The beauty of a spring meadow in bloom, the profound sense of presence in a grove of Redwoods - the heart takes flight and the spirit is healed. This is not the only way in which the magnificent flora with which we share our planet can bring healing to our hearts, it can be physical as well. 
   
Half the annual mortality in America results from heart and blood-vessel diseases, so any contribution that herbal medicine can make to its treatment is to be welcomed. Modern cardiology can achieve  much and is seemingly miraculous when it comes to acute emergencies, but what of maintaining good health and preventing the development of a pathology? Is there more that we can do for ourselves than simply minimizing risk factors and appropriate exercise? Emphatically yes! 

There are profound concerns about toxicity from long term use of prescription medications. Although it is resplendent in ‘wonder drugs’, the materia medica of modern medical science is sorely lacking in preventive medicines. Tonics are not mentioned in pharmacology texts as the concept is considered illusory.

The discarding of gentle toning therapies in favor of intensely active ones can be seen as one of the core problems with orthodox health care. This need not be seen as a clash of approaches which are mutually exclusive. There is a place for gentle toning  just as there is a place for the often dramatically successful techniques of cardiology. They can complement and support each other. 
   
Plants still maintain a central position in orthodox medicines treatment of various heart problems. Herbs containing constituents called cardiac glycosides are used world-wide for treating heart failure and arrhythmia’s. They increase the strength of heart beat, and normalize the rate of beat. Foxglove is the source of the widely used medication digoxin but it is not just Foxglove that has such actions, as Lily of the Valley shares its therapeutic value.
     
However, another group of herbs, known as cardiovascular tonics, are uniquely suited for treating problems of the heart and blood vessels. While not having the dramatic, rapid and often life-saving effects of many cardiological drugs, they have a definite advantage when treating or preventing chronic degenerative conditions. In addition to tonic remedies for the heart there are also tonics for the blood vessels, often rich in constituents called flavones. These remarkable herbs include Hawthorn, Garlic, Linden and Ginkgo.
     
There some limitations to the use of herbs in treating the heart. This is not a herbal limitation but a human one as self diagnosis is a very hazardous pastime! In the hands of a well trained clinical phytotherapist medicinal plants offer a great deal in the treatment of cardiovascular conditions, but for the non-professional, self selection of herbs or self-diagnosis should never replace competent diagnosis or a substitute for prescription medicines.
   
There is a need for safe, effective, readily available and affordable herbs that also have a pleasant taste or aroma or as the medieval herbalist Gerard would say “toothsome”. Traditional herbalism offers a cornucopia of remedies that fit the bill (although unfortunately they are not all toothsome!).  Such tonic herbs should be part of a holistic program  designed to meet the unique needs and circumstances of each individual.
     
Hawthorn (Crataegus spp.) is the most relevant tonic for the heart. There are stronger herbs, but none that provide the nourishing regeneration of Hawthorn. The turn of the century physician, Dr. Ellingwood said of Hawthorn that “... it is superior to any of the well known and tried remedies at present in use for the treatment of heart disease, because it seems to cure while other remedies are only palliative at best.”  
     
Hawthorn offers a way of strengthening the heart in the face of the struggles and strife of life, a medicine that is remarkably free of side effects, effective in its actions, and affordable.  Following a report by the German Federal Ministry of Health, Hawthorn has gained full recognition as a heart remedy in Europe.1[1]  They found that it increases the strength of contraction of the heart muscle, normalizes irregular heart beat and increases coronary circulation by dilating the coronary arteries. They concluded that its clinical applications were the long-term treatment of ‘loss of cardiac function’, any situation where there is a subjective feelings of congestion and 'oppression' in the heart region, mild arrhythmia’s and conditions of the aging heart that do not call for Digoxin. Most significantly no side effects were noted.
     
How does the it achieve results?  By dilating the coronary arteries and improving coronary circulation, it reduces the likelihood of anginal attacks and relieves the symptoms. Hawthorn also aids availability and utilization of energy by heart tissue. The end result is a gentle but long term, sustained positive effect on degenerative age-related changes. It does not produce rapid results but they are persistent once achieved.
     
Putting it simply - Hawthorn will help keep the heart healthy, preventing the development of coronary disease.  It may be safely used in conditions such as myocardial problems, angina pectoris, angina pectoris, hypertension.
     
A very pleasant tea can be made from 2 teaspoonfuls of the berries infused in hot water and drunk daily.  Using the tincture is a convenient and effective way of gaining the therapeutic benefits, but to gain most 100 drops are taken twice a day. This may be taken over long periods of time as their is no concerns of toxicity.
     
Hawthorn need not be seen as a ‘medicine’, but as a food. As an example of how this heart tonic can be used daily how about making a conserve:
     
Hawthorn Berry Conserve
   
Soak a large handful of dried berries in apple juice, enough to cover plus a few inches, with a cinnamon stick  overnight in a refrigerator. Take out the cinnamon stick and blend the berries with a little honey. Keep refrigerated.
     
Another important heart herb, Ginkgo, has an abundance of research revealing  many important therapeutic effects. Focusing on the cardiovascular use the research shows that it lowers blood pressure, dilates peripheral blood vessels, and increases peripheral blood flow.  In patients with peripheral arterial insufficiency there was an improvement in the ability to walk without pain. In addition to its preventive use, Ginkgo has  been recommended in the treatment of a number of heart and blood vessel problems, especially those due to vascular insufficiency. Its use is indicated in both peripheral circulatory insufficiency and cerebral vascular insufficiency. An exciting use is in treating circulatory disturbances due to aging, diabetes and tobacco.
     
In addition to the heart tonics, other herbal actions can be helpful. Especially important are the relaxing herbs, such as Motherwort, Linden, Scullcap and Valerian.  Circulatory stimulants, such as Cayenne, Ginger and Prickly Ash increase blood flow supporting oxygenation of tissue and the elimination of waste. This makes them important in circulatory problems as well as conditions such as rheumatism.
     
On the other hand there are other herbs that should be avoided even though they do not contain cardiac glycosides.  Examples are Scots Broom and Ma Huang, both of which stimulate heart activity and raise blood pressure. They are contra-indicated in many conditions and should not be considered tonics.
     
A well rounded program that strengthens the heart must involve more than simply herbs. There is not the space here to explore all the other factors in detail but a major influence to heart disease are risk factors whose impact can be minimized.  Whole forests have been turned into paper for articles about these factors, and anyone trying to read them all and follow the debates that rage invites a hypertensive crisis!
     
Some of the factors that contribute to the scourge of heart disease are well known and have lead to widely accepted guidelines for lessening risk. However simple statements can be misleading. For example, one study failed to show any association between heavy coffee consumption and long term hypertension. Such coffee drinkers tend to be heavy smokers as well and this in turn may be associated with a lower body weight and thus a lower blood pressure - but with increased risk of heart attack!

Eat food that you like as well as being low in cholesterol and the saturated fats. A diet free of animal products can lower cholesterol levels and blood pressure. 
    
Ensure an adequate amount of fibre in your diet. Fiber such as that from oat bran and psyllium seeds will lower the assimilation of cholesterol from the diet. 
    
Minimize salt, avoid stimulants and drink little or no alcohol. 
    
Don’t smoke tobacco. 
    
Ensure you get enough exercise, that is both aerobic and enjoyably. 
    
Relax - watch the grass grow! 
    
Maintain your health in general and especially maintain normal blood pressure. 
    
As Dr. Andrew Weil puts it ‘open your heart’.

An emotionally ‘broken heart’ is not just a coincidental use of the word. Compassion, careing and loving respect are all heart tonics.
   
Cholesterol has become a name that carries fearful connotations! However as a normal part of metabolism, found in all cells of the body, it fulfills vitally important functions, but eating too much is  a major risk factor.  Plants can influence cholesterol levels in a way that has evolved as our bodies evolved, effecting fat metabolism and blood chemistry in a variety of safe ways.
   
Garlic has a well deserved reputation for lowering both cholesterol levels and blood pressure. It is also a gently effective anti-thrombotic agent. In one study  a group of healthy volunteers who were fed Garlic was compared with a group of people with coronary heart disease and raised serum cholesterol. Beneficially changes were found in all involved and reached a peak at the end of 8 months.  The clinicians concluded that Garlic possesses a distinct fat reducing action in both healthy people and patients with coronary heart disease. Cayenne pepper and its relatives lower blood cholesterol levels, as does the widely used spice Fenugreek. 
   
Garlic also reduces the tendency for unnecessary clotting to occur within blood vessels, lessening the ‘stickiness’ of blood platelets by reducing aggregation and inhibiting the release of clotting factors in the blood. Interestingly, the blood pressure normalizing and cholesterol lowering action of Garlic are not lost in cooking, whilst the anti-microbial effects appear to be. The cold pressed oils from Evening Primrose, Borage seed and other plants are rich sources of the polyunsaturated fats that are natural precursors of prostaglandin in the body. These substances dilate blood vessels, reduce platelet stickiness, reduce cholesterol production. 
   
In a addition to use in the maintenance of heart health, the tonics can be a valuable contribution to the treatment specific conditions.  The heart tonics are a safe adjunct to aid in the recovery from a heart attack. Remedies such as Hawthorn and Ginkgo support in the renewal of tissue and regaining as much cardiac function as possible.  Relaxing herbs such as Linden and adaptogens such as Siberian Ginseng  ease anxiety and help in coping with stress. 
   
Hypertension, an all too common problem in our culture, can often be effectively treated with herbs. A number of herbs have a reputation as being effective, working because of their impact on one or other of the processes involved in the conditions development. A partial list of the most widely would include Fenugreek, Garlic, Green Tea, Hawthorn, Linden, Siberian Ginseng and Valerian. 
   
A safe and pleasant combination that will gradually normalize the blood pressure consists of Hawthorn and Linden. This is most conveniently used as a tincture where equal amounts of both herb tinctures are combined and half a teaspoonful of the resulting mixture is taken twice daily. If using the dried herb, make a tea with two teaspoonfuls of a mixture of the herbs and drink 3 times a day. Garlic should be used as a dietary supplement. Relaxing herbs such as Valerian and Linden will any tension and anxiety, whilst  Siberian Ginseng should be consider where stress as a major factor.

[1] Ammon & Handel : Planta Medica 1981, 43 (3) 209