Natural treatments for angina
Natural treatments for angina, a condition characterized by chest pain due to insufficient oxygen supply to the heart muscle, focus on various supplements and herbal remedies that may enhance heart function and alleviate symptoms. L-carnitine and magnesium are highlighted as principal natural treatments; L-carnitine aids in energy production for the heart, while magnesium may improve oxygen transport and prevent blood vessel spasms, with studies suggesting both can enhance exercise capacity and reduce chest pain. Other proposed treatments include the herb Terminalia arjuna, which has shown promise in reducing anginal episodes and improving heart function, as well as amino acids like arginine and glutamine, and Coenzyme Q10.
While some herbal remedies such as hawthorn and khella are commonly recommended, their effectiveness remains largely unsubstantiated. Caution is advised when considering herbs and supplements, as they may interact with conventional medications. Additionally, adopting a plant-based diet has been associated with symptom relief for some individuals. It's essential to approach natural treatments for angina under the guidance of a healthcare professional to ensure safety and effectiveness, as angina requires careful management to prevent serious complications like heart attacks.
Natural treatments for angina
DEFINITION: Treatment of muscle cramping of the heart
PRINCIPAL PROPOSED NATURAL TREATMENTS: L-carnitine and L-propionyl-carnitine, magnesium
OTHER PROPOSED NATURAL TREATMENTS: Arginine, chelation therapy, the woolly plectranthus (Coleus barbatus), fish oil, glutamine, hawthorn, khella or toothpick weed (Visnagadaucoides), the Arjun tree (Terminalia arjuna), traditional Chinese herbal medicine, vitamin E, coenzyme Q10 (CoQ10)
Introduction
Angina is essentially a muscle cramp in the heart—the one muscle that cannot rest. Angina develops when the heart muscle does not receive enough oxygen for its needs from the coronary arteries. Angina is, therefore, a symptom of coronary artery disease. Atherosclerosis (hardening of the arteries) is the most common cause of coronary artery disease, which causes thickened arterial walls and impaired blood flow.
People usually experience angina as a squeezing chest pain, as if a heavy weight rested on the chest or a tight band wrapped around it. This is often accompanied by sweating, shortness of breath, and possibly pain radiating into the left arm or neck. Usually, angina is brought on by exercise because the more rapidly the heart pumps, the more oxygen it needs. Atherosclerosis is the most common cause of angina.
People with angina are at high risk for a heart attack, and treatment must take that into account. Drugs that expand (dilate) the heart’s arteries, such as nitroglycerin, can give immediate relief. Other drugs help over the long term by making the heart’s work easier. It is also important to slow or reverse the progression of atherosclerosis by treating high blood pressure and high cholesterol and by reducing other risk factors. Surgical treatments, such as angioplasty and coronary artery bypass grafting, physically widen the blood vessels that feed the heart.
Principal Proposed Natural Treatments
Angina is a serious disease that requires conventional medical evaluation and supervision. No one should self-treat for angina. However, alternative treatments may provide a useful adjunct to standard medical care when monitored by an appropriate healthcare professional. Dosages are not provided in this section because they should be individualized by a doctor.
L-carnitine. The vitamin-like amino acid L-carnitine is likely a good addition to standard therapy for angina. Carnitine plays a role in the cellular production of energy by transporting fats into mitochondria. Although carnitine does not address the cause of angina, it helps the heart use energy more efficiently, thereby enabling it to get by with less oxygen. L-carnitine can be taken in supplement form, but it also naturally occurs in several foods, including beans, avocados, dairy products, peanut butter, asparagus, fish, tempeh, and red meat, particularly lamb.
In one controlled study, two hundred persons with angina (the exercise-induced variety) either received a daily dose of L-carnitine or were left untreated. All study participants continued to take their usual medication for angina. Those taking carnitine showed improvement in several measures of heart function, including a significantly greater ability to exercise without chest pain. They were also able to reduce the dosage of some of their heart medications (under medical supervision) as their symptoms decreased. The results of this study cannot be fully trusted because it did not use a double-blind, placebo-controlled design.
A smaller trial that used a double-blind, placebo-controlled format evaluated fifty-two people with angina. The results showed that daily use of L-carnitine significantly improved symptoms compared with a placebo. Other studies (both single-blind and double-blind) used a special form of L-carnitine called propionyl-L-carnitine, and researchers found evidence of benefit. Notably, L-carnitine and propionyl-L-carnitine are used to treat angina, but the form acetyl-L-carnitine is more useful for Alzheimer’s disease and brain disorders.
Magnesium. Magnesium has actions in the body that resemble those of drugs in the calcium channel blocker family, although much weaker. Because these drugs are useful for angina, magnesium has been tried too. In a six-month, double-blind, placebo-controlled study, 187 persons with angina were given either daily oral magnesium or a placebo. The results showed that the use of magnesium significantly improved exercise capacity, lessened exercise-induced chest pain, and improved general quality of life. Similarly, two double-blind, placebo-controlled studies, enrolling about one hundred people with coronary artery disease, found that supplementation with magnesium significantly improved exercise tolerance.
Magnesium decreases angina symptoms by improving the transport of oxygen to the heart and preventing spasms in blood vessels. Additionally, individuals who are naturally deficient in magnesium are susceptible to more anginal incidences because the smooth muscle tissue in the heart muscle depends on magnesium to regulate ions needed to avoid hyper contractions and pain. Magnesium may be consumed in supplement form, but it can also be consumed in black beans, pumpkin, soy products, almonds, cashews, spinach, bananas, and avocados. Similarly, magnesium is also helpful in preventing heart arrhythmias.
Other Proposed Treatments
A one-week, double-blind, placebo-controlled crossover trial of fifty-eight people evaluated the effectiveness of the herb Terminalia arjuna for angina by comparing it with a placebo and with the standard drug isosorbide mononitrate. The results indicated that the herb reduced anginal episodes and increased exercise capacity. It was more effective than the placebo and approximately as effective as the medication. A subsequent three-month study compared the effectiveness of T. arjuna with the placebo in forty people who had recently had a heart attack. All participants in this study had a particular complication of a heart attack called ischaemic mitral regurgitation. The results showed that the use of the herb improved heart function and reduced angina symptoms. Another study found benefits with an Ayurvedic herbal combination containing T. arjuna.
Preliminary evidence suggests that the amino acids arginine and glutamine might improve exercise tolerance in angina. CoQ10 is best known as a treatment for congestive heart failure, but it also offers benefits for angina. However, it also may interfere with some blood thinner medications. N-acetylcysteine may be helpful when taken with the drug nitroglycerin, but severe headaches may develop.
Results are conflicting on whether the omega-3 fatty acids found in fish oil are helpful for people with angina. The herbs hawthorn, khella, and Coleus barbatus are often recommended for angina by herbalists, but there is no meaningful evidence that they work. Vitamin E has been found to be only slightly effective for angina, and beta-carotene may increase angina. Chelation therapy is widely promoted for the treatment of angina, but there is no meaningful evidence that it is effective, and there is some evidence that it is not.
In a randomized trial of sixty-six adults with angina, four weeks of daily Chinese herbal Shenshao tablets (containing ginsenosides and white peony) were found to reduce angina frequency and improve quality-of-life scores. Similar studies also found various traditional Chinese medicine techniques effective. One should be cautious of taking certain herbs and supplements, which may interact adversely with drugs used to treat angina.
In a small number of studies, a plant-based diet was found to improve angina symptoms, and when the participants resumed a typical Western diet, their symptoms returned. Though most of the studies surrounding this topic fail to meet the standards necessary to find scientific proof, many people advocate for this diet change in the treatment of angina.
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