My 75-year-old mother has stable angina and takes medication for it, but still suffers chest pain when going up the stairs or walking. She’d love to be able to exercise more and not have to rely so much on her medication. Can you suggest any natural solutions?
T.S., via email
Typically described as a feeling of squeezing, heaviness, pressure or tightness, angina is a type of chest pain that develops when the heart muscles don’t get enough oxygen. Often this happens when the arteries that supply oxygen-rich blood to the heart become rigid and narrowed—a process known as atherosclerosis.
Stable angina, the form your mother has, is the most common type and is generally predictable, coming on when the heart has to work harder such as during exercise or climbing stairs. Unstable angina is classed as a medical emergency as it’s unpredictable and may signal a heart attack. Angina caused by spasms of the coronary arteries is known as variant angina.
Fortunately, natural medicine has plenty to offer when it comes to stable angina. Besides following a heart-healthy lifestyle that includes eating a balanced diet, not smoking, minimizing alcohol, maintaining a healthy weight and exercising regularly, here are some natural options found to alleviate angina. Crucially, many of them may help improve your mother’s ability to exercise, which is so important for heart health.
Just make sure your mother is monitored by a doctor and seeks medical help immediately if she notices any worsening of her angina, or if symptoms don’t go away within a few minutes of rest or medication.
Traditional Chinese herbs and techniques have proved effective in treating angina:
Herbs. Salvia miltiorrhiza (known as danshen or red sage) combined with conventional treatment was better than conventional treatment alone at reducing angina symptoms and the frequency of attacks in a review of 56 trials.1 And the herbal remedy suxiao jiuxin wan was superior to the standard drug treatment nitroglycerin for angina in a review of 15 trials.2
Acupuncture. This needling technique can improve angina symptoms and electrocardiography (ECG) results (showing heart rhythm and electrical activity) and reduce the need for medication.3
Acupressure. Similar in principle to acupuncture but using physical pressure rather than needles, this technique appears to be just as effective as nitroglycerin, but works faster and comes without adverse effects.4
Visit www.atcm.co.uk in the UK or www.nccaom.org in the US to find a qualified practitioner who can tailor-make a treatment plan specifically for you.
The amino acids L-carnitine and L-arginine can be helpful for angina. Taken as supplements, both appear to improve the ability of angina sufferers to exercise without chest pain or other symptoms.5 In one study, 23 percent of patients became free of angina with L-carnitine compared to just 9 percent with a placebo.6
Suggested dosages: L-carnitine: 1 g two to three times daily; L-arginine: 2 g three times daily
Supplementing with these antioxidants may be beneficial for angina:
Coenzyme Q10. Well-known for its heart-healthy effects, this vitamin-like substance was found to improve exercise tolerance as well as reduce angina attacks and medication use, although the results weren’t statistically significant.7
Suggested dosage:
150 mg/day ubiquinol
Vitamin E. Low levels of vitamin E have been linked to angina, and some evidence suggests that supplements can have a small but significant protective effect.8
Suggested dosage: 50 mg/day was the dose used in the study, but higher dosages are commonly used
Vitamin C. Angina sufferers have been found to have lower levels of vitamin C,9 and one study reported that vitamin C infusions were helpful for variant angina.10
Suggested dosage: 1–3 g/day
Several other nutritional supplements appear to be beneficial for angina:
Magnesium. This mineral can improve exercise tolerance, exercise-induced chest pain and quality of life in patients with coronary artery disease.11
Suggested dosage: 365 mg/day magnesium citrate
Bromelain. An enzyme derived from pineapple, bromelain has been found to minimize the severity of angina and control attacks.12
Fish oil. Those taking fish oil supplements saw a 40 percent reduction in angina attacks, while no change was seen in the placebo group.13
Suggested dosage: 10 g/day
According to herbalist Meilyr James, owner of the Herbal Clinic in Swansea, Wales (www.herbalclinic-swansea.co.uk), the herb of choice for stable angina is hawthorn (Crataegus monogyna). “Hawthorn increases the strength of the heart muscle and improves the oxygen uptake by the heart,” says James. “It has been shown to reduce atherosclerosis, the buildup of plaques in the artery walls, which plays a significant role in angina.” In fact, research shows the herb can be effective for alleviating angina symptoms. Hawthorn is very safe, says James, and can be taken over a period of several months.
How to take: Make a decoction of the berries (see box) and drink one cup per day (sweetened with honey if desired)
You can also make tea using hawthorn leaves and flowers and combine it with other helpful herbs, such as:
Motherwort (Leonurus cardiaca). This herb is good for heart issues aggravated by anxiety, says James, and traditionally used to treat angina worsened by effort.
Common lime (Tilia europaea). This encourages dilation of the blood vessels, reduces atherosclerosis and is valuable for those who feel agitated, says James.
How to take: Combine equal parts of the dried herbs (hawthorn, motherwort and common lime).
Use 1 Tbsp per mug of boiling water and infuse for
10 minutes. Drink one mug per day.
Alternatively, a tincture of these herbs can be used in the following ratio:
Hawthorn (1:3 tincture) 50 mL
Common lime (1:4 tincture) 25 mL
Motherwort (1:4 tincture) 25 mL
How to take: combine in one bottle and take 40 drops three times daily in a little water.
A couple of individual case studies suggest that following a plant-based diet might alleviate angina. In one, a 77-year-old woman (taking medication for angina) saw her symptoms more or less disappear one month after switching to a whole-food plant-based diet that included all vegetables, fruits, whole grains, potatoes, beans, legumes and nuts and excluded all animal-derived products, such as eggs, cow’s milk, yogurt, chicken and beef. Her symptoms quickly returned when she resumed her previous diet.14 Try adopting a plant-based diet for a few months to see if you notice an improvement.
Yoga and meditation both appear to be helpful for angina,15 so try incorporating these or other mind-body techniques, such as tai chi or qigong, into your life.
•Soak 4 Tbsp of berries overnight in 4 cups of water.
•In the morning, bring them to boil, using the same water they were soaked in, and simmer for 20 minutes with the lid on.
•Strain the berries from the liquid. This should produce around 3 cups of liquid hawthorn decoction.
•Any additional decoction can be kept in the fridge and warmed to make a drink as needed.
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