Hypotensive effects of hawthorn for patients with diabetes taking prescription drugs: a randomised controlled trial.
BACKGROUND
Hawthorn (Crataegus laevigata) leaves, flowers and berries are used by herbal practitioners in the UK to treat hypertension in conjunction with prescribed drugs. Small-scale human studies support this approach.


OBJECTIVE
To investigate the effects of hawthorn for hypertension in patients with type 2 diabetes taking prescribed drugs.


METHODS
Randomised controlled trial.


METHODS
General practices in Reading, UK.


METHODS
Patients with type 2 diabetes (n = 79) were randomised to daily 1200 mg hawthorn extract (n = 39) or placebo (n = 40) for 16 weeks. At baseline and outcome a wellbeing questionnaire was completed and blood pressure and fasting blood samples taken. A food frequency questionnaire estimated nutrient intake.


RESULTS
Hypotensive drugs were used by 71% of the study population with a mean intake of 4.4 hypoglycaemic and/or hypotensive drugs. Fat intake was lower and sugar intake higher than recommendations, and low micronutrient intake was prevalent. There was a significant group difference in mean diastolic blood pressure reductions (P = 0.035): the hawthorn group showed greater reductions (baseline: 85.6 mmHg, 95% confidence interval [CI] = 83.3 to 87.8; outcome: 83.0 mmHg, 95% CI = 80.5 to 85.7) than the placebo group (baseline: 84.5 mmHg, 95% CI = 82 to 87; outcome: 85.0 mmHg, 95% CI = 82.2 to 87.8). There was no group difference in systolic blood pressure reduction from baseline (3.6 and 0.8 mmHg for hawthorn and placebo groups, respectively; P = 0.329). Although mean fat intake met current recommendations, mean sugar intake was higher and there were indications of potential multiple micronutrient deficiencies. No herb-drug interaction was found and minor health complaints were reduced from baseline in both groups.


CONCLUSIONS
This is the first randomised controlled trial to demonstrate a hypotensive effect of hawthorn in patients with diabetes taking medication.
Walker
Ann F
AF
Hugh Sinclair Unit of Human Nutrition, School of Food Biosciences, The University of Reading, Reading. a.f.walker@reading.ac.uk
Marakis
Georgios
G
Simpson
Eleanor
E
Hope
Jessica L
JL
Robinson
Paul A
PA
Hassanein
Mohamed
M
Simpson
Hugh C R
HC
D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D027825:Crataegus; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D041743:Herb-Drug Interactions; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000209:etiology; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D008517:Phytotherapy / Q000379:methods*; D016896:Treatment Outcome
D000959:Antihypertensive Agents; D007004:Hypoglycemic Agents