It is always advisable to seek professional medical support in case of any cardiovascular health issues. 

If you have a pre-diagnosed cardiovascular condition and wish to take herbal medicines to help with this, it is advisable to seek the guidance of a medical herbalist who will ensure that you are provided with appropriate support unique to your condition.

Find a local herbalist on the where to find a herbalist page for further details on how to book an appointment with a medical herbalist.

Hawthorn (Crataegus spp.)

Hawthorn is a wonderful tonic for the heart, both physiologically and energetically. It is known as a cardiac trophorestorative, meaning it helps to restore and strengthen the tissues of the cardiovascular system, including the heart muscle and blood vessels. This trophorestorative action provides support to the entire cardiovascular system, aiding recovery from and preventing progression of cardiovascular issues.

Hawthorn is considered such a beneficial support for the cardiovascular system that many herbalists prescribe it for people above the age of 50 as a preventative measure for reduced cardiac function commonly associated with older age.  In addition to its cardiac trophorestorative actions, hawthorn is also considered a  safe herb to take as a preventative and for patients with diagnosed heart conditions.

Hawthorn has a long history of traditional use for cardiovascular health, dating back as far as 1640, when it was recommended in cases of dropsy (fluid accumulation caused by heart failure).

Hawthorn has a variety of modern applications including:

• Angina pectoris
• Mild congestive heart failure
• Cardiac arrhythmias
• Hypertension (high blood pressure)
• Mild heart and circulatory conditions (especially when stress is a factor as it also eases anxiety)
• Palpitations, which although felt as a hard beating of the heart, are usually not a cardiovascular problem as such, but often triggered by anxiety or stress.
• Improves peripheral circulation
• Preventative for atherosclerosis
• Antioxidant (preventing cholesterol oxidation) (3)

Both the flowering tops (leaves and flowers) and berries of the plant are used. They each have varying quantities of similar constituents known to exert a beneficial effect on the cardiovascular system.

Generally, the berries are considered more effective for lowering blood pressure, and the flowering tops for improving peripheral circulation.  A combination of the two parts can be taken to address both issues. 

The main constituents found in hawthorn that support cardiovascular health include:

Flavonoids

Quercetin and rutin being the predominant ones. 

High flavonoid intake is associated with reduced risk of cardiovascular disease.Flavonoids are known to improve the integrity of blood vessels, especially reducing capillary fragility and permeability (3).Studies have found that people with the highest rate of dietary flavonoid intake have the lowest rate of heart disease(4).  An average daily intake of as little as 75 mg of quercetin was found to offer protection from cardiovascular diseases (5).

Oligomeric proanthocyanidins (OPCs)

Proanthocyanins have been found to have a host of beneficial effects on the cardiovascular system :

• Protective for blood vessels
• Reduce capillary permeability
• Prevent oedema
• Antioxidant
• Prevent and reduce damaging effects of atherosclerosis (3)

The flowers contain the highest levels of flavonoids, and the leaves the highest level of OPCs, so a combination of flowering tops offers the most comprehensive benefit. 

Hawthorn exerts its effect on the cardiovascular system through a number of mechanisms including (6):

• Positively inotropic: This strengthens heart’s contractions so it can pump more blood with fewer heartbeats.
• Negatively chronotropic: Decreases the heart rate.
• Increases coronary blood flow: This is the supply of blood to the heart itself which provides vital nutrients and oxygen to the heart muscle.

Hawthorn increases the parasympathetic tone of the heart, thereby slowing down the heart rate (negatively chronotropic). This, combined with the positively inotropic effect means that the pumping action of the heart muscle becomes more efficient, conserving energy used by the heart.

Many of these findings about the actions of hawthorn on the cardiovascular system have been from in vitro (studies on tissues or cells), and in vivo (animal studies), which do not produce results directly relatable to humans. However, other placebo-controlled, double blind trials studying the effect of hawthorn berries and leaves in cardiovascular patients found significant reductions in heart rate times and blood pressure, suggesting that these effects are also expressed clincally(7).

The varying perspectives on the energetic qualities of hawthorn are concurrent with modern herbal applications, especially in cases of cardiovascular symptoms associated with nervousness, stress, or anxiety.

According to Ayurvedic principles, hawthorn is helpful in cases of vata heart conditions such as nervous palpitations.  It is also considered helpful for cardiovascular issues of older age (which is considered the age of vata), such as arteriosclerosis (8).

In traditional Chinese medicine, the heart is considered to store the shen, and disturbed shen can include symptoms such as anxiety and palpitations.  This ties in with both the Ayurvedic perspective of imbalances in vata, and the Western herbal perspective of hawthorn as a cardiovascular trophorestorative (9).

A literature review of Crataegus monogyna concluded that it is helpful as a preventative medicine for cardiovascular disease. Hawthorn appears to reduce cardiovascular risk factors, such as hypertension and thrombosis, with an overall beneficial effect on cardiac function. It is also considered a safe herb with no adverse effects showing up in clinical trials (10).

A randomised, multicenter, double-blind, placebo-controlled, international clinical trial looking at the effect of a Crataegus extract given to patients with chronic heart failure was carried out with a large sample size (2681 participants randomised into placebo and the medication group).  The primary outcome measure was the number of days between baseline and the first cardiac event.  There were various secondary outcome measures including echocardiography and quality of life measures.

The results of this study did not show a statistically significant difference in time to first cardiac event with the hawthorn extract as an add-on to conventional treatment compared to conventional treatment alone. However, most outcomes measured showed favourable results for those in the group taking the hawthorn extract compared to the placebo group, even if these results were not statistically significant. Furthermore, the authors concluded that on analysing the secondary outcomes of the study that the addition of the hawthorn extract seemed to reduce sudden cardiac death in patients with a specific type of heart failure (LVEF) between 25–35%. The hawthorn extract was well tolerated with an excellent safety profile (11).

It should be noted that the hawthorn extract given during this trial was WS® 1442, which is a dry extract from hawthorn leaves and flowers (4–6.6:1), extraction solvent: ethanol 45% (w/w). The extract is adjusted to 17.3–20.1% oligomeric procyanidins. Film-coated tablets containing 450 mg of the extract were used at a dose of two capsules per day corresponding to 900 mg per day.

Bilberry (Vaccinium myrtillus)

Bilberry has an affinity for the circulatory system ast it improves the integrity of the capillaries and blood vessels. It is particularly helpful in cases of varicose veins, haemorrhoids, and venous insufficiency (reduced circulation of the blood from the legs back towards the heart, due to poor venous function) (2).

Bilberry contains anthocyanins, which are cardioprotective not only through protecting damaged capillaries, but also through promoting their repair (6).  Bilberry has been shown to increase peripheral blood circulation.

Bilberry can be taken as a fluid extract, and is often taken as a supplement.  However, a recent analysis of supplements sold in pharmacies and health food stores found that they are often adulterated with anthocyanins from other cheaper berry extracts, or, they do not contain any beneficial extracts at all (12).

It would be advisable to only take the supplements from a reputable source or to seek guidance of a medical herbalist.

Lime flower (Tilia spp.)

Lime flower has a long history of traditional use as a remedy for cardiovascular issues which are linked to stress and anxiety.   It is a peripheral vasodilator and relaxant, helping to relax the blood vessels, making it a useful herb in cases of hypertension (2).

Lime flower eases restlessness and irritability so can be particularly helpful when cardiovascular symptoms such as high blood pressure or palpitations are accompanied by stress or tension. It is also recommended in cases of arteriosclerosis, and any circulatory conditions such as varicose veins due to its toning and soothing effect on peripheral blood vessels. The best way to enjoy this herb is as a strong infusion of the flowers and leaf-like bracts which can be collected in spring.

Motherwort (Leonurus cardiaca)

The Latin name for this herb cardiaca, is suggestive of this herb’s affinity for the heart and its long history of traditional use for treating conditions of the cardiovascular system.

Motherwort is considered a cardiotonic, as it improves the tone and function of the cardiovascular system and is helpful for issues of the heart, especially when they are exacerbated by emotional stress (2).

Motherwort is beneficial for palpitations, high blood pressure (especially when stress or anxiety are a factor), in nervous tachycardia (fast heartbeat), and arrythmias (9).

A study on participants with arterial hypertension accompanied by anxiety and sleep disorders were treated with motherwort. The results showed significant improvements in blood pressure, heart rate, ECG, and psycho-emotional status (13). However, this study was carried out using a motherwort oil, and in practice it is usually tinctures or infusions which are taken, so although promising, these results do not necessarily translate to different preparations of motherwort.

The herb can be drunk as an infusion, it has a distinctive bitter taste and may blend well with hawthorn, which brings a slight sweetness.

Yarrow (Achillea millefolium)

Yarrow is a known peripheral vasodilator, making it helpful in combination with other herbs for managing hypertension. It combines well as a herbal infusion with hawthorn and lime flower.

Yarrow has been noted in a recent review of medicinal plants in the treatment of hypertension as a herb which was used in traditional Persian medicine as part of a treatment for hypertension and cardiovascular health. This was under the principle that alleviating hypertension helps to ease the pressure on the cardiovascular system and prevent further disease (14).

Yarrow also has a styptic action, meaning it can staunch bleeding when applied directly to a wound on the skin, as well as a vulnerary action to stop bleeding, tone the tissues and promote healing (2). It may be this combination of actions which also makes yarrow essential oil helpful in the treatment of varicose veins when blended into a cream for topical application.

Arjuna (Terminalia arjuna)

Arjuna is a traditional Ayurvedic remedy for heart conditions. It is considered a cardiotonic, as it strengthens, nourishes, and repairs the heart and blood vessel tissues. It is given as treatment for angina, hypertension, congestive heart failure, and coronary artery disease (15). It can aid recovery from heart attacks, as well as act as a preventative measure for those at risk of cardiovascular diseases (8).

Arjuna can reduce inflammation and coagulation of blood, which may impact cardiovascular function. Energetically, arjuna is thought to provide courage and strength of will, fortifying the heart to accomplish one’s true goals in life (8).

Garlic (Allium sativum)

Garlic has a host of benefits for the cardiovascular system, including helping to decrease hypercholesterolemia (high cholesterol), hypertension, and as a preventative for atherosclerosis (2). A recent literature review supports the idea that garlic has the potential to treat and prevent a variety of cardiovascular conditions (16).