When you have angina, the pressurelike pain in your chest is more of a warning signal than a cry for help. It’s usually a sign that something isn’t right in the spaghetti-size arteries that deliver blood to your heart muscle. That firm, relentless squeeze often means that the arteries have been narrowed by cholesterol-laden plaque. As plaque starts to clog those all-important pipelines, blood flow is reduced. When the arteries are starved of hearty red blood, with its supply of oxygen and nutrients, they are more likely to go into spasm, which reduces blood flow even more.
That squeezing in your chest is a tip-off that your heart muscle isn’t getting enough oxygen-laden blood to meet its needs. Often, the attack hits when some other part of your body needs increased blood flow to feed your muscles or warm up your limbs. Maybe you’ve been exercising or are under a lot of stress. It can also occur in cold weather or after a big meal.
People with angina need to be on the same low-fat, high-fiber diet that lowers cholesterol, says Decker Weiss, N.M.D., a naturopathic doctor at the Arizona Heart Institute in Phoenix. He also recommends that his patients take a variety of supplements that may reduce the risk of heart disease.
Traditionally, physicians treat angina with medications such as nitroglycerin that improve blood flow to the heart. If the blockage is bad enough, a doctor might recommend an artery-opening procedure such as angioplasty or bypass surgery.
Certain nutrients and herbs, however, can also improve blood flow to the heart and enhance energy production in the muscle cells. With the aid of these nutrients, the heart muscle can work better even though blood supply is reduced, Dr. Weiss says.
If you have a history of angina, your doctor will want you to keep a medication such as nitroglycerin on hand, and, of course, you need to check with your doctor first about taking supplements. But many people are drawn to alternative treatments by the prospect of avoiding procedures such as angioplasty and bypass surgery. By taking helpful nutrients and pursuing other measures to ensure good heart health, you may be able to clear up the symptoms of angina and its causes as well, says Dr. Weiss.
Ease the Squeeze with Magnesium
At the top of Dr. Weiss’s prescription list for angina is magnesium, a mineral that helps relax the muscles that wrap around blood vessels.
In several studies, intravenous magnesium was effective in stopping a type of angina characterized by spasms in the coronary arteries. In a British study that addressed another type of angina, intravenous magnesium again showed its power. People who received the magnesium had fewer angina episodes than those who didn’t receive it.
"Magnesium dilates the coronary arteries, improving oxygen delivery to the heart," Dr. Weiss says. It also plays an important role in energy production in all cells, so magnesium is especially important to heart muscle cells, which are high energy producers, he says.
Magnesium deficiency can be induced by drugs meant to help heart problems, including diuretics, which help your body excrete excess fluid. You also have to watch out for deficiency caused by the commonly prescribed digitalis heart medications digitoxin (Crystodigin) and digoxin (Lanoxin). Signs of magnesium deficiency include muscle weakness, nausea, and irritability.
If you have angina, you probably have heart disease, so it’s best to consult a doctor who’s knowledgeable in nutrition before taking supplemental magnesium. Dr. Weiss recommends two forms—magnesium orotate and magnesium glycinate—but check with your doctor before you settle on a dosage of either.
Get Some 10, 6, and 3
Coenzyme Q10 is a vitamin-like substance that plays an essential role in producing energy. CoQ10, as it’s commonly called, actually increases oxygen delivery to heart muscle cells. For anyone with angina, it’s a supplement to consider.
In one study, 12 people with one type of angina who took 150 milligrams of coQ10 daily for four weeks cut the frequency of angina attacks in half compared with a group taking inactive, look-alike pills (placebos).
If you’re buying coQ10 for the first time, you might wonder which kind to use—gel capsules or tablets. Since coQ10 is fat-soluble, the gel capsules are more potent and more readily absorbed than the tablet form. If you opt for tablets, chew them with a fat-containing food such as peanut butter to maximize absorption.
Doctors also recommend two kinds of fatty acids—omega-3’s and omega-6’s—for people who have angina. These are found in fish oil, flaxseed oil, cold-pressed safflower or sunflower oil, and borage oil. "I recommend 1,000 to 3,000 milligrams a day of a mixture of these two essential fatty acids," Dr. Weiss says.
Experts also advise people with angina to cut back on saturated fats (those that are solid at room temperature), hydrogenated fats (margarine and shortening), and polyunsaturated fats (corn oil).
Get Help from Ginkgo and Amino Acids
"I absolutely recommend ginkgo for angina," says Dr. Weiss, noting that the herbal supplement can help stimulate blood flow around the damaged area of the heart.
Ginkgo also helps prevent platelets from sticking together, says Dr. Weiss. Platelets are components in blood that promote clotting, and they can also pile up at a site where an artery has been clogged by cholesterol. Dr. Weiss recommends 60 milligrams of ginkgo biloba extract (standardized to 24 percent ginkgoflavoglycosides) up to three times a day.
Another possible alternative for people who have angina is amino acids. These include carnitine, taurine, and arginine, Dr. Weiss says.
"Carnitine is vital, and I recommend it because many people with heart disease need extra carnitine to utilize the essential fatty acids that their hearts need," Dr. Weiss says. This amino acid helps transport fatty acids into the mitochondria, the tiny areas within cells where energy is produced. Supplemental carnitine may help the heart muscle better utilize its limited supply of oxygen, studies show.
The daily therapeutic dose for carnitine is 1,500 to 3,000 milligrams for an average person. Take three divided doses a day, advises Dr. Weiss.
Taurine is also important for the normal function of the heart and vascular system, says Dr. Weiss. It’s the most abundant amino acid found in the heart. In Japan, taurine is widely used to treat various types of heart disease.
Arginine is involved in the production of nitric oxide, a compound formed by the cells that line the arteries. With increased nitric oxide, the arteries can relax and dilate, which helps augment blood flow to crucial heart muscle.
Your best bet for using these amino acids? Ask your doctor to recommend a formula that contains a balanced mixture. Recommended doses will vary depending on your current and past history of heart disease.
Hawthorn Helps Your Heart
Hawthorn is an herb with a long history of use for heart problems, with good reason. It improves the blood supply to the heart by dilating coronary arteries and aids the transformation of food into energy in your heart muscle cells. The herb can help eliminate some types of arrhythmia (irregular heartbeat), says Dr. Weiss.
"It is a wonderful herb for atherosclerosis," he says. Since atherosclerosis (hardening of the arteries) is a buildup of artery-blocking plaque, it leads to angina. "Taking hawthorn can lower the frequency, duration, and severity of angina."
Hawthorn takes two weeks to a month to work. It is available in several different forms, Dr. Weiss says. A typical tonic dose is ¼ teaspoon of liquid extract taken two or three times a day. Many people stir this syrupy extract of hawthorn berries into a glass of hot water. If you prefer a tincture, take 30 to 60 drops daily. For capsules, take 160 milligrams three times a day. If you have a heart condition, however, check with your doctor before taking hawthorn.
Nutrients That Ease Angina
Certain vital nutrients help prevent cholesterol buildup in arteries and protect the cells lining blood vessels from damage that makes blockage more likely. These protective nutrients include vitamins C and E and the trace mineral selenium. "I routinely suggest these nutrients to someone with angina," Dr. Weiss says.
In a study, supplements of vitamin E, along with vitamin C, vitamin A, and beta-carotene, reduced the incidence of angina. Vitamin E affects both cholesterol and platelets in a way that reduces the risk of heart disease, Dr. Weiss explains. He recommends 400 to 800 international units (IU) a day.
Vitamin C helps keep blood vessels open because it prevents the breakdown of nitric oxide, which helps promote blood flow, says Dr. Weiss.
Selenium, when teamed with vitamin E, can also offer some protection from angina. One study found that people with heart disease who took 200 IU of vitamin E and 1,000 micrograms (a very large dose) of selenium had a significant reduction in angina pain compared with people taking placebos. Doses of selenium over 200 micrograms must be taken with a doctor’s supervision.
Doctors who recommend selenium supplements to their heart patients generally stick with no more than 50 to 200 micrograms a day. You’ll also want to make sure that you’re getting about 400 micrograms of folic acid, along with 1,000 micrograms of vitamin B12 and 50 to 100 milligrams of vitamin B6, says Dr. Weiss. These B vitamins help your body process homocysteine, an amino acid by-product that can damage arteries by creating rough spots on artery walls that can pick up fatty deposits.
Bromelain and Curcumin: The Anti-Angina Duo
Dr. Weiss may also use a mixture of bromelain, a protein-dissolving enzyme found in pineapple, and curcumin, the yellow pigment in turmeric, for people with angina. Bromelain helps reduce the formation of fibrous tissue and clots in damaged arteries, and curcumin acts somewhat like aspirin, he says. It helps to reduce the tendency for blood to clot and also reduces inflammation.
For the best therapeutic effect, Dr. Weiss recommends divided doses. A standard dose of bromelain is 125 to 450 milligrams three times a day on an empty stomach, he says. Do not take bromelain with food, though, or it will simply act as a digestive enzyme.
Usual doses of curcumin are 400 to 600 milligrams a day, Dr. Weiss says. Ask your doctor what dosage is best for you.
