Cardiovascular
The heart is arguably one of the most fascinating organs of the mammalian body; in the human being, the heart begins its formation, as early as twenty-one days after conception, in the shape of a simple tube; this tube folds in on itself and forms four chambers thirty-four days after conception. Barely a month old, the embryo now has a fully functioning beating heart, though the circulatory and vascular systems will take many more months to complete their amazing development.
The heart is comprised of myocardial muscle, one of the three types of muscle cells (the other two are smooth and skeletal muscle). It is an organ located behind the ribs, just to the left of the sternum, that is divided into four chambers: the right and left atrium, and the right and left ventricle. The right atrium brings blood from the body that has traversed the circulatory system and distributed its oxygen; this blood is pumped through the tricuspid valve into the right ventricle, which shunts the blood through the pulmonary valve, into the pulmonary artery, and straight into the lungs. After collecting fresh new oxygen, the blood is pumped by the ventricle through the pulmonary veins up to the left atrium and then into the left ventricle; from here, the blood courses through the aortic valve to the aorta and on to the rest of the body. This entire process is based on electrical impulses.
With the average adult’s heart rate between seventy and eighty beats per minute (about one hundred thousand times per day), it takes approximately one minute for blood to make its circulation throughout the entire body. During strenuous exertion, an adult’s blood may complete its circulation of the body in as little as twenty seconds, a remarkable feat considering it has roughly one hundred thousand miles of veins and arteries to travel—almost half the distance from the Earth to the moon.
Veins carry blood to the heart to re-oxygenate, while arteries carry oxygenated blood to other parts of the body. Arteries require the direct pumping action of the heart to move blood because they depend on the pressure caused by the heart’s pumping action and the restriction of the size of the artery; veins, on the other hand, use one-way valves that are controlled by the contraction of muscles. For this reason, arteriolosclerosis and atherosclerosis are so dangerous, because the more compacted an artery is with cholesterol-based plaque, the less efficient its pumping action and the greater the pressure is exerted on the tissues of the artery.
General Protocols for the Heart
According to the World Health Organization, more people die globally from cardiovascular disease (including coronary heart disease and stroke) than from any other cause. 14 The WHO lists unhealthy diet, physical inactivity, and tobacco use as top causes of cardiovascular disease. Obesity is known to severely complicate the workings of the heart and the circulatory system; the pressure on the body’s cavities and vessels is great, not to mention the excessive amounts of cholesterol-based plaque that form on vessels from a poor diet. If the obesity is caused by hormonal or glandular issues, then the cardiac muscle and system is already compromised.
Smoking is often hailed as the number one cause of heart disease, but why? What is it about tobacco that makes it such a detriment to heart health? Tobacco smoke directly reduces blood circulation and constricts blood vessels; this raises blood pressure and deprives the body’s tissues of oxygen. Second-hand smoke puts non-smokers at a 25 percent higher risk for developing heart disease, and smoking doubles the risk for stroke. It also blocks pulmonary vessels, causing chronic obstructive pulmonary disease (COPD). Between its negative effects on the heart and the lungs, tobacco use is responsible for roughly 6 million largely preventable deaths per year.
One of the most effective and enjoyable ways to reduce the risk of heart disease (for both prevention and recovery) is walking. While strenuous, quick, competitive, and muscle-building exercise routines often cause damage to body tissues and tax the heart, walking is a paced, effective, and toning way to increase blood circulation, improve digestion through bowel muscle toning, improve respiratory function through increased breathing rate (and fresh air), and strengthen cardiac muscles gradually and with purpose. Most of my clients mention walking along a trail or beach as one of their number one methods for reducing stress. I take my dog walking daily on a nearby system of trails, and the brisk walking makes a big difference in my productivity and state of mind. Try to walk between one and three miles daily, lifting the feet and keeping good posture. Keep the head up and push from the belly and the backs of the thighs. Carry light one-pound weights if desired.
General dietary protocols are easy to follow, inexpensive, and go a long way toward maintaining and supporting a healthy heart. For most adults, the following regimen of foods and supplements will be appropriate for both prevention and recuperation:
Cardiotonics and Vascular Tonics
Some herbs have the ability to affect heart tissue operation and rhythm, which likely evolved as protection mechanisms to deter predators. Some of these mechanisms involve making the predator nauseous, or causing the predator to have hallucinations—either way, the predator won’t want to snack on that plant again. Some plants cause the predator’s heart to race faster—or to stop pumping altogether.
Herbalists have carefully studied these reactions over the centuries and have learned which plants affect the heart. For instance, foxglove (Digitalis spp.) is a known cardioactive and curative with very distinct effects—it is not a tonic. Foxglove contains powerful cardiac glycosides that increase the heart’s ability to hold on to increased sodium and calcium levels within the cells, enhancing the efficiency and force of the heart’s pumping action without increasing its demand for extra oxygen, allowing muscles to be more effective as blood transporters without using undue energy or suffering from a lack of oxygen due to lowered blood pressure or cell membrane permeability. 15 Today, scientists extract or isolate the so-called “pharmaco-active” substance, the cardiac glycoside digoxin from the foxglove plant. However, cardiac glycosides have a potential downfall: they are fairly insoluble and are not excreted from the body as quickly as many medical practitioners would like. This can lead to an overly strong pumping action of the heart and possibly death.
Foxglove is an example of a cardioactive plant; it has a direct stimulatory action on the heart or cardiovascular system, and it contains pharmaceutically active cardiac glycosides. This is in contrast to cardiotonics that have no cardiac glycosides and are considered tonic, nourishing, and sustaining to the cardiovascular system and the heart in particular. Safe and common cardiotonics include:
Additionally, some herbs are not tonics but are tier 3 corollary herbs to support the cardio system:
High Blood Pressure
Blood pressure is determined by measuring the systolic pressure (when the heart pumps blood through the arteries) and then the diastolic pressure (when the heart rests between beats). Normal blood pressure for infants is generally 90 over 60, written 90/60. Normal blood pressure for adults 120/80, while 140/90 is considered high, though everyone is different and certain conditions, such as diabetes, affect what is considered “normal.”
Key risk factors for the development of high blood pressure and hypertension include obesity, the consumption of alcohol over an extended period of time in great quantities, smoking tobacco, genetic predisposition, excessive sodium intake, and stress. Reversing these risk factors is essential in reducing the symptoms of the disease and guarding against the consequences of the disease, which can include stroke, myocardial infarction, embolism, and aneurism, among others. High blood pressure can lead to chronic heart disease, brain damage, kidney (renal) disease and renal failure, and death.
Vasodilator herbs can reduce the stress on the vascular system by increasing the diameter of the vessel and reducing the volume of fluid pumping through the veins, thereby relieving stress on the heart muscle. Some herbs, such as mistletoe, have been used throughout history but lack scientific study; others such as hawthorn are more familiar and demonstrate reliable safety.
Safe tier 1 tonic herbs include all the cardiotonics listed above: hawthorn, motherwort, linden, and ginkgo. Also consider:
High Blood Pressure Formulas
A Formula for High Blood Pressure
Another Formula for High Blood Pressure
Low Blood Pressure (Hypotension) and Poor Circulation
Medically, low blood pressure is diagnosed by a systolic/diastolic reading of 90/60 with no symptoms. Hypotension presents with inadequate blood flow, poor circulation, light-headedness, dizziness, nausea, and/or foggy thinking. It often reveals itself when a person stands up from a seated or supine position and suddenly feels faint. Low blood pressure is not considered a problem if it is a life-long reading of blood pressure at low numbers, but it is advisable to monitor the condition to guard against acute hypotension.
Risk factors and causes include pregnancy, certain medications and drugs, severe injury and loss of blood, dehydration, allergic reaction to medication, food, or alcohol (anaphylactic shock), heart arrhythmias, heat exhaustion, and liver disease.
A number of drugs can induce a state of hypotension, especially drugs that (directly or indirectly) affect the contractility of the heart and lower blood pressure or rhythm; these drugs can include high blood pressure medications, diuretics, antipsychotics, anti-anxiety drugs, and antidepressants. Similarly, taking a diuretic herb such as dandelion can exacerbate hypotension.
There are few herbal vasoconstrictors, though astringents are often helpful:
Warming herbs and spices may help improve circulation. These include:
Low Blood Pressure (Hypotension) and Poor Circulation Formulas
A Formula for Low Blood Pressure
A Formula for Poor Circulation to the Periphery
Cholesterol and Atherosclerosis
The condition of having high cholesterol levels in the arteries and vessels is known as hypercholesterolemia, a serious issue that can cause heart disease and stroke. Cholesterol is a perfectly normal substance—rather waxy and fatty, named from the Greek chole- (bile) and stereos (solid)—and it’s produced in our livers and found in the foods we eat. We need some cholesterol to synthesize vitamin D and to achieve proper function of our bodily systems; steroid hormones, such as testosterone and cortisol that are manufactured in the adrenal cortex and the gonads, for example, can only be manufactured from cholesterol.
But too much cholesterol is not good; it builds up in our blood vessels and arteries, and since it’s waxy and doesn’t wash away with the flow of blood, but instead sticks to vessel walls, it builds up over time. The thickening of arteries due to this plaque build-up is called atherosclerosis—this is different from arteriolosclerosis, which is the hardening of the vessel walls themselves. Plaque build-up leads to a smaller opening through which blood can flow, forcing the heart to pump harder and leading to high blood pressure. Caucasians typically suffer more cholesterol symptoms (and therefore more gallbladder and gallstone issues) since the antioxidant melatonin is believed to enhance the conversion of cholesterol to bile. As a result, fewer people of color experience gallstones and other cholesterol-related illness.
Plants contain cholesterol-like substances called phytosterols, which are virtually identical to human cholesterol. Since the cholesterol we produce in our livers is shunted into the digestive system and then recycled and sent back to the livers to be used again, the presence of plant-derived phytosterols tricks the body into utilizing phytosterols instead, excreting the excess through the feces. This reduces the amount of cholesterol the body believes it needs to make, which results in lower cholesterol in our bloodstreams. Taking advantage of these phytosterols is a common-sense approach to reducing cholesterol levels in the body. Plants with ideal phytosterol chemistry include vegetable oils and nuts.
Supplements for the reduction of symptoms of atherosclerosis include niacin (though this one is controversial and, for the herbalist, not a holistic method), as well as omega-3 fatty acids and vitamin C. To obtain these last two, consume salt-water fish with meals and vitamin C–rich foods and herbs, such as lemon, lime, watercress, spinach, rose hips, and sorrel.
Herbs that support the reduction of cholesterol include:
Cholesterol and Atherosclerosis Formulas
A Formula for High Cholesterol or Atherosclerosis
Another Formula for High Cholesterol or Atherosclerosis
Pre- and Post-Stroke and Heart Attack Strategies
If ever there was an opportunity to reverse disease and illness based on simple lifestyle changes, heart health is it. The heart and entire cardiovascular system responds readily to changes in the diet—both positively and negatively, and our choices make a world of difference in current and future heart health. Eating less, stopping smoking, eating less fatty and fried foods, and walking daily have an enormous positive impact on the structure and function of the heart and vascular system. Without these positive lifestyle choices, diseases can result:
Obviously, stroke, heart attack, embolism, and aneurism are dire medical emergencies and I make no claims here to treat any of these conditions. What we can do, however, is provide herbs and dietary and lifestyle guidance to help prevent these occurrences from happening in the first place, as well as herbal support to strengthen the cardiovascular system in particular in a preventive and supportive fashion. Healing arts professionals can help their clients at risk for stroke, heart attack, embolism, or aneurism (either because of genetic predisposition, smoking, alcoholism, poor mobility, high cholesterol, or previous history with weakened arteries or vessels) by encouraging them to follow the following formulary program as a beginning point for reducing that risk. Educate your clients about reversing poor lifestyle choices in favor of heart-healthy choices. Your goal should be to support the body in its efforts to strengthen capillary and vessel walls, to reduce plaque build-up and lower cholesterol, to improve flow of blood through the system through physical exercise and mobility, and to strengthen the heart’s pumping action and its efficacy in transporting oxygenated blood through the core and to the periphery. Follow the dietary and supplement guidance in the Cholesterol section (using food and diet as medicine), slowly adding herbal remedies such as teas, tinctures, or capsules over time.
Pre- and Post-Stroke and Heart Attack Formulas
A Formula for Preventive Heart Care
A Formula for Preventive Heart Care
A Formula to Strengthen Blood Vessels
A Formula for Post-Heart Attack Care
A Formula for Post Angina Pectoris
Another Formula for Post Angina Pectoris
Grief and Heartache
Heartache is an emotional condition but throughout Western history it has been associated with the organ in our chests that pumps blood. Rightly or wrongly, this connection has bequeathed herbal heritage with many plant-based remedies, liqueurs, and beverages that help the heart and bear names linking the cardiac muscle with love, affection, and friendship. For instance, the herb motherwort is Leonurus cardiaca, or “heart of the lion,” alluding to its traditional use in formulas that give a person courage as well as in formulas that literally strengthen the heart. (It may also allude to a mother’s large heart, as this is an herb given to mothers of young children who demonstrate unconditional love). The medieval drink, the cordial, was also named for its cardiovascular strengthening properties, and Welsh herbalist David Hoffmann notes that borage was the herb of choice in first preparing cordials (etymologically related to courage) because this herb was known to give people “heart.” 22 A quick look in the dictionary shows that the word cordial is now associated with sincerity and deep emotion, warmth and geniality, though its original sense of “relating to the heart” is diminishing.
Heartache and sadness of the heart have been poetically recounted for centuries in ballads, love-songs and sonnets, and healers have long offered solace to the bereaved. Having heart, falling in love, bearing something courageously, and feeling your heart burst from anguish or sadness are all expressions we use to connect our emotions with the heart. Whether or not science will one day confirm that the heart has something to do with our deepest inner emotions remains to be seen. But our herbal tradition offers a great deal of warmth and medicine to alleviate all conditions of the heart: physical, emotional, or spiritual.
Grief is one of those conditions, and it has profound physiological consequences on the body. The sadness of losing someone or something of great meaning in one’s life can be devastating, leading to depression, suicidal feelings, remorse, guilt, a “heavy heart,” and the separation of oneself from a community of people who could help. Loss can be excruciating, and of course there is no magic herb that will return those we have lost. A centeredness in spirituality and a familiarity with cycles can begin to bring about a sense of understanding and acceptance of death, knowing (with both mind and heart) that death is part of life. It’s such an emotional concept that it hardly makes cognitive sense when we’re experiencing a good day, so it’s generally very difficult to grasp when we’re bereaved, but it’s worth noting that a spiritual approach to grief, loss, death, and transition (as opposed to a pharmaceutical approach) is the most genuine and enduring way to find peace.
In this context, there are a few special herbs that have long been part of this process, and how you use them is up to you. British herbalist Anne McIntyre once said it doesn’t matter how you use them—whether as teas, tinctures, powders, etc.—as long as you connect with them. A spiritual connection is encouraged here, which is a longstanding traditional tenet of herbal medicine alongside its pharmacological aspects.
Other traditional herbs for grief include borage, violet, mullein, St. John’s wort, basil, spearmint, holy basil (tulsi), lemongrass, and the heart herb hawthorn.
Grief and Heartache Formulas
A Formula for Grief (as a tea or honey)
Another Formula for Grief (as a tincture)
A Formula for Opening Up to Love (as a tea or hot cocoa)
Headache and Migraine
We’ll end this chapter on the care of the cardiovascular system with a discussion of headaches. There are two primary types of headaches: tension and vascular (or migraine). Tension headaches are often caused by stress or emotional irritation, which lead to involuntary muscular constriction in the neck and shoulder and results in aches in the head, neck, shoulders, and eye pain. Migraines, however, appear to be related to involuntary blood vessel constriction in the brain and are notoriously difficult to treat with herbs, as few herbs are strong enough to eradicate migraines, and those that are can be dangerous to use, especially for those suffering from chronic and frequent migraines. Therefore the recommendations here are primarily for mild-to-moderate tension headaches. Headaches can be triggered by an allergic reaction to food, spinal damage that needs correction, hormonal imbalance, illness (influenza or other viral infection), constipation, liver obstruction, Lyme infection, addictive substance withdrawal, dehydration, and as the result of cleanses or certain weight-loss diets.
Encourage clients to discover the cause of their headaches. Often this is easy (maybe they fought with someone or participated in an irritating meeting), but sometimes it’s not obvious. Did they eat a disagreeable food? Explore their diet and check for other symptoms present in the body. Have they been bitten by a tick? In New England among other locales, headaches and muscle aches are red flags to look for the typical red bull’s-eye of an infected tick bite. What about their normal routine? Is there a new diet or medication? Finally, don’t ignore headaches reported by children; though they may be pleas for attention, chronic headaches in children could indicate an emergency condition and should be addressed. For an occasional tension headache, suggest the following:
When a headache is caused by the constriction of blood vessels, part of the therapy can involve “opening” up those vessels so proper blood flow can resume. The formula should include nervine tonics, analgesics, circulatory tonics, and any other corollary support herbs needed. Analgesics lessen or even eliminate pain, especially if corollary actions are taken to mitigate the causes. Choose tier 1 tonics (primarily nervines), tier 2 Specifics (primarily analgesics), and then tier 3 corollary herbs, perhaps antispasmodics for muscle tension or bitters for digestion. Cardiovascular tonics such as ginger can both relieve stagnant congestion and stimulate digestion. The best tier 4 vehicle is traditionally feverfew, which has a folk use of numbing headaches and encouraging blood flow to the brain. Other tier 4 vehicles that increase blood flow to the brain include ginkgo (Ginkgo biloba) and gotu kola (Centella asiatica).
Headache and Migraine Formulas
A Formula for a Mild Tension Headache
Another Formula for a Mild Tension Headache
A Formula for a Vascular Headache
The cardiovascular system is one of the most intricate, the most readily influenced, and one of the most treatable systems of the body. Despite its importance, I encourage you to feel confident in working within the parameters of this book to positively support the structure and function of the heart muscle and vascular system. Our heritage of herbal healing for the heart is vast, well-documented, and accessible, with many of the most profound cardiotonics being easy to obtain or grow. Care for the heart is a sacred responsibility as well as a practical goal; using the tonic herbs in this chapter as well as dietary and lifestyle changes or management are the best ways to advance the health of these organs and live long into the future.