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Conventional Treatment for Angina Pectoris

 

Angina Pectoris is a serious condition and the supervised care of a licensed physician is very important. Conventional treatments of angina pectoris are coronary vasodilators, beta-blockers, and calcium antagonists. One such vasodilator, nitroglycerin, is the most commonly prescribed medication in treating angina pectoris.  Nitroglycerin causes the vasodilatation (opening) of the coronary arteries,  which results in increased blood flow to the heart muscle; thereby ending the painful episode. 

Angina Pectoris Drugs: Individuals with angina who have known underlying coronary artery disease or other cardiovascular disease may be on anti-hypertensive drugs, beta blockers, calcium channel blockers, and anti-lipid drugs. 

Alternative treatment should not only focus on conventional medicines, but also on reducing an individual's risk factors for angina pectoris.  Although not appropriate for treating an acute episode of angina, the treatment of the underlying coronary artery disease is equally important. 

 

 

Supplements for Angina Pectoris

 

Hawthorne Berry

Hawthorne berry (Crataegus) is a cardio-protective herb. The berries are high in flavonoids, which makes it an effective anti-oxidant.  It improves energy metabolism for muscles, including the heart muscle.  Hawthorne berry is also thought to enhance the contractility (strength of contraction) of the heart, and may assist in lowering both blood pressure and cholesterol.  Hawthorne is considered a legitimate dietary supplement for persons suffering from angina pectoris, as it improves oxygen delivery via dilation of the coronary vessels.[5]

 

Garlic

Garlic (Allium sativum) is botanical that can be used to reduce the risk of angina and also the risk of reoccurrence. Garlic does not treat acute episodes of angina, however , it has been shown to positively influence high cholesterol.  Elevated cholesterol levels are a precipitating factor for coronary artery disease and angina. In study, garlic has been shown to lower total cholesterol, LDL, and triglycerides by 15%. It also produced an increase in high-density lipoproteins (HDLs) by nearly 10%.[6] Garlic has also been shown to have blood pressure lowering effects, which can be helpful for individuals with angina pectoris.[6]  In other studies, garlic extract was equally effective at decreasing atherosclerotic plaque formation.[7]

 

Khella

Khella, Ammi visnaga, is another botanical herb that has been used to treat angina pectoris.  Mediterranean physicians have used khella regularly within the past decade to treat spasms of smooth muscle, including cardiac tissue.  Its constituents are known to dilate coronary arteries. The main constituent, khellin, is effective at relieving the symptoms of angina and its effects are compared to those of nitroglycerin.  It has also been shown to improve exercise tolerance and normalize electro cardio-gram (ECG or EKG)  results.

 

Commiphora mukul

Commiphora mukul, myrrh tree, is a botanical medicine that is effective at decreasing total cholesterol, LDL, and triglyceride blood serum levels. It also raises HDLs, or good cholesterol levels. Its physiological actions are comparable with conventional medications for lowering blood lipid count.  Commiphora mukul may also combat platelet aggregation and promote the breakdown of fibrin (a component of arterial plaques). 

 

Folic Acid, Vitamin B6, Vitamin B12

Deficiencies in folic acid, vitamin B6 and vitamin B12 have been shown to cause an increase in homocysteine.  Increased homocysteine levels promote damage to the lining of arteries, which may lead to atherosclerosis. B-vitamin compounds, like folic acid, B6, and B12, are nutrients that can be used to treat the many underlying factors causing angina pectoris.  Repeated studies have indicated that supplementation with folic acid, B6 and B12 effectively reduces homocysteine levels.

 

Arginine

Arginine is a nonessential amino acid synthesized by the body.  However, its supplementation is recommended for individuals suffering from angina pectoris.  Arginine is a biochemical precursor to nitric oxide.  Nitric oxide is the precursor to the "endothelial derived relaxing factor," which causes vasodilatation of arteries. Nitric oxide is also important for regulation of blood pressure, proper heart muscle function, and regulation of the inflammatory response by heart muscle.[8]

 

One study found that supplementation with arginine improved symptoms of angina pectoris during attacks.  Exercise capacity, as tested by electro cardio-gram, was also improved after arginine supplementation for a period of just three days.[9] Another clinical trial found that supplementation with arginine over longer durations (greater than 3 weeks), improved angina class, systolic blood pressure, and quality of life.[10]

 

Carnitine

Carnitine is an important nutrient for energy production inside the heart muscle cell.  It has been shown to effectively transport fatty acids into the mitochondria (energy factories) of cells. A deficiency of carnitine is associated with a buildup of fatty acids outside of mitochondria and an overall decrease in energy production by the cell.  Carnitine also enables the heart muscle to better utilize the available oxygen, therefore being protective by improving efficiency when there is limited supply of oxygen.  Carnitine is also considered an effective anti-oxidant, decreasing damage caused by oxidative stress on the heart.  It also quenches reactive oxygen species,  which are known to be a factor for the development of coronary artery disease.

 

In one particular clinical trial, carnitine supplementation for three months resulted in an increase in duration of exercise and decrease in recovery time after an episode of angina pectoris, when comparing ECG at baseline and the end of the study.[10]  Another study found that carnitine protected the heart cells from hypoxia and oxidative damage.[11]

 

Coenzyme Q10

Coenzyme Q10 is an essential nutrient for energy production inside the mitochondria of heart cells. Because of the heart's continual pumping action, it needs a continuous production of energy. Individuals with angina pectoris and other heart disease need increased levels of coenzyme Q10.

 

Studies have shown that CoQ10 supplementation caused a 53% decrease in frequency of angina pectoris episodes in patients with stable angina.[12]  Exercise tolerance on treadmill test was also increased in another comparative study concerning patients supplementing with coenzyme Q10.  This study also concluded that CoQ10 supplementation was safe, well tolerated, and an effective treatment for angina.[13]


 

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