Episodes of angina can actually protect your heart from heart attack, and here are a few other remedies to help tip the balance in your favour, says Dr Harald Gaier
I am 52 years old and have had a few episodes of pressure and pain in the centre of my chest, recently diagnosed as angina pectoris. What should I be doing to improve my condition?
Ella McPh., Glasgow
Angina pectoris, as you were probably told, is a spasm of the coronary arteries. Most forms of alternative medicine, particularly naturopathy, set great store by the healing power of nature, and angina is an excellent example of this formidable power in action. Contrary to popular belief, the symptoms of inadequate oxygen to the heart muscle-angina-does not necessarily mean an inevitable decline, as it may often lead to a lower risk of heart attack.1
Experimental studies have shown that two amazing, paradoxical, changes are generally seen in heart muscle after a brief spell of ischaemia (obstructed but non-lethal blood flow to the heart) followed by a renewed blood supply that thereafter protects against heart attack.2
One adaptive change is the development, in cases of long-term stable angina, of collateral (additional) coronary vessels and potentially lifesaving anastomoses (connections formed between two previously separate blood vessels).3 The other is so-called ischaemic 'preconditioning',4 which protects against myocardial infarction and sets up a subsequent long-lasting effect that can ward off heart attacks.5
Many complex (and some rather perplexing) mechanisms have been proposed to explain this protective effect, and concerted efforts are being made to find a possible chemical mediator.6 Several studies suggest that activation of the protein kinase C enzyme may be involved in this protective mechanism against ischaemia, but the many likely knock-on effects on other kinases and enzymes are unclear.7
Patients with angina before a heart attack differ from those without angina before such an attack in that the former are likely to seek clot-busting help earlier and are probably taking nitrates or other antianginals; they also most likely have a better-developed collateral vascular support system to avoid arterial blockages.
So, the good news for angina sufferers like yourself is that a history of preinfarct angina suggests a reduced risk of heart attack and an improved prognosis.8
In the procedure called 'coronary angioplasty', a balloon is inflated within the coronary artery to stretch the diameter of the vessel and push any obstructions out of the way. But the balloon also obstructs coronary blood flow, at least temporarily, which can lead to 'transient myocardial ischaemia', with pain just like an ordinary angina attack-in other words, an artificially induced episode of angina.
This may well mean that angioplasty 'works' by harnessing the healing power of nature in response to the 'angina' caused by angioplasty. Indeed, it may be another example of ischaemic preconditioning.9
But this doesn't mean we should stop treating angina pectoris, as breakthrough episodes of angina can trigger preconditioning too.
And neither should any of our readers wait until they get angina before worrying about their hearts because, in more than 50 per cent of cases, the first sign that something is seriously wrong with the blood supply to the heart is having a heart attack-and
about half of those having such an attack
die on the spot.
What to try instead
Homeopathy.Crataegus oxyacantha (hawthorn) has been widely used in tincture form with great success ever since numerous published studies, beginning in 1939, have confirmed the non-toxic efficacy of this reliable remedy for protecting the heart following ischaemia.10
Coenzyme Q10 (ubiquinone).A daily 150-mg dose of CoQ10 brought about a 53 per cent reduction in angina attacks in 12 patients with stable angina in a high-quality trial.11 In another study, a daily dose of only 30 mg of CoQ10 led to measurable improvement after two months in more than half of 20 patients with congestive heart failure due to either hypertensive or ischaemic heart disease, while 30 per cent saw a "remarkable decrease" in chest congestion.12 In addition to helping with angina problems, there is good evidence that CoQ10 can reliably provide substantial help with other related cardiac disorders, such as mitral valve failure, arterial hypertension and severe cardiomyopathies (diseases of heart muscle that can lead to heart failure and heart transplantation).
Herbs.Ammi visnaga (khella) is a wild member of the carrot family that grows in Africa; its extract visnadine, available as Carduben (Madaus AG, Cologne, Germany), has clinical evidence of a good response in angina pectoris, particularly when treatment is continued between attacks.13
It can improve blood supply to heart muscle, screen against sympathetic nervous system impulses and improve the efficiency of myocardial metabolism-in other words, it prevents heart rate increases and the effects of hypotension (too-low blood pressure). Although its symptomatic relief may be rapid in cases of a fresh heart attack, Carduben needs to be taken for some time to be fully effective. It can be taken safely together with typical heart drugs like strophanthin, digitalis, anticoagulants and hypotensives. (Carduben is available in the UK from Natural Touch Ltd, 7 Dragoon House, Hussar Court, Waterlooville PO7 7SF, Hampshire, tel: 01705 791 799; in the USA from Murdock Madaus Schwabe Professional Products, Inc, 10 Mountain Springs Parkway, Springville, UT 84663, tel: 800 613 0102.)
Besides Carduben, extract of barberry root bark (Berberis vulgaris) can treat and prevent cardiac arrhythmias due to ischaemia.14
Ditch dairy.There's plenty of evidence that cow's milk, even with the butterfat removed, causes clogging of the arteries.15
Vitamin C.Even a marginal vitamin C deficiency can contribute to cardiovascular diseases like atherosclerosis and angina.16
Vitamin E and selenium.Deficiencies in these nutrients may be associated with increased LDL (bad) cholesterol, and supplementation can reduce angina pain in such cases. In one study, 22 out of 24 patients taking daily doses of 1 mg of selenium and 200 IU of vitamin E reported reduced angina pain compared with three out of 24 patients taking a placebo.17
And note that anyone taking omega-3 fatty acids, which are also beneficial for angina, needs to also increase their intake of vitamin E to prevent possible cellular damage.
Beta-carotene (or vitamin A).The evidence shows that the lower your blood levels of beta-carotene, the higher your risk of angina, so make sure you're getting enough.18
Proteolytic enzymes.Bromelain, the enzyme derived from the pineapple plant, has a fibrinolytic action (it breaks down fibrin in blood clots) useful for angina and related cardiovascular disorders. In one study, angina patients taking around 1,200 mg of bromelain every day were symptom-free within four to 91 days, depending on the extent of sclerosis of their coronary arteries. The symptoms returned on stopping bromelain.19
Steer clear of cadmium.This toxic metal, whether it's airborne, in cow's milk or in cigarettes, appears to be firmly linked to cardiovascular disease that ultimately leads to death.20
Go Ayurvedic.Abana, an Ayurvedic herbomineral medicinal preparation containing Terminalia arjuna, Withania somnifera, Tinospora cordifolia, Boerhaavia diffusa and Nardostachys jatamansi, resulted in one experimental double-blind study in significant improvement of left-ventricular heart function as well as a significant fall in diastolic blood pressure (there was mild hypertension).
It does this by easing the degree of heart muscle expansion and contraction needed to pump blood around the body, which would also have beneficial effects on coronary ischaemia.21
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Yamasawa I et al. 'Experimental studies on effects of co-enzyme Q10 on ischaemic myocardium', in Folkers K et al., eds. Biomedical and Clinical Aspects of Coenzyme Q, vol 2. Amsterdam: Elsevier, 1980: 333-47
van Fraechem JHP et al. 'Co-enzyme Q10 and physical performance in myocardial failure', in Folkers K et al., eds. Biomedical and Clinical Aspects of Coenzyme Q, vol 4. Amsterdam: Elsevier, 1984: 281-90
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Harald Gaier, one of the UK's leading experts on alternative medicine and a registered naturopath, osteopath, acupuncturist, homeopath and herbalist, practises at The Allergy and Nutrition Clinic, 22 Harley Street, London. Visit his website at www.drgaier.com.
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