I always think it's a good idea to learn to derive your special nutrients from foods rather than pills and nutritional supplements. Certain foods, like garlic and onions for example, are so potent that they are included in the Chinese materia medica. Walnuts, or he tao ren in Mandarin Chinese, are classified as sweet, warm, and have a special benefit to the Kidney-adrenals, Large Intestine and Lungs. The recommended daily dose of 9-30 grams can be eaten or added to herbal formulas to relieve lower back pain, chronic knee weakness, calm wheezing and promote bowel movement by lubricating the large intestine.

Walnuts for Back Pain

About 65 million Americans suffer from back pain each year, (the second most common reason for medical visits. These people should include a small handful of walnuts in their diet every day.

Walnuts for Constipation

Constipation caused by intestinal dryness in the elderly (the Metamucil crowd) as well as a wide number of other GI tract conditions can all be remedied by including a small handful of walnuts in your diet once or twice a day.

Walnuts to Strengthen the Lungs

As for the Lungs, walnuts are specific for asthma, emphysema and wheezing. Be sure to include the thin pericarp (skin) on the walnut meat, as this apparently has a special therapeutic benefit for the Lungs. A famous and simple classical Chinese formula called Ginseng and Walnut Combination (Ren Shen Hu Tao Tang) consists of the following:

  • 6-9 g Chinese ginseng
  • 10-15 g walnuts
  • 3-6 g fresh ginger

This formula that tonifies both the Lungs and the Kidneys, relieves chronic coughing and is anti-asthmatic. (Note that the organs, such as the Kidneys and Lungs, not only refer to the actual organs but also refer to a variety of functions associated with them. Most notably, the TCM kidneys include the adrenals, which in turn include the entire endocrine system.)

This combination is specific for low energy, weakness, cough, asthma, bronchial asthma, chronic bronchitis, pulmonary emphysema as well as cold extremities, lower back pain and facial edema.

While much of the benefit can be derived from simply eating about five walnut meats twice a day, the formula given above would be even stronger. Prepare it by bringing four cups of water to a rolling boil, add the walnuts and ginseng and continue to simmer until two cups of fluid remain, remove from the heat, add 3 to 5 slices of fresh ginger and cover to steep until cool enough to drink. Have a cup twice a day and you should notice a significant improvement within a week or two. I suggest continuing this regime for about three months.

Because this is a strongly heating formula, it is contraindicated for symptoms of yellow or blood-streaked phlegm, night sweats and for those with loose watery stools.

Another tasty way to enjoy the benefits of walnuts is mixed with honey perhaps with a sprinkling of ginger, cinnamon and cardamom. This is an excellent way to have children take them and they make a wonderful, albeit somewhat 'sticky' snack.

Walnuts: A Rich Source of Omega-3 Fatty Acid

Walnuts are high in alpha-linolenic acid, which is an omega-3 fatty acid found in plants, and similar to the omega-3 fatty acids in fish oil. While not as concentrated in alpha-linolenic acid as flaxseed oil, it offers a worthy alternative especially when included as part of the diet.

Omega-3 fatty acids are good for heart disease, high cholesterol, high blood pressure, arthritis, asthma, breast cancer prevention, inflammatory bowel disease, depression, menstrual pain, and a wide range of other inflammatory disorders.

An article published in Science Daily (Oct 4, 2010) described how Penn State researchers found that foods high in polyunsaturated fats, in this case especially referring to walnuts, reduce low density lipoproteins (LDL) and other markers of inflammation including C-reactive protein and generally relieve cardiovascular responses to stress leading to high blood pressure. This was the first study showing that walnuts and walnut oil reduce blood pressure caused by stress and thereby reduce the risk of cardiovascular disease.

Walnuts for Weight Loss

Walnuts pack up to 6,500 calories per kilogram (slightly over 2 pounds). Despite this, walnuts can actually promote weight loss because they keep one satisfied for a longer time, thus reducing hunger and cravings.

The Walnut Tree

One species of walnut, Juglans cinerea, is also known as butternut bark and instead of the round nut of European walnut, it has a longer nut shaped more like a pecan. The Iroquois natives boiled them to extract the oil, which was used for cooking and a spread, like butter. It was reported that they would use the butter as a topical poultice to relieve toothache.

Walnut bark, hulls and leaves all contain juglandic acid, juglone and tannins. Juglandic acid and juglone have a mild cathartic action due to the presence of napthaquinones.

Bark: For Constipation and Cleansing

Herbalists use the chopped inner bark of the walnut tree as a laxative for treating constipation. By stimulating the release of bile from the liver and gall bladder, it promotes overall internal cleansing and detoxification including the process of regulating hormones through liver detoxification.

Further adding to walnut's detoxifying properties, it is also one of the best vermifuge and anti-parasite herbs. For this, an ounce of walnut bark powder with several slices of ginger can be soaked in a pint of brandy or vodka to make an alcoholic extract. Begin by taking a teaspoon once or twice a day and adjust the dose more or less as needed. The average transit time for bowel movement with walnut bark is between four to eight hours and does not cause cramping, especially when it is taken with ginger or angelica, which have warming anti-spasmodic properties. Of course the powder can also be taken mixed with honey or in capsules.

Leaves

Taken as a tea, walnut leaves can be used alone or in formulas as an alterative, antibacterial, cholagogue, or blood purifier.

Hulls: Potent Anti-Parasite Remedy

Juglone, found in all parts of the tree except the nut, is a potent defense against worms and parasites. It is highly concentrated in the roots of the walnut tree causing many plants to not grow within a 40- to 60-foot radius of a walnut tree. Made into a strong decoction, walnut husk tea can be used as a spray in the early spring against insect herbivores.

Considering that the hulls have had widespread use for centuries, I consider them to be the finest and safest anti-parasite botanical remedy I know. Walnut husks taken internally as a powder or liquid extract are effective for all forms of parasites and worms. While black walnut hulls are recommended, either English or black walnut hulls are equally effective.

To make a potent black walnut tincture, assemble a number of mostly green-hulled black walnuts or English walnuts in a stainless steel pot or wide mouthed jar. Cover completely with alcohol or vodka. Sprinkle a teaspoon of vitamin C (ascorbic acid granules) over this. Cover with a lid and let sit for three days. Stir in another teaspoon of ascorbic acid, and using a funnel, poor into glass bottles, amber if available. Store in a dark or cool place or freezer. The ascorbic acid is used to maintain the green color of the extract. Potency will last for several years, especially if unopened and even if it darkens slightly.

Juglone also has anti-cancer properties, and the above formula is sometimes used as part of anti-cancer treatment.

Walnut hulls are a key ingredient in Planetary Herbals' Wormwood Intestinal Detox formula where it is combined with a number of other herbs including butternut (walnut) bark extract, as a safe, mild laxative to help get the worms and parasites out of the body. Botanical detox formulas such as Wormwood Intestinal Detox should be taken over the course of two weeks at the therapeutic dose of two tablets three or four times daily with the treatment repeated at least once again in two weeks. At the same time, avoid sugar and refined carbs as these feed the parasites.

Walnut hull extract may be painted on topically for the treatment of scabies (it will temporarily stain the skin a darker color). A poultice or fomentation of mashed walnut hulls has antiseptic properties and is applied topically for healing sores and various wounds.

According to Appalachian herbalist Phyllis Light, walnut hulls (the outer green covering of the nut) contain a very high concentration of iodine and are used for treating iodine-deficient hypothyroid gland dysfunction. I do not have personal experience with this.

Despite popular use, the toxicity of walnut leaves and hulls to humans has not been sufficiently investigated, warranting the hulls to not be recommended in the German Commission E report on the safety and uses of medicinal herbs.

Walnut Hull Extract for Fish diseases

Finally, I personally discovered a hitherto unknown use for walnut hulls and consequently hold an exclusive use patent for a walnut hull-based extract known in the industry as Ich Attack. Ich Attack is a treatment for parasitic protozoa infections and all types of external fungus infections of fresh and saltwater fish. It is safely used for fresh and salt water aquariums and ponds. Unlike other drug based products, Ich Attack does not require water changes between treatments and is safe for use with aquatic invertebrates (snails, shrimp, crabs, coral, anemones, etc.).

Just as the use of walnuts and all parts of the walnut tree supplant the need for a number of potentially harmful drugs and a number of anti-inflammatory supplements, they now have a place in the of fish, giving a positive spin on the term 'fishy' for the medicinal properties of herbs.

Michael has just done a great blog on hypertension, so I decided to supplement that with further information that I use. I have found a system created by the acupuncturist/teacher, Jimmy Chang, to be very useful clinically, as a couple of these patterns are not normally mentioned in books, classes or articles. He determined a correlation between blood pressure and pulse rate to help determine the TCM patterns involved. What he created follows the Eight Principle Diagnostic system and treats not only hypertension, but hypotension as well.

This system starts by first taking the blood pressure with a machine. Now I learned from an MD how to get the best reading when taking blood pressure. First of all, put the cuff on loosely and then completely rest the arm for 10 minutes (lay it down by one's side, it doesn't have to be up at heart level according to this doctor). After the 10 minutes are up, tighten the cuff and take the blood pressure. Next, take 10 points off the top number (the MD said that the portable machines available measure higher than the traditional cuff and pneumatic machine found in doctor offices). As well, note the pulse rate.

Once you get the numbers, jot them down. The overall blood pressure measures the pressure of the blood flowing through the blood vessels. The higher the blood pressure, the harder the heart has to work. The top number is the systolic rate and measures the pressure in the arteries while the heart beats; diastolic pressure measures the pressure in the arteries between the heart beats, (the pressure should decrease between the heart beats).

Next, compare the numbers from the machine with the following:

Normal blood pressure: 120/80

Hypertension: greater than 140/90

Normal pulse rate: 60/100; 40 range for highly trained athletes

Note the broad range for the pulse. Some have said that 72-80 is normal, but that's the average range. Thus, the higher the number is, the more it's toward the fast side and vice versa.

Now, take all of this information and see which of the following categories the obtained numbers fit:

 

 

 

Jimmy Chang's Blood Pressure Patterns:

TYPE

PRESSURE

HEART RATE

DIAGNOSIS

HERBS

Type 1

High   High

Fast

Excess Heat

Heat clearing

Type 2

Low    Low

Slow

Yang Deficiency

Yang tonics

Type 3

High   Normal

Slow

Deficient Heat & Blood Stasis

Blood moving, herbs that cool the Blood & herbs that clear Heat from Deficiency

Type 4

Low    Low

Fast

Yin Deficiency Heat

Yin tonics, herbs that cool the Blood & herbs that clear Heat from Deficiency

 

This system presents us with one new pattern not normally included when following a TCM hypertension treatment protocol, Blood stasis with Deficiency Heat. As well, there is clearly one pattern, low systolic, low diastolic and slow pulse, that indicates hypertension.

Again, I give credit for this above system to Jimmy Wei-Yen Chang (L. Ac., Dipl. Ac., licensed acupuncturist in Taiwan and New York state). What follows now is from me:

TYPE SYSTEM ANALYSIS:

 

Type 1: Excess Heat - this generally correlates with either Ascendant Liver Yang hyperactivity or Phlegm Fire.

Ascendant Liver Yang

Symptoms: headache, dizziness, vertigo, tinnitus, ringing in the brain, head distention and pain, red face, restlessness and agitation, easily angered, bitter taste in the mouth, insomnia, tongue with red tip and/or edges with yellow coat, and bowstring pulse

Treatment Principle: Ascendant Liver Yang: sedate uprising Yang and clear Heat; Phlegm Fire: transform Phlegm and clear Fire

 

Herbal Therapy: Ascendant Liver Yang: Gastrodia and Uncaria Combination (Tian Ma Gou Teng Yin); Phlegm Fire:  (Huang Lian Wen Dan Tang)

 

Appropriate Hypotensive Chinese Medicinals to include:

prunella (xia ku cao), abalone shell Concha haliotidis (shi jue ming), cassia seeds (jue ming zi), chrysanthemum (ju hua), gastrodia (tian ma), tribulus (bai ji li), gardenia (zhi zi), coptis (huang lian)

 

 

Phlegm Fire

Symptoms: dizziness, chest oppression, profuse phlegm and balls of it, nausea, vomiting, head distention, palpitations, bitter taste, slimy tongue with tip and/or sides red with yellow coat, slipper, fast and bowstring pulse

Treatment Principle: transform Phlegm and drain Fire

 

Herbal Therapy: Coptis Decoction to Warm the Gallbladder (Huang Lian Wen Dan Tang)

 

Appropriate Hypotensive Chinese Medicinals to include:

coptis (huang lian), pueraria (ge gen), phellodendrun (huang bai), prunella (xia ku cao), gardenia (zhi zi), moutan (mou dan pi), scute (haung qin)

 

 

Type 2: Yang Deficiency

Symptoms: coldness, cold back and knees, nighttime urination, abundant clear urination, infertility in women, impotence, paleness, low back pain, knee pain, joint problems, urinary problems, poor memory, especially short term, sexual issues, poor digestion, premature ejaculation, edema of the legs, loose stools, pale, swollen and wet tongue, and a weak, deep and slow pulse

Treatment Principle: tonify Kidney Yang

 

Herbal Therapy: Replenish the Right Decoction (You Gui Wan) or Rehmannia Eight Combination (Ba Wei Di Huang Wan)

 

Appropriate Hypotensive Chinese Medicinals to include:

cordyceps (dong chong xia cao), eucommia (du zhong)

 

 

Type 3: Deficient Heat and Blood Stasis:

Symptoms of Deficient Heat:heat in the palms and soles, night sweats, irritability, restlessness, thirst, tidal fever, afternoon fever, fevers at night followed by coolness in the morning (without sweating), steaming bones, loss of semen, abnormal bleeding (from the nose, lungs, vagina, intestines and so on plus hemorrhage, subcutaneous bleeding, menorrhagia, coughing up or vomiting blood) all due to Heat in the Blood, purpuric rashes due to Heat in the Blood, red or scarlet tongue that's possibly peeled, and thin and fast pulse

Symptoms of Blood Stasis: sharp fixed, stabbing or boring pains, blocked, painful or difficult menstruation with dark blood and large clots, immobile masses and lumps, painful and irregular periods, serious pain in the chest, blood clots, dark complexion, purple lips, nails, tongue or veins, some cysts, fibroids, tumors, varicosities, bleeding with dark blood and dark clots, tremors and swelling of the Organs, purplish tongue with large sublingual veins, and wiry, choppy or rough pulse

Treatment Principle: move the Blood, clear Heat from the Blood and clear Deficient Heat

 

Herbal Therapy:Most Blood moving herbal formulas that I know are warming in energy, which could create more Heat in the Blood here. Thus, use Cooling or neutral herbs to create your own formula or to modify another. Be sure to combine blood movers with herbs that Cool the Blood, herbs that clear Heat from Deficiency and if indicated, herbs that stop bleeding:

Possible Herbs to Choose:

Blood movers: Salvia miltiorrhizae (dan shen), red sage root, safflower (hong hua), achyranthis (niu xi), turmeric tuber (not rhizome, which is warming) (yu jin), motherwort(yi mu cao), Polygonum cuspidatum (hu zhang), bushy knotweed or giant knotweed rhizome, persica (tao ren), peach kernel, red peony root (chi shao), white peony root (bai shao), Sparganium stoloniferum (san leng), common burr reed, myrrh (mo yao), achyranthis (niu xi), cyathula (chuan niu xi), vaccaria seeds (wang bu liu xing)

Herbs that Cool the Blood: raw rehmannia (sheng di huang), moutan peony (mu dan pi), lithospermum (zi cao)

Herbs that clear Heat from Deficiency: lycii cortex (di gu pi), Artemisia annua (qing hao), sweet wormwood or sweet annie

Herbs that stop bleeding: cattail pollen (pu huang), sanguisorbae (di yu), sophora flowers (huai mi), sophora fruit (huai jiao), agrimony (xian he cao), blettilla (bai ji), donkey skin gelatin (e jiao), calcined human hair (xue yu tan), Panax pseudoginseng (san qi).

Appropriate Hypotensive Chinese Medicinals to include:

rhodiola (hong jing tian), phellodendrun (huang bai), eucommia (du zhong), abalone shell Concha haliotidis (shi jue ming), dragon bone Os draconis (long gu), oyster shell (mu li), pearl shell Concha margaritiferae (zhen zhu mu), hematite (dai zhe shi), chrysanthemum (ju hua), uncaria (gou teng), gastrodia (tian ma), loranthus (sang ji sheng)

 

Type 4: Yin Deficiency Heat

Symptoms: heat in the palms and soles, night sweats, irritability, restlessness, thirst, tidal fever, afternoon fever, fevers at night followed by coolness in the morning (without sweating), steaming bones, loss of semen, red tongue that's possibly peeled, and thin and fast pulse

 

Treatment Principle: tonify Yin, clear Deficient Heat and cool the Blood

Herbal Therapy: Replenish the Left Decoction (Zuo Gui Yin) modified with herbs that clear Heat from Deficiency and herbs that Cool the Blood:

 

Possible Herbs to Choose:

Herbs that clear Heat from Deficiency: lycii cortex (di gu pi), Artemisiae annuae (qing hao), sweet wormwood or sweet annie

Herbs that Cool the Blood: moudan peony (mu dan pi), raw rehmannia (sheng di huang), lithospermum (zi cao)

Yin Tonics (if you desire to create your own formula): eclipta (mo han lian), ligustrum (nu zhen zi), privit fruit, black sesame seeds (hei zhi ma), (glehenia/adenophorae (sha shen), American ginseng (xi yang shen), ophiopogon (mai men dong), asparagus root (tian men dong), dendrobium (shi hu), lily bulb (bai he), polygonatum (yu zhu), scented Solomon's seal rhizome

 

Appropriate Hypotensive Chinese Medicinals to include:

rhodiola (hong jing tian), phellodendrun (huang bai), eucommia (du zhong), abalone shell Concha haliotidis (shi jue ming), dragon bone Os draconis (long gu), oyster shell (mu li), pearl shell Concha margaritiferae (zhen zhu mu), hematite (dai zhe shi), chrysanthemum (ju hua), uncaria (gou teng), gastrodia (tian ma), loranthus (sang ji sheng)

 

HYPERTENSION AGGRAVATING MEDICINALS:

 

And last but not least, here are herbs that should NOT be used if there's hypertension because THESE CAN RAISE THE BLOOD PRESSURE:

ginseng (ren shen), licorice (can cao), ephedra (ma huang), deer antler (lu rong), immature tangerine peel Citri aurantii (zhi shi), Angelica dahurica (bai zhi), mugwort (ai ye), psoralea (bu gu zhi), asarum (xi xin), wild ginger, Portulacae oleraceae (ma chi xian), mint (bo he), garlic, although in some cases it can lower blood pressure (Yang Deficiency), in others it can elevate it (Heat conditions).

If you suffer from hypertension, several avenues of treatment are available to you. How do you choose what is best for your unique condition? In this blog, I'll explore the approaches to hypertension offered by Western conventional medicine, Western herbal medicine, Traditional Chinese Medicine (TCM), and East Indian Ayurvedic medicine. Each of these has a well-respected track record backed up by practice and research.

Western conventional medical approach to hypertension

Western medicine considers hypertension (HTN, or high blood pressure,) as a cardiac condition where the arterial blood pressure, the blood pumped from the heart through the arterial conduits of the body, is abnormally elevated.  A measurement is taken using a blood pressure cuff to determine systolic blood pressure (BP) and diastolic blood pressure.

Systolic pressure measures the resistance of the artery when the blood is pumped from the heart while the diastolic measures what resistance remains on the artery between systolic 'beats' or episodes.  Averages differ with age and other activities such as exercise, stress, etc., but a systolic pressure (the top number) consistently over 140 is a high systolic BP while a diastolic pressure (the bottom number) consistently over 90 represents a high diastolic BP reading.  Differential analysis is based on whether the condition is 'primary hypertension' or 'secondary hypertension.' Primary hypertension accounts for over 90% of HTN and is defined as having no known medical cause. Secondary hypertension accounts for the remaining HTN cases and is caused by other conditions that affect the kidneys, heart or endocrine systems.

I consider it essential to purchase a good blood pressure cuff called a sphygmomanometer at your local drug store or online. Take your blood pressure four times daily, both resting and sitting up, noting the readings each time. This should be over the course of three or four days. Then try to find an average of all the readings.

All systems of medicine regard hypertension as one of the risk factors for stroke, myocardial infarction, heart failure and arterial aneurysm. It is also considered the leading cause of chronic kidney failure. Even moderate hypertension is a known cause of shortened life expectancy. All medical systems also recognize that certain dietary and lifestyle changes will decrease hypertension and its associated risks.

Western conventional drug-based medicine may need to be employed when herbal, dietary and lifestyle approaches yield unsatisfactory results. This is one reason why seeking the guidance of a qualified medical practitioner is important.

Diuretics aside, drugs in the antihypertensive class share a similar pharmacologic action.

Commonly used prescription drugs include:

  • ACE inhibitors (e.g. captopril)
  • Alpha blockers (e.g. prazosin)
  • Angiotensin II receptor antagonists (e.g. losartan)
  • Beta blockers (e.g. propranolol)
  • Calcium channel blockers (e.g. verapamil)
  • Diuretics (e.g. hydrochlorothazide)
  • Direct rennin inhibitors (e.g. aliskiren)

All of the above drugs come with considerable risks versus benefits.

ACE (angiotension converting enzyme) inhibitors specifically regulate intercellular and extracellular fluid in the body and reduce arterial tension. It is a standard prescription for those suffering from congestive heart failure associated with excessive fluid buildup in the system which puts an extra burden on the heart to circulate it throughout the body.

ACE inhibitors have relatively few side effects. Most are caused by low blood pressure with one of the most common being dizziness, especially upon waking, with more extreme cases accompanied with fainting spells. Other side effects can include kidney problems and persistent cough.

Combinations of an ACE inhibitor, a diuretic and a NSAID (non steroidal anti-inflammatory drug) like ibuprofen should be avoided as this has been known to cause renal failure or what in the Australian health industry is called a 'triple whammy.'

Calcium channel blockers decrease the force of contraction of the myocardium (heart muscle), which in turn lowers the heart rate.

Besides decreasing the heart's muscular contraction, they also slow down the electrical conduction within the heart. Calcium channel blockers should be avoided or used with extreme caution in individuals suffering from weakness of the heart muscle (cardiomyopathy).

The number of various calcium channel blocker drugs are too numerous to mention here, however they all lower what in TCM terms would be called Heart Qi, which causes the common complaint of extra tiredness and exhaustion by those taking these drugs.

Adverse symptoms from taking calcium channel blockers are generally more serious than ACE inhibitors and are divided into non-life threatening and serious.

Relatively non life-threatening include:

  • Abdominal pain
  • Constipation
  • Drowsiness
  • Fatigue
  • Heart palpitations
  • Flushing or hot flashes
  • Nausea
  • Headaches
  • Sore throat
  • Swelling or water retention in the extremities

The following serious or life-threatening side effects make me wonder why anyone suffering from hypertension would ever want to take such drugs, especially when more natural lifestyle, dietary and herbal alternatives could work for them.

  • Chest pain
  • Heart attack
  • Serious low blood pressure symptoms such as dizziness, lightheadedness and fainting
  • Severe water retention with difficulty breathing which can be signs of heart failure
  • Depression
  • Paranoia
  • Breast enlargement in men (gynecomastia)
  • Temporary blindness
  • Various allergic reactions such as an unexplained rash, hives, itching, swelling, difficulty breathing, wheezing or swallowing

ACE inhibitors and calcium channel blockers are the two main weapons in a medical doctor's armamentarium for the treatment of hypertension heart failure. Most doctors prescribe a combination of both in order to broaden the effect of treatment.

Western herbal approach to the treatment of hypertension

Western herbalists usually prescribe hawthorn berries and leaf as well as garlic for the treatment of hypertension. Several studies have been generated around the successful use of these herbs.

Hawthorn

Researchers in Reading, UK conducted one such trial on 79 patients with type 2 diabetes. They were randomized to receive either 1200 mg of hawthorn extract daily or placebo for 16 weeks. Medication for high blood pressure was used by 71% of the patients. At the end of 16 weeks, those taking the hawthorn supplement had a significant reduction in mean diastolic blood pressure (2.6 mm Hg) with no herb or herb drug side effects or interactions.

From a traditional Western herbal perspective, hawthorn increases blood circulation, relieves nervousness and anxiety, and from Traditional Chinese Medicine (TCM) perspective, it promotes the digestion of protein and fats. Clearly the aim here is to treat the cause rather than just the symptoms of high blood pressure. I imagine with the above study what might be achieved with a somewhat higher dose of hawthorn taken over a longer period of time than a mere 16 weeks. The same would be true for the other herbs and supplements which I will describe as follows.

Garlic

For centuries, both Mediterranean and Chinese people have used garlic to prevent and treat cardiovascular disease including hypertension.  Some research has shown that garlic can reduce hypertension by as much as 7% or 8% and even lowers blood pressure in people with normal blood pressure. Garlic has also been found to reduce blood lipids and prevent arthrosclerosis in the aged. Because garlic works partially by thinning the blood and has potential to reduce even normal blood pressure, it should not be used with those taking blood-thinning drugs and used with caution for those taking hypertensive drugs.

From an herbalist's perspective, garlic is a virtual pharmacopeia in terms of the many benefits it has in health and healing. No wonder the old adage says, 'Garlic treats all diseases except the one that it causes.'  It is also said that there is no remedy for garlic breath except that others should also be taking garlic. I find that garlic gently promotes blood circulation, aids digestion, prevents and reduces fluid and phlegm accumulation and is anti-inflammatory. All of these together have a powerful effect on reducing hypertension.

Fish Oil

Fish oil assists blood viscosity (aiding circulation) and is powerfully anti-inflammatory. Preliminary studies have shown that it may have a modest effect on lowering high blood pressure.

Co Q10

Coenzyme Q10, or ubiquinone, is a naturally-occurring compound found in every cell of the body, thus its name 'ubiquinone,' from the word 'ubiquitous' meaning 'everywhere.'  From a TCM perspective Co Q10 would be an ultimate Spleen Qi tonic because of its key role in producing energy in the mitochondria of the cell which is responsible for the production of adenosine triphosphate (ATP), which acts as the cell's major energy source, responsible for many vital biological processes including muscle contraction, which would have a direct bearing on the contractile strength of the heart and the production of protein. In addition, Co Q10 is one of the most powerful antioxidants, serving to detoxify the body, strengthen the immune system and promote maximum longevity. Based on these facts, I would deem Co Q10 as the 'ginseng' of natural supplements.

Based on this fact alone, one would easily see how Co Q10 could benefit heart energy, most notably congestive heart failure. Certainly anyone taking antihypertensive drugs such as ACE inhibitors and calcium channel blockers, which are notoriously associated with fatigue, would benefit from adding at least 100 to 300 mg of Co Q10 to their daily regime.

For hypertension, there is evidence that Co Q10 may help in reducing hypertension. So far only a few relatively small trials have been conducted. However these have shown that even a modest dose of 60 mg of Co Q10 taken twice daily for 12 weeks will reduce systolic blood pressure 17.8 mm Hg. Another study conducted at the University of Western Australia involving 74 people with type 2 diabetes who were give 100mg of CoQ10 twice daily for 12 weeks significantly reduced both systolic and diastolic blood pressure with a mean reduction of 6.1 mm Hg and 2.0 mm Hg respectively.

So from the above we see how a Western herbalist might address hypertension.  A more wholistic oriented Western herbalist, however, would not be simple prescribing herbs and supplements for the heart but based on individual presentation, they might treat some of the underlying causes perhaps involving the liver or the kidneys that would be part of the unique imbalance of a patient presenting with high blood pressure.

Ayurvedic Treatment of Hypertension

In Ayurveda, the traditional medicine of India, high blood pressure, as with other diseases, is treated according to tridosha or the three constitutional types: pitta (fire), vata (air) and kapha (water) types.

The pitta or fire type has a tendency towards inflammation and will exhibit a more inflammatory form of hypertension, similar to a hypertensive pattern in TCM 'Exuberant Liver Fire' discussed below. This type will have many other heat sensitive signs, including heat sensitivity, flushed face, red eyes, headaches, light sensitivity, anger, irritability, and possibly nosebleeds. Keep in mind that one does not have to exhibit all of these to have a mixture of different Ayurvedic forms of hypertension.

The kapha or more phlegmatic, water type may have similar symptoms to what in TCM would is described below as 'Obstruction of Phlegm and Dampness' type hypertension. This type might exhibit symptoms of excess weight, water retention, high cholesterol and general feelings of heaviness and fatigue.

Finally, the vata or air type is a predominant neurological type of hypertension. It may be similar in TCM to what is described as both '˜Yin Deficient and Yang Excess' or 'Yang Deficient' type of hypertension. This individual will exhibit signs of general hypersensitivity to cold, bloating and gas, constipation, insomnia, nervousness, worry, or anxiety.

Besides recommending an appropriate pitta, kapha or vata balancing diet, specific herbal compounds would be prescribed. First and foremost Triphala, consisting of three fruits which harmonize and balance each of the three doshas, would be given. Amla fruit (Emblica myrobalan) works on the liver and lowers inflammation. Bhibitaki (Beleric myrobalan) works on the heart and cardiovascular system and reduces kapha in the form of excess fluids and blood lipids. Haritaki (Chebulic myrobalan) works on the vata or nervous system. All three are gently detoxifying and promote regular elimination.

Guggul is another Ayurvedic compound that is used because it is anti-inflammatory and promotes healthy cardiovascular circulation and reduces excess blood lipids. Finally, the Ayurvedic herb arjuna (Terminalia arjuna) is regarded as the single most effective herb for the heart and cardiovascular system generally. It relieves hypertension, lowers blood lipids, and strengthens the heart muscle for more efficient contractions. It is a virtual panacea for the heart.

Traditional Chinese Medical approach to treating hypertension

Traditional Chinese Medicine (TCM) treats according to disease and corresponding patterns. Hypertension in TCM is called Gao Xue Ya and there are four associated patterns that the TCM doctor must distinguish between.

The following is excerpted from Traditional Chinese Medicine: Pathologies and Patterns compiled and researched by John Ryan Wahnish, D, Ac., D.Ac., L.Ac.

 Some if not all of the above Chinese formulas are available as a Plum Flower Brand manufactured by Mayway Herbs.  The East West Clinic carries many of these but you may also purchase them from Chinese Herbs Direct.Dietary and Lifestyle Changes for HypertensionIdeally, any practitioner treating someone for hypertension would recommend dietary and lifestyle changes including reduction of salt, less or no red meat and dairy, and limiting or cutting out sugar, alcohol and caffeine.Benefits have been found from following a high-protein or even a high animal fat diet, the ketogenic diet. There is not sufficient consensus on this extreme dietary approach and other issues associated with it. That most individuals are unable to follow it on a long-term basis is an issue to consider.High vegetable and fruit diet seems to be beneficial for most people because these serve to eliminate toxic wastes and acids that tend to build up in the body. Reduction or elimination of refined carbohydrates, especially sugar and flour, are extremely important dietary measures to take for this condition.Whenever possible the healthiest cuts of fish, meat, poultry, range-fed eggs, and unpasteurized dairy should be favored over inferior options.Other lifestyle factors should also be attended to including lessening one's daily stress setting aside sufficient down time to recuperate. In addition one should try to include some aerobic activity a few times a week and get seven to eight hours of sleep each night. If, as with many who are older, it is difficult to sleep a full eight hours, try integrating a short afternoon nap as part of your daily routine.There are many causes and predispositions that can lead to hypertension and while most are, some are not amenable to natural herbal treatment. Again, consulting with a qualified health provider is ideal. In general, if it is not immediately life threatening, it is good to give the more natural approach to treatment a chance for one or two months before embarking on a lifetime of pharmaceutical drugs with a relatively high risk of adverse reactions.At the East West clinic, we have helped many patients suffering with hypertension. Those of you who are interested can make an appointment to consult with us personally or you can visit the East West Herb and Acupuncture clinic website at http://www.eastwestclinic.net/ and arrange for a personal telephone consultation with myself or my wife, Lesley. The East West Herb and Acupuncture Clinic is located in downtown Santa Cruz, 912 Center St. Sc. 95060. Call us at 831-429-8066.

Pathologies

Indications

Tongue/Pulse

TX Method

Formulas

EXCESS PATTERNS

Exuberant Liver Fire

Dizziness and vertigo, aching of the lower back and knees, hot feeling of the feet, palms and/or chest, palpitations, insomnia

Tongue '" red with little coating

Pulse '" thin, wiry

Nourish Liver and Kidney Yin, subdue Yang

Lycii and Chrysanthemum Pills (Qi du huang wan)

Exuberant Liver Fire

Dizziness and vertigo, distending pain of the head and eyes, irritability and anger, dry bitter mouth taste, dark urine, constipation

Tongue- red with yellow coating

Pulse '" rapid, wiry

Calm the Liver and drain Fire

Gentiana Combination (Long dan xie gan tang)

Obstruction of Phlegm and Dampness

Dizziness and vertigo, aggravated heaviness and pain of the head, irritability, nausea, oppression in the chest, low appetite, numbness and heaviness of the limbs, obesity

Tongue- enlarged with slimy white coating

Pulse-slippery, wiry

Dispel phlegm, transform dampness

Pinellia and Gastrodia Combination (Ban xia bai zhu tian ma tang)

DEFICIENCY PATTERNS

Yin and Yang Deficiency

Dizziness and vertigo, aggravated by movement, blurred vision, headache, tinnitus, palpitations, shortness of breath, weakness and aching of the lower back and legs, lack of strength, numbness of the hands

Tongue '" light red

Pulse '" thin, wiry

Tonify Kidney Yin and Yang

Two Immortals (Er xian tang)

arjuna

Thus far in this series we have described two other powerful herbs for coronary heart disease: hawthorn from the Western herbal tradition, and dan shen (Salvia miltiorrhiza) from the Chinese herbal tradition. Rounding out the trio with arjuna, a botanical from the Ayurvedic herbal tradition, we see that while all three have similar properties and effects, each has their own distinct virtues that work very nicely to complement each other in an herbal formula.

All three promote blood circulation, probably by making the blood less viscous or 'sticky.' Because of this shared blood thinning property, the same precaution holds for all three, which is that one should not take them with blood-thinning drugs and should consult with a qualified medical practitioner before using these herbs.

Hawthorn is particularly rich in flavonoids, which accounts for its well-known benefits for the heart. Dan shen contains tanshinone, which is a diterpenoid napthoquinone responsible for its blood-moving properties. Both hawthorn and dan shen also have mild calming properties so that either are effective for most cardiovascular diseases ranging from hypertension, arrhythmias, angina, hypertension, and heart failure, to strokes.

Arjuna is also rich in antioxidant effects as the other two herbs due to its flavonoid content, but it uniquely also possesses cardiac glycosides. A mention of cardiac glycosides usually brings up a red flag of caution because of their toxicity. (The notorious digitalis, derived from the common foxglove plant, is used medically to both slow and strengthen heart contraction, which sounds like a great thing, but it is quite toxic and most herbalists avoid it due to its narrow safety range.) In the case of arjuna, its cardiac glycosides are potent but safe. This means that while it possesses all the virtues of hawthorn and dan shen, arjuna is also able to gently strengthen and slow the heart rate with no risk of any adverse effects.

There's a well-known Chinese adage that says, 'It is far more difficult to win a battle if one begins to forge weapons after the war is in progress.' What this means in terms of cardiovascular disease is that along with following a healthful regime of regular moderate exercise, and a diet with adequate protein and essential fatty acids, organic whole grains, fruits and vegetables, it is the better part of wisdom to include herbs such as hawthorn, dan shen and/or arjuna as 'special foods' for the heart, for both the prevention and at least part of the treatment of cardiovascular disease.

Finally, having said this, I must reiterate that cardiovascular diseases are serious and life-threatening. It is therefore prudent that one consults with a qualified medical doctor and discusses the possibility of integrating or using herbs such as the three that I've presented as a substitute or at least in complement to whatever is medically recommended. While a cardiologist should be your first stop when dealing with such diseases, most are not trained herbalists and should not be expected to know the herbs described in this series. Chinese herbalists, licensed naturopathic medical doctors, experienced professional clinical herbalists such those with a registered herbalist degree (RH), professional American Herbalists Guild (AHG) members, and finally graduates of the East West Herb School with an East West Certified Herbalist (EWCH) degree should be able to offer appropriate guidance.

For a private herbal consultation contact Michael Tierra O.M.D., RH or Lesley Tierra, L.Ac., RH, at the East West clinic (831) 429-8066.

 


 

Notes:

Int J Cardiol. 1995 May;49(3):191-9.Salutary effect of Terminalia Arjuna in patients with severe refractory heart failure.
Bharani A, Ganguly A, Bhargava KD.

Terminalia arjuna Wight & Arn.--a useful drug for cardiovascular disorders. Dwivedi S. Preventive Cardiology Group, University College of Medical Sciences, University of Delhi, Delhi 110095, India. This email address is being protected from spambots. You need JavaScript enabled to view it. A, Ganguly A, Bhargava KD. Department of Medicine, M.G.M. Medical College, Indore, India.

http://www.raysahelian.com/arjuna.html

Sage Advice For the treatment of Coronary Heart Disease

It's not too often that a representative of a pharmaceutical company will call an herbalist asking what herb might be worth researching for a particular condition. Several years ago I had one such call and the representative was inquiring about herbs specific for cardiovascular disease and the relief of angina pectoris (periodic chest pains caused by cardiovascular malfunction). This condition is often a precursor to the number one disease in the Western world: coronary heart disease (CHD).

I thought that perhaps this was to be 'my day in the sun' with an opportunity to bring one of my favorite herbs to a much wider public. I considered mentioning hawthorn, but I knew of an herb that was even more effective for angina than hawthorn. In fact it's one that I've found to be practically 100% clinically effective for angina! (Of course, when it comes to healing, nothing is ever really 100% effective, but for the dozens of people complaining of angina to whom I recommended this herb, it proved to be 100% effective.)

I'm referring to the Chinese herb dan shen, known in the West as red sage root (Salvia miltiorrhiza).[i]

I put patients complaining of angina pectoris on red sage root, usually in pill form, dosed at approximately 3 grams, three times a day. In as few as two or three days on the herb, these patients reported no further angina attacks. Of course, this is a condition that will require a much longer period of treatment; for many, this may mean a lifetime commitment to dan shen.

What is angina pectoris?

Angina pain occurs when there is a reduction of blood flow to an area of the heart muscle. This can be due to damage to the inner layers of the coronary arteries caused by smoking, high blood lipids due to a high fat diet, high blood pressure, diabetes, or perhaps the most important cause of CHD, elevation of the amino acid homocysteine. When any of these occur, the result can be inflammation and scarring of the blood vessels. As these attempt to heal, atherosclerosis results: accumulated plaque hardens and narrows the arteries causing diminished flow of blood to the heart, which in turn causes the chest pain known as angina pectoris.

Other forms of plaque are soft and more likely to rupture and form blood clots, which in turn can block the coronary arteries and cause angina.

Four types of angina are recognized.

1. Stable angina

Physical exertion is the most common cause of this type of angina. Stable angina occurs when severely narrowed arteries do not allow enough blood to reach the heart to fulfill its demand for oxygen. It doesn't occur when one is sitting. Other causes of stable angina are

  • Emotional stress
  • Exposure to very hot or cold temperatures
  • Heavy meals
  • Smoking

2. Unstable Angina

This occurs when an artery is partially or totally blocked by blood clots. Blood clots may form, partially dissolve and reform so that angina occurs each time a clot interferes with arterial blood flow.

3. Variant Angina
This is caused by a spasm in a coronary artery that causes the walls to tighten and narrow. This type of angina can occur both in people with and without CHD. Some causes for this type can be:

  • Exposure to cold
  • Emotional stress
  • Medicines that tighten or narrow blood vessels
  • Smoking
  • Cocaine use

4. Microvascular Angina (MVD)

This type of angina is caused by reduced blood flow in the smallest coronary arteries, which can be caused by inflammation, plaque build-up, or spasms of damaged or diseased arterial walls.

Today, an estimated 6.5 million people in the US alone suffer from some form of angina pectoris. Barring an angioplasty, where a cardiologist operates to physically unblock clogged arteries, the standard of care usually involves the prescription of anti-platelet medications or blood-thinning drugs.

Enter red sage root, whose strikingly brassy red roots resemble the veins and arteries of the body.

Dan shen is used in Traditional Chinese Medicine (TCM) to 'regulate or move blood.' In Chinese medicine it is classified as having a bitter taste (usually meaning that it is moving and detoxifying) with a cool energy. It specifically enters the Heart, Pericardium and Liver meridians. The average effective daily dose is between 6 to 15 grams, divided into two or three doses per day. Apart from its use as a superior cardiovascular herb, it is used for many other conditions where promoting blood circulation and relieving blood stagnation (this would include blood clots) is needed, for clearing inflammation (recognized as a major cause of CHD), to calm the mind and soothe irritability (also associated with heart disease), and finally, to relieve stomach pain probably caused by ulcers and esophageal reflux. Those with an advanced understanding of herbal medicine recognize that the inclusion of blood-moving herbs in a formula greatly enhance the treatment of most chronic disease. This is especially true when treating angina and CHD diseases.

Despite my suggestion to the pharmaceutical industry to study red sage root for the treatment of CHD, to this day little Western research has been undertaken for this herb. However, a considerable number of Chinese studies support the therapeutic claims for this remarkable botanical. Both animal and human studies conducted in China have found that dan shen improves blood circulation by limiting the stickiness of blood platelets while inhibiting the production of fibrin. This significantly reduces the formation of arterial plaque and blood clots.

An in vitro study from Yamanashi Medical University, Japan[ii] found dan shen comparable to a typical calcium channel-blocker in its effect of increasing coronary blood flow, making it a potential treatment for angina without the invasive risks and side effects of conventional medical treatment.

Unlike pharmaceutical drugs that only thin the blood and make one vulnerable to bleeding disorders, dan shen actually promotes healing of traumas and wounds but also has a calming and relaxing effect, which is known to relax and widen the blood vessels around the heart. Needless to say, this makes dan shen particularly useful for the treatment of hypertension.

Danshen is also useful as:

  • A potent antioxidant preventing the oxidation of LDL cholesterol [iii]
  • Can be used for patients undergoing cardiovascular disease from heart damage during surgery[iv], [v]
  • Improves the survival rate of patients after a heart attack[vi]

Many doctors will give their aging patients a prescription of nitroglycerin to have on hand just in case they should ever suffer a heart attack. Wouldn't it be better if instead they recommended daily use of dan shen to prevent the slow buildup of conditions that lead to CHD? One study has shown that dan shen is more effective than nitroglycerin for improving heart function and circulation. [vii]

Much more can be said about this remarkable herb for treatment and prevention of CHD as well as many other diseases including diabetes, cancer, HIV/AIDS, osteoporosis, hearing loss, and Alzheimer's Disease.

Dan shen seems to be an ideal herb for the aged to take prophylactically, which is one reason it is so popular in China. It can be taken singly or in combination with other blood-moving, heart protective herbs, which in many cases will offer a wide range of benefits.

Thus far I have discussed a common Western herb, hawthorn berry and leaf, popular in North American and European herbology and now a Chinese herb that one can even grow in one's (seeds or plant starts available from Horizon Herbs. My next blog will conclude the series with a discussion of a powerful Ayurvedic herb for the heart.

Caution: Dan shen (or any blood-moving herb) should not be taken unsupervised by patients taking anticoagulant medications such as warfarin, heparin, or Ticlopidine.[viii] Further, CHD is a potentially lethal disease for which one should seek qualified medical assistance. I don't recommend simply substituting or dropping any prescribed drug without first consulting with your primary care physician. After carefully weighing all the pros and cons, I believe it is a patient's right to pursue whatever course of action they deem to be prudent.

Those seeking a personal consultation may call the East West Herb Clinic at (831) 429-8066.



[i]Ji XY, Tan BK, Zhu YZ., Department of Pharmacology, Faculty of Medicine, National University of Singapore, 10 Kent Ridge Crescent, Singapore 119260. Acta Pharmacol Sin. 2000 Dec;21(12):1089-94, .Salvia miltiorrhiza and ischemic diseases

[ii] Sugiyama A, Zhu BM, Takahara A, Satoh Y, Hashimoto K. Cardiac effects of salvia miltiorrhiza/dalbergia odorifera mixture, an intravenously applicable Chinese medicine widely used for patients with ischemic heart disease in China. Circ J. 2002 Feb;66(2):182-4.

[iii] O K, Lynn EG, Vazhappilly R, Au-Yeung KK, Zhu DY, Siow YL, Magnesium tanshinoate B (MTB) inhibits low density lipoprotein oxidation, Life Sci. 2001 Jan 12;68(8):903-12.

[iv] Zhou S, Shao W, Duan C. Observation of preventing and treating effect of Salvia miltiorrhiza composita on patients with ischemic coronary heart disease undergoing non-heart surgery. Zhongguo Zhong Xi Yi Jie He Za Zhi 1999 Feb;19(2):75-6.

[v] Tang MK, Zhang JT, Salvianolic acid B inhibits fibril formation and neurotoxicity of amyloid beta-protein in vitro, Acta Pharmacol Sin. 2001 Apr;22(4):380-4.

[vi] Ji X, Tan BK, Zhu YC, Linz W, Zhu YZ. Comparison of cardioprotective effects using ramipril and DanShen for the treatment of acute myocardial infarction in rats. Life Sci. 2003 Aug 1;73(11):1413-26.

[vii] O K, Cheung F, Sung FL, Zhu DY, Siow YL. Effect of magnesium tanshinoate B on the production of nitric oxide in endothelial cells.Mol Cell Biochem 2000 Apr;207(1-2):35-9.

[viii] Chan TY. Interaction between warfarin and danshen (Salvia miltiorrhiza). Ann Pharmacother. 2001 Apr;35(4):501-4.

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