Botanical Therapies
Research has confirmed the effectiveness of a number of traditional cardiovascular botanicals. Arjuna from the bark of the Terminalia Arjuna tree is recommended in Indian Materia Medica for endocarditis, mitral regurgitation, pericarditis, angina, and as a heart tonic44. Several double-blind, placebo-controlled trials have illustrated arjuna’s effectiveness. Among 58 males with chronic stable angina, arjuna treated patients had significantly decreased frequency of angina and significantly better treadmill parameters45. Among 105 patients, total cholesterol in the arjuna group decreased from 8-13%, LDL cholesterol decreased from 16-26%, and lipid peroxide levels decreased significantly46. In a study of 12 patients with chronic congestive heart failure, arjuna treatment resulted in improvement of congestive heart failure symptoms, including stroke volume and ventricular ejection47,48. In 20 angina patients, arjuna treatment resulted in a 50% reduction of angina episodes; lower systolic blood pressure; and slight increases in HDL cholesterol and ventricular ejection49,50. Safety was demonstrated in all studies.
Elmwood Park, NJ-based Nutraceuticals International imports arjuna through a joint venture with Indian producer Amruta Herbals Pvt. Ltd. It is standardized to 25% tannins and is ethanol-extracted. “Arjuna is widely distributed in India. Now we are bringing these ancient healing techniques to the forefront of the American market,” said Deborah Vickery, Nutraceuticals International’s director of new product development.
Gugul, an oleoresin from the Comiphora mukul tree, is another Ayurvedic herb with thousands of years of usage in Asia. In a 12-week multi-center open trial of 205 patients, over 70% of patients lowered their cholesterol by an average of 24% and triglycerides by 23%51. In a double-blind, crossover study of 233 patients, subjects’ cholesterol lowered 11% and triglycerides 17% in the gugul treatment group. HDL also increased among 60% of the gugul group52. Other human and in vivo studies have also supported these findings53,54.
Hawthorn berry, or Crataegus oxyacantha, has been used traditionally for angina pectoris, valvular deficiency, endo-myo and pericarditis, tachycardia, cardiac neuralgias, palpitation and rheumatism of the heart55,56,57. Various double-blind, placebo-controlled, randomized human studies have shown hawthorn’s efficacy among heart patients: Hawthorn treatment increased arteriole tone, cardiac performance, orthostatic blood pressure58; improved diastolic blood pressure and anxiety59; increased exercise times, quality of life and improved dyspnea60; increased contraction force and force generation61; improved cardiac pressure, heart rate and quality of life62; and improved palpitation, dyspnea, resting pulse, ST depression, arrhythmias, and myocardial perfusion63.
This research has prompted hawthorn’s exponential growth in the marketplace. Antoine Dauby, marketing manager for France-based Naturex, explains that the company’s Moroccan plant—where they work with local growers to harvest the hawthorn plant’s berries, leaves and flowers—is probably the world’s largest hawthorn operation. “We experienced 25% growth in our hawthorn extract sales for 2007 versus 2006,” Mr. Dauby said. Hawthorn 5/7:1 extract from Naturex is standardized to vitexin-2”-O-rhamnoside.
Pycnogenol, an extract of the French maritime bark tree, has also been shown to have various cardiovascular benefits. A 2007 double-blind, randomized, placebo-controlled study carried out at Hiroshima University revealed that Pycnogenol stimulates the production of nitric oxide (NO), enabling increased blood flow and artery expansion64. Frank Schönlau, PhD, director of scientific communications for Horphag Research, worldwide distributors of Pycnogenol, explained, “It has already been shown in various studies that Pycnogenol makes platelets less ‘sticky’ and lowers high blood pressure by supporting better NO production. The fact that Pycnogenol acts as catalyst for more efficient NO production in healthy young men suggests that Pycnogenol allows their bodies to adapt more quickly to sudden metabolic challenges such as physical exercise.”
Garlic (Allium sativum) has been lauded for its ability to lower blood pressure, thin blood, lower cholesterol and reduce oxidative radicals. Although questioned for its blood lipid-reducing effects, it has been suggested its active constituent levels are often lost during heating and extraction techniques65. Even so, a meta-analysis of 1798 reports, 45 randomized human trials and 73 additional studies standardized to placebo-controls point to conservative yet real reductions in total cholesterol, triglycerides and LDL, along with significant reductions in platelet aggregation66. Other human and in vitro studies have concluded that garlic results in increased tissue blood flow67; platelet aggregation inhibition68,69; inhibition of thrombosis70; protection against oxidation and glycation of LDL71; lowered artery-wall adhesion via cholesterol ester transfer protein activity72; fibrinolytic activity; decreased artery wall thickening and decreased atherosclerosis effects73; and inhibition of endothelial cell injury, reduced LDL oxidation and greater artery wall cell viability74.
Ginger (Zingiber officinalis) has been shown to reduce blood pressure through endothelium calcium channel blocking effects75,76; inhibit platelet aggregation77; reduce atherosclerotic lesion areas by 44%, triglycerides by 27%, cholesterol by 29%, VLDL by 36% and 53%, LDL by 58% and 33%, oxidation of LDL by 45-60%78,79; inhibit atherosclerosis80,81; modulate artery wall contraction82; increase atrial contractile force83; and reduce blood pressure, bradycardia and aponea84.
Many other botanicals have been used in traditional therapies for cardiovascular benefits. Turmeric and its central rhizome constituent curcumin (diferuloylmethane) apparently work to inhibit cyclooxygenases and lipooxygenases that contribute to LDL oxidation85. Cayenne (Capsicum frutescens or Capsacin annum L.) has been shown to reduce blood pressure, bradycardia and aponea in vivo; increase sympathetic-parasympathetic nervous system ratio86; and be a potent antioxidant87. Cilantro (Coriandrum sativa) has been shown to lower cholesterol in vivo by decreasing lipid uptake while enhancing lipid breakdown88.
Other herbs traditionally used for cardiovascular health but probably need additional research support include fo-ti for possible lipid and circulation improvement; wild yam for potential cholesterol reduction; reishi mushroom for possible cholesterol and blood pressure benefits; ginkgo for potential antioxidant and circulatory benefits; and bilberry for potential improvement of circulation and blood pressure reduction. According to Nyvia Roman of Bellville, NJ-based Ecuadorian Rainforest, bilberry is a traditional herb native to Ecuador that is considered an effective therapy for poor circulation.