Angina

Angina

It's amazing how much herbal information you can pick up wandering the halls of the U.S. Department of Agriculture (USDA). Many of my colleagues there used to ask me for herbal advice and for solutions to assorted health problems.

One of my more conservative colleagues--not the kind of person who gravitated toward herbal medicine--surprised me one day by asking me what sort of herbal concoction I might recommend for angina. This problem had been bothering him for several months.

I mentioned a couple of the herbs in this chapter--hawthorn and garlic--and he thanked me. Then he told me that he'd been taking ginger for about a week, and he felt considerably better.

That was a new one on me. I knew that ginger helped lower cholesterol and blood pressure, which benefits the heart, but I didn't know that it had anti-angina benefits as well. It turned out that he was right--it does.

Angina, technically angina pectoris, is a form of heart disease that causes moderate to severe chest pain. In stable angina, the pain develops after some form of physical exertion, anything from a brisk jog to a leisurely stroll. In unstable angina, the pain strikes while a person is at rest.

Angina is caused by atherosclerosis, a disease in which cholesterol-rich deposits called plaque cause the coronary arteries to narrow. Atherosclerosis limits blood flow into the heart, and the resulting lack of nourishment and oxygen triggers angina pain. Both kinds of angina (but particularly unstable angina) indicate that a person has major risk of heart attack.

Green Pharmacy for Angina

Anyone with angina should be under a physician's care, and it's extremely important to follow your doctor's recommendations. Typical recommendations involve taking nitroglycerin, aspirin and frequently other medications that lower cholesterol and blood pressure.

In addition to these measures, there are a number of medicinal herbs that can help. Before you take any of these herbs, however, you should discuss it with your doctor.

Hawthorn (Crataegus, various species). In Europe, hawthorn berry preparations are widely used to treat mild angina.

Extensive research has demonstrated that hawthorn extracts improve heart function by opening up the coronary arteries. This in turn improves the blood and oxygen supply to the heart. Hawthorn also decreases blood cholesterol levels, another heart-healthy benefit, and it is safe to use for extended periods of time, according to European clinical experience.

In his excellent book Herbs of Choice, Varro Tyler, Ph.D., dean and professor emeritus of pharmacognosy (natural product pharmacy) at Purdue University in West Lafayette, Indiana, explains that hawthorn's heart benefits are due to special compounds in the plant--oligomeric procyanidins (OPCs). People get additional beneficial effects from several other compounds known as flavonoids, which open (dilate) the smooth vessels of the coronary arteries.

Commission E, the German expert panel that evaluates medicinal herbs for the German government, approves hawthorn for a number of heart problems. Naturopaths recommend a daily dosage of 240 to 480 milligrams of standardized extract. Hawthorn is a powerful heart medicine, so do not take it without discussing it with your doctor.

Hawthorn The flowers, leaves and fruits of this plant are all used for medicinal purposes.

Angelica (Angelica archangelica) and other herbs of the carrot family. Calcium channel blockers are a standard class of anti-angina drugs, and angelica contains 15 compounds that act much like these channel blockers. Similar compounds appear in other plants in the carrot family: carrots, celery, fennel, parsley and parsnips.

If I had angina, I'd combine them all in a drink that consists of juiced angelica, carrots, celery, fennel, parsley and parsnips, with some water and spices added.

It's well-known that vegetarians have a low incidence of heart disease. Usually, their lower-fat diet gets the credit. But I'd be willing to bet that part of the reason is that they eat lots of plants from the carrot family.

Bilberry (Vaccinium myrtillus) and other fruits. Bilberry contains compounds known as anthocyanins that have a cholesterol-lowering effect. This herb is also a vasodilator that opens blood vessels and lowers blood pressure. Anthocyanins help prevent formation of the blood clots that trigger heart attack.

Until pharmaceutical firms start studying anthocyanins, we won't know how effectively these compounds help to prevent coronary problems. But one thing is clear. Bilberries are not the only fruit that contains them. Other good sources include blackberries, black chokeberries, boysenberries, black currants, blueberries, cherries, cranberries, red grapes and red raspberries. I suspect that all of these fruits might help prevent and treat angina.

Garlic (Allium sativum) and onion (A. cepa) Both of these spicy herbs help treat heart disease by lowering cholesterol and blood pressure and by preventing formation of the blood clots that trigger heart attack.

According to one study, munching one clove of garlic daily cuts cholesterol by 9 percent. Every 1 percent decrease in cholesterol translates to a 2 percent decrease in heart attack risk, so a clove a day reduces risk of heart attack by 18 percent. Onions have similar benefits, although not as pronounced.

Ginger (Zingiber officinale). After my USDA colleague persuaded me to explore ginger's anti-angina benefits, I read that it was endorsed for heart attack prevention in Ginger: Common Spice and Wonder Drug by New England herbalist Paul Schulick. He notes that an Israeli cardiology clinic now recommends a daily half-teaspoon of powdered ginger.

It seems that ginger is an antioxidant that offers the blood vessels some protection against the damage caused by cholesterol. Ginger also boosts the strength of heart muscle tissue, as does the medication digitalis. If I had angina, I would take ginger regularly and use it liberally in cooking.

Khella (Ammi majus). A 1951 article published in the New England Journal of Medicine touted the anti-angina benefits of khellin, a compound in khella that increases blood flow into the heart. The article called khellin "a safe and effective drug for the treatment of angina pectoris."

As little as 30 milligrams of khellin a day can help, but noted naturopath Michael Murray, N.D., co-author of Encyclopedia of Natural Medicine and several other scholarly books on nutritional and naturopathic healing, recommends taking 250 to 300 milligrams daily of khella extracts that are standardized for khellin content (typically 12 percent). If you buy khella in standardized extract form, that information will be on the label.

Kudzu (Pueraria lobata). Chinese clinical studies attest to the anti-angina benefits of kudzu. In one study, 71 people took 10 to 15 grams of a root extract a day for 4 to 22 weeks. During this time, 29 were much improved, 20 showed some improvement, and 22 showed little or no improvement.

Kudzu extracts dilate coronary arteries, increasing blood flow and decreasing blood pressure. They also help stabilize heart rhythm. Kudzu root preparations have produced no adverse effects in human trials.

Purslane (Portulaca oleracea). antioxidants are substances that protect cells from damage caused by free radicals, highly reactive oxygen molecules in the body. And they appear to play a key role in preventing heart disease. I recommend purslane because it's extremely well endowed with antioxidants, and in addition, it's our best leafy source of omega-3 fatty acids, beneficial oils that also help prevent heart disease.

Willow (Salix, various species). Studies have shown that low-dose aspirin--anywhere from 30 milligrams to a standard 325-milligram tablet a day--helps prevent heart attack by preventing the formation of blood clots. This is a major concern for people with angina.

Willow bark is herbal aspirin. A daily cup or two of willow bark tea would probably provide the equivalent of the low aspirin dose recommended for heart attack prevention. (Incidentally, the latest studies show that aspirin, and presumably willow bark as well, also help prevent colon cancer. So there's more than one reason to adopt it.) Remember, though, that if you're allergic to aspirin, you probably shouldn't take aspirin-like herbs, either.

Evening primrose (Oenothera biennis). Primrose is an excellent source of gamma-linolenic acid (GLA), a compound that lowers both cholesterol and blood pressure. GLA also has an anti-clotting effect. My friend C. Leigh Broadhurst, Ph.D., a geochemist with expertise in nutritional medicine, suggests that evening primrose and flaxseed, which is discussed below, should be taken together.

Flax (Linum usitatissimum). Flaxseed contains an abundant amount of alpha-linolenic acid, a compound that many claim has heart-protective ability.

Sichuan lovage (Ligusticum chuanxiong). This Asian herb helps prevent the formation of heart attack­triggering blood clots, according to pharmacognosist (natural product pharmacist) Albert Leung, Ph.D., and noted Arkansas herbalist and photographer Steven Foster. In their book, The Encyclopedia of Common Natural Ingredients, they note that this herb contains compounds similar to those in angelica. These compounds dilate the coronary arteries, increasing blood flow to the heart. Small wonder that Sichuan lovage is used in China to treat angina and other heart conditions.