Herbs for the Heart

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People of ancient cultures thought the heart was the center of intelligence, creativity, and emotion. Today we know it’s central to our health. We also know more about keeping this vital organ in good shape: A growing body of scientific and clinical evidence shows that herbs, vitamins, and other nutritional elements can help prevent heart disease. So, focusing on nutrition is one of the best places to start when you’re aiming to keep your heart and circulatory system healthy.

Hawthorn is the key herb to use in heart disease prevention. It can also benefit, to various degrees, people already suffering from heart disease, including those with angina and early-stage congestive heart failure (CHF). In some cases, hawthorn can complement drug therapy or be used alone both to improve quality of life for people with stable angina and slow the progression of early-stage CHF. And, as we’ll see, there are some nutritional supplements, including coenzyme Q10 (CoQ10), that must be mentioned when addressing prevention and management of heart disease.

As you learn about these nutritional elements, remember that the key to using them successfully is to work closely with your naturopathic doctor or herbally informed physician. And the hallmark of an optimal program begins with a sound diagnosis and regular evaluation by your health-care professional.

The Benefits of Hawthorn

Hawthorn can protect against developing heart disease, provided it’s used along with other healthy habits such as eating a well-balanced diet and getting plenty of exercise. Hawthorn helps blood circulate efficiently through the body and reduces the level of cholesterol and triglycerides in the bloodstream.

These same actions make it useful for some people who already have heart problems. Hawthorn, particularly extracts made from its leaves and flowers, exerts a gentle, measured effect on the heart and circulation, good initial therapy for people with weakened hearts. It’s especially effective during the early stages of congestive heart failure, before stronger drugs such as digitalis are required. Using hawthorn not only gives the heart a fighting chance at recovery, it may also slow the progression of heart disease.

Modern development of hawthorn extracts began with the discovery of a group of compounds in the plant’s leaves, flowers, and berries. These compounds are flavonoids–pigments that protect plants from harmful sun rays and fight free ­radical damage–and include vitexin, quercetin, hyperoside, and oligomeric ­procyanidins. The leaves and flowers seem to have more of these constituents, so ­extracts made from leaves and flowers have largely replaced berry preparations in Europe, where hawthorn is widely prescribed by doctors.

How Hawthorn Works

Put simply, hawthorn’s flavonoids make the heart a stronger and more efficient pump. The herb achieves this partly by increasing blood supply to and from the heart and partly by decreasing the resistance of blood vessels to normal blood flow. What we gain is a healthier heart, as well as improved blood circulation.

The research to date shows that hawthorn

• improves blood flow through the coronary arteries

• improves heart contractions, making the heart more efficient in pumping blood out to the body

• improves circulation to the extremities by lowering resistance in the arteries, partly because it inhibits a substance in the body known as ACE (angiotensin-­converting enzyme) that contributes to the creation of a potent blood-vessel constrictor known as angiotensin II

• counteracts the damaging effects of free radicals on the cardiovascular system because of its high antioxidant content.

Hawthorn and CHF

Throughout the 1990s, hawthorn extracts have been used successfully to treat people with early-stage CHF. Studies ­pointing the way to hawthorn’s use in this treatment include one eight-week study involving thirty people aged fifty to seventy with early-stage CHF; it was conducted in 1992 in Germany. Along with exercising regularly on a stationary bicycle, participants took either a placebo or 160 mg of hawthorn extract prepared from leaves and flowers and standardized to its fla­vonoid content. The people taking haw­thorn exercised longer before reaching exhaustion and told researchers they had more endurance and felt better than they did before taking the hawthorn.

Other studies with larger numbers of early-stage CHF patients have included daily doses ranging from 160 mg to 900 mg. In these studies, exercise tolerance improved while shortness of breath and post-exercise fatigue decreased. Participants also experienced improved heart function as measured by electrocardiogram.

Hawthorn extract compares favorably to the drug Captopril in the treatment of early-stage CHF. While Captopril is used to reduce resistance to blood flow in peripheral arteries, one study shows that hawthorn does this equally well and without the side effects associated with Captopril, which include abdominal pain, ­diarrhea, insomnia, vomiting, and, less commonly, anemia, inflammation of the nose and/or tongue, and palpitations.

Hawthorn may also prove useful for people with stable angina. In a 1983 study, researchers gave sixty angina patients either 180 mg of hawthorn extract or a placebo daily for three weeks. The patients taking hawthorn exercised for longer periods of time without an angina attack. Their electrocardiogram measures improved, as did blood flow and oxygen delivery to the heart muscle.

Coenzyme Q10

If hawthorn is the key herb in the management of early stages of CHF and angina, then CoQ10 is the key nutritional supplement. CoQ10 plays an essential role in heart function and metabolism (the highest concentrations of CoQ10 are in the heart muscle).

This fatty, vitaminlike substance is an essential nutrient for mitochondria, which are the powerhouses of cells and depend on a complex chain of reactions to convey energy. In clinical studies, CHF patients taking 90 mg to 150 mg of CoQ10 a day found their heart function improved in as little as four weeks. The most notable ­improvements were an increase in blood ­output from the heart and decreased resistance to blood flow in the peripheral ­arteries. Such actions make CoQ10 a ­perfect partner for hawthorn leaf and flower ­extracts in the management of early-stage CHF.

CoQ10 has also shown promise in the treatment of angina. One clinical study found a twofold reduction in angina attacks and a 50 percent reduction in nitroglycerin use after angina patients took 150 mg of CoQ10 daily for four weeks.

Cholesterol-lowering drugs such as niacin or lovastatin may decrease your CoQ10 levels. So, if you’re taking a “statin” drug, you may wish to supplement your diet with 60 mg to 90 mg of CoQ10 every day.

Other Add-ins

We’re learning more about the important heart benefits found in two other nutritional add-ins: L-carnitine and magnesium.

L-carnitine is an important nutrient for proper energy metabolism, particularly for fatty acids, which provide fuel for ­energy production in cells. L-carnitine comes from two of the essential amino acids that the body cannot produce on its own; it can only be obtained from meat and dairy products or in natural supplement form.

Clinical studies have found that L-carnitine supplementation leads to increased exercise tolerance and better heart function after seven months for patients with early-stage CHF. Similar benefits have been seen in people with angina. The research indicates that people with either CHF or angina will benefit from taking 2 g to 3 g of L-carnitine per day.

People with CHF and angina may also wish to consider adding magnesium to their daily supplement regime. CHF patients are often advised to take drugs that, while helping relieve symptoms, also act as diuretics, leading to a de­pletion of magnesium, a mineral that ­promotes absorption and use of other minerals, helps metabolize proteins, and turns on essential enzymes.

But using magnesium should be closely monitored by your doctor. For people taking a diuretic designed not to deplete magnesium or for those who have kidney problems, taking a magnesium supplement may lead to excessive amounts of this mineral, which can cause a drop in blood pressure and an irregular heartbeat. Make sure to consult with your health-care professional before adding magnesium to your daily supplement regime.

Don Brown is a naturopathic physician and director of Natural Product Research Consultants. He is author of Herbal Prescriptions for Better Health (Prima, 1996).

Additional reading

The reference list for this article is ­extensive. If you would like a copy, write to Herbs for Health, Hawthorn Reading List, 201 East Fourth Street, Loveland, Colorado 80537-5655.

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