Clinical Considerations
➤General comments
– The prevalence of coronary artery disease (CAD) is increasing in industrialized countries. This is certainly attributable to a general lack of physical exercise, increased consumption of fatty foods, and cigarette smoking, but is also due to the fact that people now live longer.
– Despite intensive research, some risk factors of CAD are still unknown or untreatable.
➤Herbal treatment measures
– In Germany, topical heart ointments containing aromatic herbs that increase local blood flow of cutivisceral reflex regions are thought to be beneficial in acute functional coronary artery spasms.
– Flavonoids in hawthorn extract reduce wall tension in normal and sclerotic blood vessels. These chemicals are also presumed to stimulate beta-2 receptors and, thus, to widen coronary arteries and blood vessels in skeletal muscle. The usefulness of hawthorn in CAD is therefore arguable, but has not yet been confirmed in clinical studies.
➤Clinical value of herbal medicine
– The recommendations in this section are solely based on empirical experience. Clinical study data or controlled studies on most of these indications are not yet available.
– Once CAD has become manifest, herbal measures should be restricted to adjunctive treatment only.
➤Herbal measures to help counteract risk factors
– Antilipemic herbs: Garlic (see p. 70), artichoke (see p. 36).
– Antithrombotic herbs: Garlic (see p. 70).
– Antihypertensive herbs: Garlic (see p. 70).
➤Clinical value of herbal medicine for risk factors of CAD
– The herbal treatments outlined here are purely prophylactic and adjunctive measures that can be recommended as home remedies. Clinical studies are available.
Coronary Artery Disease Recommended Herbal Remedies (Overview)
External Remedies of Coronary Artery Disease
➤ Aromatic plant medicaments such as camphor (Cinnamomic camphorae aetheroleum), rosemary leaf (Rosmarini folium;), pine needles (Pini aetheroleum), eucalyptus leaf (Eucalypti folium), and menthol (Menthae aetheroleum).
–Action: Stimulate cutivisceral reflexes, blood flow and spasmolysis, thereby reducing CAD-related pain.
– Dosage and administration : The preparations are applied to the left precordial region of the chest and rubbed into the skin as often as needed.
Warning: Ointments containing camphor can cause skin irritation and inflammation and should not be applied to damaged skin.
Internal Remedies of Coronary Artery Disease
➤ Hawthorn.
Range of Applications
Acute Angina Pectoris
➤Hawthorn leaf and flower.
–Dosage and administration: Dose is diluted oil or other balm applied several times daily or as needed for mild pain of angina. Apply twice daily to the left precordial region, or as needed when chest pain occurs.
–Clinical value: Clinical studies have not been conducted. Large interindividual differences in the effects of these remedies can be observed.
Prevention and Treatment of Early-stage CAD
➤Hawthorn leaf and flower.
– Steep 2 teaspoons of the herb in 150 mL of boiling water for 20 minutes. Sweeten lightly. This mild infusion should be used only for health-promoting benefits.
– Hawthorn tincture: 2–4 mL several times a day.
– Extract standardized to flavonoids and/or proanthocyanins: 1 to 2 capsules or tablets.
–Dosage and administration: One dose, 2 to 3 times daily.
–Clinical value: For low-potency treatment, hawthorn extracts that are not standardized have a smaller therapeutic range than the corresponding standardized commercial products.
Early-stage CAD with Mild Hypertension
➤Tea Rx: Crataegi flos; Crataegi folium; Visci albi, aa ad 100.0.
–Dosage and administration: 1 to 2 teaspoons per cup, 2 times daily.
–Clinical value: For low-potency treatment. The extract is not standardized and has a smaller therapeutic range than commercial products. CAD with Gastrocardiac Symptom Complex (Roemheld’s Syndrome)
➤TinctureRx: Ol. Carvi 5.0; Tinct. Convallariae, Tinct. Crataegi, Tinct. Carminativa,Spirit. Aetheris Nitrosi, ad 10.0.
–Dosage and administration: 20 drops, 3 times a day.
–Clinical value: This has proved to be a very useful remedy in elderly patients,who often develop Roemheld’s syndrome.
Long-term Treatment of CAD
➤Hawthorn preparations, garlic.
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