Heart problems like high blood pressure and cholesterol can be reduced with the likes of gingko biloba, hawthorn, and garlic.

Recently, I attended a local fund- raiser for the American Heart Association. Many attendees were local physicians, including the leading heart specialists in the area. I thought to myself, not one of these physicians has been taught about herbal approaches to the prevention or treatment of heart disease. Education on herbal medicine simply is not a part of medical training in the United States, as it is in other developed countries, notably Germany and Japan.

When it comes to medical conditions as serious as heart disease, I would like to be under the care of a physician who specializes in heart disease. It's not like a common cold or flu, which can be self- diagnosed, self- medicated, and whether or not you do anything for it, will go away on its own. Heart disease is serious. While most of us consider medical professionals to be our primary health advisors, it's also our responsibility to inform health care providers about our interest in scientifically- proven alternative treatments.

Cardiovascular Diseases

The old adage that an ounce of prevention is worth a pound of cure is probably more valuable when it comes to heart conditions than any other medical problem. Heart disease is still the number one killer in the United States. Risk factors known to most Americans include smoking and lack of exercise. Having a healthy heart means having a healthy lifestyle. But sometimes genetic risks are working against us that we can do little about. Twenty years ago, I was out for a slow- paced morning jog with a friend who was a vegetarian, in good physical shape, and who led what would be considered a very healthy lifestyle. On our jog, my friend died of a heart condition. He was only 36 years old. His father had died of the same condition at the same age.

There are a number of cardiovascular- related conditions that can respond to judicious herbal treatments. These include risk factors such as high cholesterol and hypertension (high blood pressure), which can contribute to atherosclerosis, angina, and congestive heart failure.

Atherosclerosis, a major contributing factor to heart disease, is produced by a build- up of fatty plaques on the walls of narrowed arteries. This condition, also referred to as "hardening of the arteries," is manifested by the loss of elasticity and thickening of the arterial wall, which sets in motion the narrowing of the arteries.

Atherosclerosis can reduce blood flow, hence oxygen supply to the heart muscles, leading to secondary angina attacks, characterized by a pressured or squeezing pain in the chest. The attacks can occur during exercise or high stress. Besides squeezing pain, pain may develop in the left shoulder and arm. This can be a warning sign of a heart attack.

Herbs, when made part of the diet or dietary supplementation, can help reduce risk, by lowering cholesterol and blood pressure, lessening or preventing the effects of atherosclerosis or angina pectoris, and may even be useful in the treatment of congestive heart failure.

Garlic

Garlic is one of the single most useful herbs for reducing factors associated with cardiovascular disease, including reducing high cholesterol and high blood pressure. In the past 20 years, over 1,000 papers on the chemistry, pharmacology, and clinical applications of garlic (Allium sativum) have appeared in scientific journals. Over 250 of the garlic papers published from 1950-1992 involved studies related to the cardiovascular system. With few exceptions, the same overall conclusions were reached in the human studies. In specified dosages, garlic preparations are effective as antithrombotic (preventing blood clotting in vessels) and antiarteriosclerotic (preventing hardening of the arteries) agents, and can reduce blood pressure.

As an antithrombotic agent, garlic preparations prevent blood platelet aggregation. Platelet aggregation occurs when blood platelets become sticky and cling together. Garlic also acts as an agent which increases fibrinolysis (a natural process that dissolves blood clots), in essence helping to thin the blood, slowing and balancing coagulation, and preventing excessive clotting of blood. When fibrinolytic activity becomes impaired, it may lead to an increased risk of blood clotting and thrombosis (blood clots within vessels). Excessive clotting, and platelet stickiness are factors leading to slowing down circulation and increasing blockage of blood vessels.

Various studies have focused on the ability of garlic to reduce cholesterol, triglycerides (blood fats), and increase high- density lipoprotein (HDL- the "good" cholesterol) in the blood. HDL- cholesterol helps transport fats to the liver where they can be broken down and sent to other parts of the body, where they can be utilized or eliminated. Long term ingestion of garlic has been shown to reduce serum cholesterol and triglyceride levels in both normal patients and those with high cholesterol. There have been at least 33 human studies with fresh garlic or powdered garlic products related to cholesterol and lipid lowering effects. All but one study showed positive results.

Based on the many positive studies, the German government allows garlic products to be used therapeutically for assistance in lowering elevated blood cholesterol, and helping to prevent age- related changes of the vascular system. The specified daily dose is four grams of fresh garlic per day, or prepared garlic supplements in corresponding doses. While garlic's chemistry is extremely complex, pharmacological and clinical studies conducted since 1988 point to allicin as one of the most important compounds. Positive effects can be expected from a daily dose of 900 mg garlic powder, with 5.4 mg allicin (standardized to 0.6% allicin per 100 mg). Garlic should be taken for several weeks or months for positive benefits.

Ginkgo

The best- selling phytomedicine on the European market is derived from the leaves of an ancient tree, Ginkgo biloba. Complex, standardized extracts of ginkgo leaf, calibrated to 24% bioflavonoids, as well as terpenoids- ginkgolides and bilobalide (all important ginkgo phytochemicals), have been used in dozens of clinical studies. Results of these studies apply only to the extract, and not, for example, to ginkgo leaf made into a tea. Many clinical studies have shown the benefits of ginkgo leaf extract improving circulation to the smaller blood vessels in the brain and extremities, and aiding a wide- range of disease conditions resulting from insufficiency of cerebral and peripheral circulation such as memory loss and claudication, (hardening of the arteries of the leg- which is a common condition in older people, causing cramping pain in the calf muscles when walking short distances).

In Germany, ginkgo is prescribed by physicians for cardiovascular diseases. It's important to have a proper diagnosis and medical supervision when using ginkgo to treat cardiovascular conditions. Its best known effect is to improve blood flow to the brain and extremities. Artery obstruction in the heart or the legs can cause angina pectoris. Narrowing of the arteries supplying the brain can lead to stroke. Administration of ginkgo leaf extracts for several weeks or months has been found to be useful in improving circulation in the management of these and other conditions. In patients with arterial occlusive disease, ginkgo extracts have proven useful in increasing the distances patients can walk pain- free. The flavonoids (plant pigments) in the leaf are also powerful free radical scavengers.

Generally, dosage of standardized ginkgo leaf extracts falls in the range of 120 to 240 mg daily, divided into two or three doses. Consult with your medical practitioner before using ginkgo for cardiovascular disease.

Hawthorn

Over 280 hawthorns (Crataegus species) are found in east Asia, Europe, and North America. Whenever closely related plant species are used by different cultures on opposite sides of the globe for similar medicinal purposes, there is a good chance of a rational scientific basis behind that use. Such is the case with hawthorns, whose fruits as well as leaves and flowers have been used in European, Chinese, and American traditions for treating heart disease.

In Europe, two hawthorn species are used, English hawthorn, Crataegus laevigata (synonym: Crataegus oxyacantha), as well as Crataegus monogyna. In Chinese medicine, Crataegus pinnatifida is used. Hawthorn is used by medical practitioners in Europe and China for management of early stages of congestive heart failure. Congestive heart failure is a serious condition. The New York Heart Association classifies the condition in four stages. Stage I, the patient is without symptoms at rest. In Stage II, impaired heart function with shortness of breath are experienced with moderate physical effort. At Stage III, minor physical exertion can cause shortness of breath and fatigue. In Stage IV, shortness of breath are experienced even at rest, and there is fluid buildup around the lungs and the ankles. Stage I & II may respond favorably to judicious use of hawthorn extracts.

There are a number of cardiovascular conditions that can respond to judicious herbal treatments including high cholesterol & hypertension.

The European species used in Europe for the treatment of diminished cardiac performance corresponds to Stages I and II of the New York Heart Association's congestive heart failure scale. Hawthorn also is used to reduce a sensation of pressure or anxiety in the heart area, a result of age-related heart problems not requiring digitalis (a plant-derived drug used to treat congestive heart failure), and for mild forms of arrhythmias (irregular heartbeats). Preparations are standardized to phytochemical compounds called oligomeric procyanidins and flavonoids. The dose is 160 mg per day (in two doses), or under a physician's supervision as much as 160 mg three times daily may be prescribed. Traditionally, a tea made from four to five grams of the fruits also is used. No side effects or conditions under which you should not take the herb, like pregnancy or hypertension, are known.

Numerous pharmacological and clinical studies have shown that hawthorn extract will help improve blood flow to the heart. It improves contractions of the heart muscle, improving efficiency of blood pumping. Hawthorn extracts also have been shown to improve circulation to the extremities by helping to reduce resistance in the arteries.

The collective experience of indigenous cultures in Asia and North America, coupled with extensive research on Hawthorn species in modern China as well as Europe, have shown that the plant is of use in the treatment of heart disease and should be intensively considered by the U.S. market as well.

Garlic, ginkgo, and hawthorn are just a few herbs that can be used to improve cardiovascular function. Advancing their use in the United States means educating the public and the medical profession about the benefits of these herbs.