Patients come to my clinic predominantly to find solutions to specific ailments and to relieve particular symptoms. But during our first session, I often remind them to look at the big picture. Achieving better sleep and more regular bowel movements may be of little use if a major heart attack or stroke occurs. Along with incorporating a stress-reducing yoga practice and bowel-moving fiber in the form of more fruits and vegetables for improved quality and length of life, a patient should consider what habits might help slow the process of cardiovascular heart disease. This process is often silent, occurring at the cellular level, where subtle microinflammation of blood vessels inexorably leads to scarring, as well as hardening and blockage of the vessels. This process, which develops slowly (and often unseen) is a major factor in heart attack and stroke, the first and second leading causes of death in most of the world’s technologically developed countries. Dramatically, studies show that most adults likely have some stage of this disease process taking place in our bodies.
As I sat talking with Judy during our first session, she expressed surprise that at forty-eight she should even think about heart disease as an important health consideration. But recent statistics show that after menopause, women are about 70 percent as likely to die from a heart attack or stroke as men—these catastrophic events being the top two killers of both women and men. And after fifty-five, women are also just as likely as men to have high blood pressure.
Judy had high blood pressure and hypercholesterolemia (high total blood cholesterol), according to her doctor, who prescribed a diuretic and a beta-blocker to reduce her blood pressure from 150/90 to 135/78. Most medical authorities agree that when positive lifestyle changes don’t lower blood pressure to about 135/80, patients should receive antihypertensive drugs.
High-quality controlled studies have shown that a combination of beta-blockers and diuretics are the best drugs to decrease the risk of dying from heart attack and stroke among people older than sixty. However, this benefit is not as well established for borderline hypertensives nor for younger people, such as Judy. She told me she wanted to be around to see her grandkids grow up but had doubts whether antihypertensives and cholesterol-lowering drugs might help her live longer, have more energy, and feel better in the long run. I acknowledged that medical science hasn’t proven these issues with certainty, but it is known that these drugs have a number of serious and even life-threatening side effects.
I try to help patients identify and evaluate all of their options when heart disease is present. Drugs are certainly one option, and a popular one, based on the number of yearly prescriptions that are written. And if drugs are effective, why does cardiovascular disease continue to progress in many cases? You may not be surprised to hear that nearly 1 million angioplasties (increasing vessel size by inserting a tube or balloon) and more than half a million bypass surgeries are performed in the United States each year.
Judy was aware that Dean Ornish, M.D., and other researchers have shown that a total program for cardiovascular health can reverse hardening and blockage of arteries and reduce the risk of dying from heart attack and stroke. She knew about the importance of practicing daily stress-releasing activities such as yoga, walking, and aerobic exercise. She also understood that diet (especially avoiding foods containing refined fat and sugar and eating a variety of whole, high-fiber, high-antioxidant foods such as fresh fruits and vegetables) was something she could control to significantly increase her chances of spending twenty years with her grandchildren.
Judy wanted to know what herbs could do to reduce her dependence on drugs and protect her cardiovascular system. She had studied herbs and their benefits, and she enjoyed brewing herbal teas and finding herbal supplements to help her stay healthy. I told Judy that, as is the case with drugs, no modern clinical trials are available to demonstrate long-term benefits for extending life and improving quality of life with herbs for cardiovascular disease. I also mentioned that herbs definitely have fewer side effects than drugs, and in fact, they often have positive side effects—such as improved cardiovascular health—rather than just reducing symptoms.
To start, I gave Judy a cardiovascular formula that contained several herbs to improve blood flow to the heart muscle to slowly improve its health and increase pumping performance. A few human studies show that regular use of hawthorn leaf and flower (Crataegus spp.) and ginkgo leaf extracts (Ginkgo biloba) can do this. Plus, both hawthorn and ginkgo act as strong antioxidants to slow free-radical damage, reducing hardening and scarring of blood vessels. This can help slow the progression of high blood pressure and cardiovascular disease. I recommended that Judy take either ½ teaspoon of hawthorn tincture in a little water or herb tea, or 2 capsules or tablets of a standardized extract, twice daily. I suggested she add a ginkgo extract in the amount advised by the manufacturer.
For moderately reducing blood pressure, I gave Judy a liquid tincture preparation containing shepherd’s purse (Capsella bursa-pastoris) and the Chinese herb eucommia (Eucommia ulmoides). These were blended in a ratio of 50 percent each, and she agreed to take 4 droppersful in a little water, twice daily, away from mealtimes.
Gentle herbal diuretics such as celery seed tincture (Apium graveolens), dandelion freeze-dried leaf (Taraxacum officinale), or uva-ursi tips (Arctostaphylos uva-ursi) are often added to herbal programs to reduce blood pressure, but their overall effectiveness is not known. Celery seed tincture, however, has shown some benefits for hypertensive patients in open trials in China.
According to some recent studies, many herbs show promise for improving the balance and health of blood lipids—for instance, by reducing total cholesterol and by reducing oxidation of low-density cholesterol, which could slow the progression of cardiovascular disease.
To start, I recommended Judy put the power of heart-healthy foods to work for her by adding 1 or 2 cloves of garlic (Allium sativum) to her daily diet (crushed first before cooking or adding to food). Adding such healthy cholesterol-balancing foods as artichokes, grapes, and apples (which contain cholesterol-reducing pectins), ginger (Zingiber officinale), and whole, well-cooked beans, which contain isoflavones and soluble and insoluble fibers, was also on her new health menu.
I also gave Judy herbs such as oyster (Pleurotus ostreatus) or shiitake (Lentinula edodes) mushroom powder (1 teaspoon to 1 tablespoon with food twice daily) and artichoke leaf (Cynara scolymus) standardized extract powder, which some studies have shown to have excellent cholesterol-balancing effects. A recent human study indicated that oyster mushrooms contain similar compounds to the popular cholesterol-lowering drug Lovastatin, along with high amounts of soluble fiber.
From these herbal strategies, I expected to see an approximate 15 percent reduction in Judy’s blood pressure over a two-month period. Judy informed her doctor that she was taking some new herbs, and he and I e-mailed each other about the additions to her diet and supplement regime. Fortunately, Judy’s doctor was open to changes that would allow a reduction of her medications, because the drugs were causing Judy some discomfort. He agreed to reduce the dosages of the beta-blockers and the cholesterol- lowering drug she was taking after six weeks if we saw improvement. Judy’s blood pressure came down about 10 percent over six weeks and stayed there for another month. Her total cholesterol also came down a modest 12 percent, which improved to 15 percent after about three months. Encouraged by the results, she stuck with the herbs. Her doctor agreed to cut her medications, and after four months her blood pressure and cholesterol levels were where they had been with the higher medication doses.
Since last year when I was seeing her regularly, Judy has continued to make progress. The increased energy and enthusiasm she felt from reducing the medications translated into more time for exercise and cooking healthy food, which probably contributed further to reductions in cholesterol and blood pressure.
Judy was able to discontinue her medications altogether after fifteen months. I was impressed with her results and story—not every case ends so well. Some patients aren’t able to stick with the natural program and herbs long enough to get significant results. In our culture we often want quick results, but with heart disease developing over twenty or thirty years, it may take a year or two to really turn things around. Judy told me that the effort was genuinely worthwhile because of the increased energy and well-being she experienced. This translated into more active time with her grandchildren.
Christopher Hobbs’s case studies are gleaned from his thirty years of studying and practicing herbalism. Hobbs, a fourth-generation botanist and herbalist, is the creator of the new correspondence course Foundations of Herbalism. Visit his website at www.christopherhobbs.com.
“Case studies” is not intended to replace the advice of your health-care provider.
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