Review Article

Effect of Crataegus Usage in Cardiovascular Disease Prevention: An Evidence-Based Approach

Table 1

Compounds derived from Crataegus in vivo cardiovascular effects.

TargetCompoundsAnimal/organsEffectReferences

Antioxidant effectTCRRat heartLipid peroxidation; Jayalakshmi and Devaraj, 2004 [28]
Activity of marker enzymes;
Antioxidant enzymes;
Oxygen uptake;
Respiratory coupling ratio

Positive inotropic effectWS 1442Human myocardial tissuecAMP-independent mechanism; Schwinger et al., 2000 [31]
Sarcolemmal Na+/K+-ATPase;
Sodium pump;
Intracellular Ca2+ concentration;

Anti-inflammatory effectAECRat heart Nitritive stress; Vijayan et al., 2012 [37]
Oxidative stress;
iNOS expression;
COX-2;
Lipid peroxidation;
Cytochrome c;

Anti-cardiac remodeling effectWS 1442RatLV chamber volumes (VOL); Hwang et al., 2008 [41]
Relative wall thickness;
Vcfc;

Antiplatelet aggregationCrataegus aronia syn. Azarolus (L)Rat bloodBleeding time; Abdullah et al., 2012 [45]
Platelet aggregation;
Serum levels of TXB2;

Vasodilating effectWS 1442Isolated rings of rat aortaEndothelium-dependent, Brixuis et al., 2006 [50]
NO-mediated vasorelaxation;
eNOS phosphorylation;
Crataegus microphylla CM extractRat thoracic aortaEndothelium-dependent relaxation; Gökçe et al., 2013 [52]
Vascular contraction;
iNOS expression;
Plasma levels of TNF- , IL-6;
Lipid peroxidation;
CERat aortaEndothelium-dependent nitric oxide(NO)-mediated relaxation; Kim et al., 2000 [54]
Tetraethylammonium-sensitive K+ channels;

Endothelial protectionWS 1442Rat main mesenteric arteriesProstanoid-mediated contractile responses; Idris-Khodja et al., 2012 [63]
Oxidative stress;
COX-1 and COX-2;

Protect I/R injuryWS 1442Rat myocardiumContractile function; Veveris et al., 2004 [67]
Infarct size;
Crataegus oxyacanthaRat heartAverage prevalence of malignant arrhythmias 
(VF + Flutter);
Makdessi et al., 1999 [68]
Average prevalence of VT;
TCRRat heartAntioxidant enzyme activity; Jayalakshim and Devaraj, 2004 [69]

Antiarrhythmic effectCrataegus meyeri extractsRatVentricular ectopic beats; Garjani et al., 2000 [72]
Single extrasystoles;

Lipid-lowering effectHFCMiceBlood lipids; Xu et al., 2009 [76]
(LDL-C)/TC;
TG levels;
HFCHamstersSerum cholesterol; Zhang et al., 2002 [78]
VLDL + LDL cholesterol;
Hepatic cholesterol ester content;
The leaf of Crataegus pinnatifida MiceTG and glucose absorption; Wang et al., 2011 [79]
Gastrointestinal transit;
TG and free fatty acid;
Hawthorn flavonoidsMiceLPL expression; Fan et al., 2006 [80]
PPARγ-dependent mechanism;
TCRRatLipids in the serum and heart; Akila and Devaraj, 2008 [81]
Lipid in liver and aorta;
Activity of antioxidant enzymes;
Whole plant of Crataegus ZebrafishIntravascular cholesterol levels; Robert et al., 2012 [82]

Decrease of arterial blood pressureCrataegus tanacetifolia leaf extract Rats coronary arteryL-NAME-induced hypertension; Koçyõldõz et al., 2006 [83]
Beneficial effects on cardiovascular system;
Aqueous extract of Crataegus RatHR and MAP; Shatoor, 2013 [84]
Sinus node suppression;
Atrioventricular blockade;
Muscarinic receptor M2;
Blockade of beta-receptors;

Notes: TCR: tincture of Crataegus; AEC: alcoholic extract of Crataegus oxycantha; Vcfc: velocity of circumferential shortening; TXB2: thromboxane B2; CE: Crataegus fruit extracts; CM: Crataegus microphylla; VT: ventricular tachycardia; TC: serum cholesterol; LDL-C: low-density lipoprotein cholesterol; TG: triglyceride; HFC: hawthorn fruit compound; HR: heart rate; MAP: mean arterial pressure.