title: Hypotensive effects of hawthorn for patients with diabetes taking prescription drugs: a randomised controlled trial.
abstract: 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.
authors.affiliation: Hugh Sinclair Unit of Human Nutrition, School of Food Biosciences, The University of Reading, Reading. a.f.walker@reading.ac.uk
authors.forename: Ann F
authors.initials: AF
authors.lastname: Walker
authors.forename: Georgios
authors.initials: G
authors.lastname: Marakis
authors.forename: Eleanor
authors.initials: E
authors.lastname: Simpson
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Hope
authors.forename: Paul A
authors.initials: PA
authors.lastname: Robinson
authors.forename: Mohamed
authors.initials: M
authors.lastname: Hassanein
authors.forename: Hugh C R
authors.initials: HC
authors.lastname: Simpson
mesh_terms: 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
chemical_list: D000959:Antihypertensive Agents; D007004:Hypoglycemic Agents