor gastrointestinal complaints, such as nausea and abdominal discomfort
  • Rare cardiac events reported in isolated cases
  • No serious adverse events reported in controlled clinical trials

Overall, Chinese hawthorn-containing products are generally well tolerated with a favorable safety profile based on clinical trials and pharmacovigilance data.

Drug Interactions

There is insufficient direct clinical evidence regarding drug interactions with Chinese hawthorn. Considering its common use alongside cardiovascular drugs, including statins and antiplatelet agents, potential interactions should be considered cautiously, although they are not well characterized in scientific literature.

Who Should Avoid It

  • Individuals with known cardiac conditions should use caution due to limited data on safety in this population.
  • Pregnant or breastfeeding women should avoid use because no clinical safety data are available for these groups.
  • Those with unknown pregnancy or breastfeeding status should also avoid using Chinese hawthorn until more evidence is established.

Evidence Limitations

  • Most studies have methodological limitations including small sample sizes, short durations, and high heterogeneity
  • Evidence quality is typically low to moderate, often downgraded due to inconsistency and imprecision
  • Lack of large-scale, multicenter, randomized, placebo-controlled trials
  • Limited data on long-term safety, drug interactions, and special populations such as pregnant and breastfeeding women
  • Predominance of studies conducted in Chinese populations may limit applicability to other groups
  • Inadequate standardization of herbal preparations and dosages across studies

References

Last Reviewed

June 2024

Disclaimer: This page is for informational purposes only and is not intended to provide medical advice. Chinese Hawthorn products are not approved by regulatory authorities for treatment of diseases. Consult with a qualified healthcare provider before starting any herbal supplements, especially if you have underlying health conditions or are taking other medications.