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Angina treatment without drugs

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If you suffer from angina-in other words, chest pain due to a lack of oxygen to the heart-there’s a long list of drugs available to treat it, ranging from aspirin to beta-blockers and statins. But, happily, there’s also a growing number of natural options showing promise as treatments for this common heart condition.

What is angina?

Angina is a type of chest pain-typically described as a feeling of squeezing, pressure, heaviness or tightness-that develops when the muscles of the heart are not getting enough oxygen. This usually arises when the arteries that supply oxygen-rich blood to the heart become rigid and narrowed-a process that is known medically as ‘arteriosclerosis’.

Angina is a warning sign that your heart is at an increased risk of an attack, which can happen if one of the coronary arteries becomes completely blocked.

There are two main types of angina: stable and unstable. Stable angina is usually predictable, and generally develops when your heart has to work harder, such as during exercise or climbing stairs. Unstable angina, in contrast, arises unexpectedly and can strike even at rest. The pain is usually more severe and, as it may be a sign of an impending heart attack, is regarded as a medical emergency.

The following natural alternatives are helpful for stable angina:

  • Nutritional supplements:

Several supplements are proving useful for angina in clinical studies.

  • l-Carnitine. A few studies have found that this amino acid can improve heart function and reduce the symptoms of angina. In one, 1 g of l-carnitine twice daily increased exercise tolerance and resulted in positive changes in terms of electrocardiography results compared with a placebo (Int J Clin Pharmacol Ther Toxicol, 1985; 23: 569-72).

Another study also reported similar findings (J Assoc Physicians India, 2000; 48: 1050-2).

  • l-Arginine. Another ami-no acid, l-arginine also appears to help against angina. In one study, 3 g/day for 15 days resulted in several protective effects in angina patients, including an increase in the activity of the free-radical-scavenging enzyme superoxide dismu-tase (SOD) and a decrease in cholesterol levels (Oxid Med Cell Longev, 2009; 2: 231-7).
  • Coenzyme Q10. This popular supplement is already well known for its heart-healthy effects. In a small, four-week study of patients with chronic stable angina, taking 150 mg/day of CoQ10 tended to reduce angina frequency as well as medication use compared with a placebo, although the results were not statistically significant. Nevertheless, there was a significant increase in the amount of exercise the CoQ10 group could manage compared with the placebo group (Am J Cardiol, 1985; 56: 247-51).
  • Antioxidants. Low levels of antioxidants in the blood, especially vitamin E, appear to be linked to angina (Lancet, 1991; 337: 1-5; Ann N Y Acad Sci, 1989; 570: 291-5). In one trial, supplementing with 50 mg/ day of alpha-tocopherol led to a small reduction in the frequency of angina attacks (JAMA, 1996; 275: 693-8).
  • Magnesium. This essen-tial mineral has been found to improve endothelial function [the functioning of the cells that line the blood vessels] in patients with coronary artery disease. It’s also been shown to signif-icantly improve exercise tolerance, reduce exercise-induced chest pain and improve the quality of life in such patients after six months of use (365 mg/day as magnesium citrate) (Am J Cardiol, 2003; 91: 517-21).
  • Bromelain. This enzyme, derived from pineapple, can prevent or minimize the severity of angina. In one study, 400-1000 mg/day of bromelain given to 14 patients with angina resulted in the disappear-ance of symptoms in all patients within 4 to 90 days (Alt Med Rev, 1996; 1: 243-57).
  • Fish oil. In 39 patients with coronary artery disease, those given 10 g of fish oil daily experienced a 40-per-cent reduction in angina attacks, whereas no changes were seen in the placebo group (Angiology, 1994; 45: 1023-31).

  • Traditional Chinese Medicine

TCM techniques have proved useful for treating angina, so it may be worthwhile consulting a qualified TCM practitioner.

  • Acupuncture. An uncon-trolled study of 49 angina patients found that acupunc-ture resulted in 58-per-cent less nitroglycerine use (one of the drugs used to control angina) and a 38-per-cent reduction in the number of angina attacks (Acupunct Electrother Res, 1995; 20: 101-16). In another study, real acupuncture was tested against fake acupuncture, where needles were inserted randomly rather than into the traditionally determined acupoints. The use of nitro-glycerine decreased in the real acupuncture group while exercise tolerance was increased, whereas no signif-icant effects were reported in the sham acupuncture group (Acta Med Scand, 1986; 220: 307-13).
  • Herbs. Various Chinese herbs have been successfully used to treat angina. A review of 15 trials involving more than 1700 people found the mixture of herbs known as suxiao jiuxin wan to be an effective remedy for angina with no serious side-effects (Cochrane Database Syst Rev, 2008; 1: CD004473). Tong-xinluo and Kangxin capsules also appear to work (Chin J Integr Med, 2011; 17: 903-7).
  • Acupressure. In a trial of 168 patients with angina related to coronary heart disease, this technique was found to have effects similar to nitroglycerine, but it worked faster and had no adverse side-effects (Zhongguo Zhen Jiu, 2011; 31: 595-8).

  • Lifestyle changes

Besides stopping smoking, losing excess weight and eating a heart-healthy diet, there are a number of spec-ific steps you can take to improve your heart health and reduce symptoms of angina.

  • Exercise. Regular exercise is an invaluable treatment for chronic angina. As researchers Anil Nigam and Jean-Claude Tardif from the Montreal Heart Institute in Quebec, Canada, point out, “Regular exercise is associated with several cardio-protective effects, including improving endothelial func-tion and reducing systemic inflammation” (Heart Metab, 2008; 38: 34-7). Moreover, exercise can reduce the symptoms of angina and cut the frequency of attacks. In one study, intense exercise for just 10 minutes a day was as effect-ive as beta-blocker drugs in patients with angina (Br Heart J, 1990; 64: 14-9). However, make sure you consult your doctor before launching out on an exercise programme.
  • Get enough sleep. Getting the right amount of sleep is important for a healthy heart, according to a large US study. Data from more than 30,000 participants revealed that people who got just five hours of sleep a night or less were more than twice as likely to suffer from angina as people who got seven hours of sleep a night-apparently the ideal amount. What’s more, sleeping too much-nine hours a night or more-was associated with a significantly greater risk of heart attack and stroke (Sleep, 2010; 33: 1037-42).
  • Meditate. Transcendental Meditation (TM), a form of meditation that uses man-tras, was found to improve angina-like chest pain andto normalize electrocardiograms (ECGs) in a small study of patients with cardiac syndrome X, a form of angina in people with otherwise normal coronary arteries (Am J Cardiol, 2000; 85: 653-5, A10). Although these patients didn’t have the classical type of angina, their chest pain was thought to result from anxiety, which can reduce blood flow to the heart, and their ECGs resembled those of classical angina patients. Other research shows that TM is associated with reductions of hype
    rtension (high blood pressure) and atherosclerosis, as well as with improvements in other risk factors of heart disease such as smoking less and lowering cholesterol levels (Aust Fam Physician, 2002; 31: 164-8).
  • Practise yoga. In a randomized, controlled trial of 42 men with coronary artery disease, one group was treated with conven-tional methods, including the American Heart Asso-ciation diet, while the other group was assigned to a programme consisting of yoga practice, moderate aerobic exercise and dietary restrictions. After one year, the yoga group showed a significant reduction in the number of angina episodes per week together with an improved exercise capacity and a decrease in body weight. Cholesterol levels (total and ‘bad’ LDL cholesterol) also showed greater reduc-tions compared with the control group. Moreover, rates of coronary angioplasty or bypass surgery were considerably lower in the yoga group (J Assoc Physicians India, 2000; 48: 687-94).
  • Cut the coffee. People who drink a lot of coffee are at a higher risk of angina, according to some evidence. In one large long-term study, men who drank five or more cups of coffee a day had nearly three times the risk of angina compared with non-coffee drinkers (N Engl J Med, 1986; 315: 977-82).

Joanna Evans

Factfile: Other signs of angina

In addition to chest pain, some people with angina also experience:

  • breathlessness
  • nausea
  • dizziness
  • belching (burping)
  • restlessness
  • tiredness
  • pain elsewhere in the body, such as in the arms, chest, neck and jaw.

WDDTY VOL 22 NO 11, February 2012

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