Contrary to popular belief, the symptoms of angina pectoris (lack of oxygen to the heart) may not always lead to heart disease. Instead it can lead to immediate increased resistance to heart attacks (Lancet,1996; 347:1059-1062).

Two amazing adaptive changes generally occur within the heart muscle after a brief attack of angina (Circulation, 1986; 74:1124-1136). One is the development, over a longer period, in cases of stable angina, of alternative blood vessels through which blood flow can be maintained (Circulation, 1991; 83:1084-1086). The other is a more general protective and strengthening effect on the heart (J Am Coll Cardiol, 1994; 24:1133-1142; J Mol Cell Cardiol, 1995; 27:1023-1034). Observations of these changes are well established (Cardioscience, 1990; 1:89-98), though not well understood and many complex theories have been proposed to explain them (Pharmacol Res, 1995; 31:1-6; Lancet, 1993; 342:6).

This doesn't mean that we should stop treating angina, because even with treatment the protection continues. It also doesn't mean we should stop worrying about heart disease because in half of cases the first heart attack is your last.

Co-enzyme Q10 (ubiquinone) is a vitamin like substance found in the heart muscle. Given in 150mg daily doses, it can bring about a substantial reduction in anginal attacks (Biomediese en Wetenschap lieke Drukkerij (Amsterdam), 1980; II:333-347). In a daily dose of only 30mg half of patients will experience improvement (ibid, 1984; IV:281-290). It's also been shown to increase stamina (Am J Cardiol, 1985; 56:247).

In herbal medicine, Ammi visnaga is a wild member of the carrot family that grows in Africa. The extract visnadine is available as a branded German product called Carduben. There is good evidence that it improves blood supply to the heart muscle and improves the overall efficiency and chemistry of the heart (R F Weiss, Herbal Medicine, Ab Arcanum, 1988). It doesn't increase the heart rate or lower blood pressure, so it can be given safely with heart and hypertensive drugs.

Another good herb is extract of barberry root bark (Berberis vulgaris), proven to treat or prevent irregular heart beats (Chung Hua Hsin Hsueh Kuan Ping Tsa Chih, 1990; 18(3):155-156).

Bromelain, an enzyme from the pineapple plant, has an action which is useful in angina and related cardiovascular disorders (Erfahrungsheilkunde, 1978; 5:274-275). Nevertheless, you must continue taking it indefinitely, since symptoms have been shown to recur after it's stopped.

It's a good idea to avoid cow's milk, even if the fat is removed, which has been shown to cause hardening of the arteries (DJL Freed, Health Hazards of Milk, Bailliere Tindall, 1984). You also need to keep up your levels of vitamin C, since even a slight deficiency can contribute to atherosclerosis and angina (J Hum Nutr, 1981; 35:53-58). Deficiencies of vitamin E and selenium are also associated with heart problems; taking supplements of both have been shown to reduce anginal pains (JAMA, 1996; 275:693-8); Ann Rev Pharm, 1975, 18:259).

Omega-3 fatty acids are also beneficial in angina, but you need to take additional vitamin E with it to prevent cellular damage.

Although beta carotene has taken a beating in the press lately, solid evidence shows adequate levels are important to prevent heart disease. Low levels in the blood tend to be associated with a higher risk of angina (Lancet, 1991; 337:1-5).

If you suffer from angina, it's a good idea to have your levels of toxic metals checked out, particularly your levels of cadmium. Too high levels are firmly linked with potentially fatal cardiovascular disease (J Am Med Ass, 1966; 198:267; Ecologist, 1971, 1:11).

A final herbal possibility is Abana, a preparation in Ayurvedic Medicine, containing herbs and minerals: Terminalia arjuna, Withania somnifera, Tinospora cordifolia, Boerhaavia diffusa and Nardostachys jatamansi. Patients using it have recorded a significant improvement in valve and pump function and in blood pressure (Jpn Heart J, 1990; 31(6):829-35).

!AHarald Gaier

Harald Gaier is a registered naturopath, homeopath and osteopath.