The Heart of the Matter: Cardio Tonic Herbs

By Maria Noël Groves, RH (AHG), Registered Clinical Herbalist

Think of the cardiovascular system as the highways and byways in the road map of our body. Nutrients, hormones, oxygen, immune cells, and other important compounds speed their way through your body through this intricate system of vessels. These vessels need to be smooth, flexible, and resilient to handle the day-to-day stress of traffic flow. At the center of this universe lies your heart, a literal symbol of vitality and life for your entire body, pumping blood to the rest of your body. The heart also plays a psycho-spiritual role; almost every culture sees it as the seat of emotions. Unfortunately, cardiovascular disease is the number one killer in the United States, and it can be difficult to catch in the early stages.

Risk factors for heart disease and cardio-related death include high cholesterol, high blood pressure, diabetes and insulin resistance, smoking, poor diet, sedentary lifestyle, inflammation, oxidation, stress, obesity, and family history. But keying in on just one of these risk factors can give us a false sense of security. For example, approximately half of first-time heart attack patients have normal cholesterol levels, and the jury is still out on whether artificially lowering high cholesterol with statins actually reduces your overall morbidity and mortality risk. While nothing is a guarantee, keeping a wide range of our risk factors at bay certainly improves our odds, as do a slew of wonderful herbs and delicious foods.

Hawthorn Berries, Leaves & Flowers (Crataegus spp), the research amazes me. How can one herb – growing happily at the forest’s edge – have such affinity for the human heart? The berries, leaves, and flowers of this thorny tree strengthen the pumping ability of the heart muscle, enhance blood flow and supply to the heart, dilate and relax blood vessels, lower blood pressure, and protect the cardiovascular system from oxidative stress. Antioxidant pigments called procyanidins in hawthorn also appear to inhibit angiotensin-converting enzyme, an enzyme that catalyzes blood vessel constriction and the target of ACE-inhibitor hypertension drugs. Over time, hawthorn improves oxygen supply to the heart and strengthens the muscles of the cardiovascular system. The red rosehip-like berry tastes good, is rich in antioxidants, and has traditionally been used. Modern phytopharmacology focuses on the leaves and flowers, and many herbalists combine all three parts into their preparations. I’m particularly fond of the solid extract, but homemade teas and tinctures – while less concentrated – still offer benefits. Hawthorn is a gentle, slow-acting tonic, so it may take a couple months of steady use to notice the effects. Blood pressure numbers may only improve a bit, but overall benefit throughout the cardiovascular system is impressive. Hawthorn shows promise for mild, chronic congestive heart failure, cardiac insufficiency, post-heart attack care, an aging heart, arrhythmia, angina, cardiomyopathy, and overall heart health. It’s very safe with few side effects or contraindications. However, hawthorn has a potentially dangerous synergistic effect when combined with digitalis/ digoxin and blood pressure meds. Practitioners in Europe purposely combine hawthorn with digoxin to lessen the drug dose and side effects while maintaining efficacy, but this requires the skill of a trained practitioner.  If you take blood pressure medication, work with your doctor to determine whether or not your medication doses should be reduced.

Hibiscus Flowers (Hibiscus sabdariffa) and Rooibos (Aspalathus linearis), are two tasty red teas that have been making headlines for their cardiovascular benefits. Popular in Central America, hibiscus offers similar plant chemicals and antioxidants as berries: blue-red pigments called anthocyanins, citric acid, malic acid, polyphenols, bioflavonoids, and as small amount of vitamin C. The plain, strong tea tastes like unsweetened cranberry juice. A handful of recent preliminary studies have found that drinking just a few cups of hibiscus tea lowers hypertension. In one study, four weeks of hibiscus outperformed the blood pressure drug lisinopril while also lowering sodium (but not potassium) levels and inhibiting ACE. Hibiscus also appears to have a positive effect on cholesterol and triglycerides and may have protective effects for the capillaries, blood sugar/diabetes, insulin resistance, and the liver. South Africans sip on rooibos, an antioxidant-rich fermented caffeine-free tea that tastes like a mild black tea with fruity, plum-y undertones. Preliminary research shows that rooibos protects the liver and reduces cholesterol and blood pressure. In one study, participants who drank six cups of rooibos tea daily for six weeks (as opposed to just water), increased blood levels of polyphenols and nutrients, decreased cholesterol oxidants, increased function of the body’s natural antioxidant systems, decreased LDL cholesterol and triglycerides, and increased HDL cholesterol. Another study found that it reduced hypertension and inhibited ACE. Even though the research on both plants is still preliminary, they have such a high degree of safety, they’re worth adding to your daily routine.

Pomegranate frequently makes headlines for its antioxidant and health-promoting properties. Research suggests the puckery, sweet seeds reduce atherosclerosis, enhance nitric oxide, improve endothelial function, reverse plaque buildup, and reduce heart disease risk. Pomegranates are in season sporadically throughout the winter months but are available year-round as juice. Look for products made with 100 percent pomegranate. Drink it straight and add it to seltzer water, smoothies, salad dressings, and sauces.

Berries pack a healthy punch in a tasty, little package. In a Finnish study published in the American Journal of Clinical Nutrition, eating about five ounces daily of mixed berries reduced blood pressure and increased good cholesterol. Cranberries and cherries also appear to reduce bad cholesterol, total cholesterol, and blood pressure while enhancing endothelial health. Dark purple grapes contain antioxidant resveratrol, noted for cardioprotective actions including the ability to tighten and tone the vascular lining. Though it’s most famous in the form of red wine, drinking 100 percent dark purple grape juice offers similar benefits. Check out the juice section as well as frozen concentrates. Aim for at least a 1/2 cup of berries fresh, frozen, pureed, juiced daily.

Linden Leaves and Flowers (Tilia spp) are abuzz with bees when in bloom. The ornamental trees, also called lime (no relation to citrus) and basswood, line the streets in cities throughout Europe and America. The leaves are shaped like hearts and are almost always enjoyed as a pleasant tasting, honey scented tea. Europeans enjoy the calming, flavonoid-rich tea after dinner. Although research is slim, European herbalists have long relied on linden to calm and strengthen the heart, reduce blood pressure, decrease inflammation, relax spasms, and soothe the nerves. It’s specific for stress that manifests in the heart and heart issues aggravated by stress, as is the less pleasant tasting motherwort (Leonorus cardiaca).

Cocoa & Dark Chocolate (Theobroma cacao) may be our most delicious heart tonics. Native people who consume cocoa beverages have reduced hypertension, and researchers back that up with clinical studies on more than 66,000 people showing that cocoa consumption reduces the risk of death due to heart disease. Chocolate is made from cocoa liquor, cocoa butter, sugar, and often milk. Beneficial compounds including antioxidant flavanols and magnesium seem to work together to have broad-reaching benefits on the cardiovascular system. Preliminary studies show that chocolate reduces the oxidative stress that aggravates atherosclerosis and plaque formation, decreases the inflammation known to aggravate cardiovascular disease, increases circulation, decreases blood pressure, improves the integrity of the walls of our blood vessels, and may also improve cholesterol and glucose levels. The higher the cocoa content, the better the effects. Dark chocolate has 120 to 150 mg of beneficial polyphenols while pure cocoa has almost five times that amount and milk chocolate has almost none. And, it boosts your mood! Enjoy a few squares of dark chocolate and incorporate cocoa nibs and cocoa powder into smoothies, hot beverages, and recipes.

Heart-Healthy Diet & Lifestyle

Dean Ornish proved that we can slow, stop, and even reverse heart disease with diet and lifestyle, and these tactics remain our most heavy-hitting heart remedies. Here are the basics:

Eat Well: Opt for low-glycemic, high-fiber whole foods (whole grains, beans, nuts, seeds), foods rich in omega 3s (fatty fish, flax oil, chia, hemp, walnuts, purslane), olive oil, ideally nine servings of vegetables and fruit daily in a rainbow of colors, garlic, onions, plenty of antioxidant and inflammatory herbs and spices, green tea, and red wine and dark chocolate in moderation. Vegetarian and vegan diets are most promising; if you opt to eat meat, choose grass-fed or wild sources (which will provide some heart-healthy omega 3s), and keep them in moderation.

About those spices… a recent study published in the Journal of Nutrition, researchers gave study participants highly spiced meals (about a half ounce of high-antioxidant spices added) or the same meal without spices. The spices meals demonstrated 20 to 30 percent less of an insulin and triglyceride response as well as 13 percent higher ORAC (antioxidant) levels. The spice blend included rosemary, oregano, cinnamon, turmeric, black pepper, garlic powder, cloves, and paprika. The researchers estimated that the spices provided similar antioxidant levels as a glass of wine or one and a half ounces of dark chocolate. Take a cue from some of the heart-healthiest, most heavily seasoned, plant-based diets in the world: Mediterranean, Indian, and Asian.

Exercise: We call it “cardio” for a reason! All forms of exercise have merit, but mild to moderate intensity cardiovascular exercises like walking, dancing, and biking strengthen the heart and lung muscles, improve circulation, and decrease blood pressure. If you currently have heart disease or are completely sedentary, work with a trainer or qualified expert to slowly work your way into a regimen.

Calm Mind: Stress has an incredible effect on heart disease and is actually a better predictor for heart disease than cholesterol, cigarette smoking, or obesity! Work-related stress doubles your risk of dying from heart disease. On the flip side, regular meditation, yoga, tai chi, qi gong, and other forms of stress management and mind-body balance have a direct beneficial effect on the heart.

Safety Note

If you have heart disease or are currently taking medication, it is particularly important that you work with your doctor, naturopath, and/or herbalist before adding herbs to your regimen. Though herbs can have a profound benefit even in serious heart disease, they may not be sufficient to replace conventional care and may also interact with medications. Many cardiovascular medications pose serious herb/food-drug interaction risks, particularly blood-thinning medications.

The statements made on this blog have not been evaluated by the FDA and are not intended to diagnose, prescribe, recommend, or offer medical advice. Please see your health care practitioner for help regarding choices and to avoid herb-drug interactions.

Maria Noël Groves, RH (AHG), registered clinical herbalist, runs Wintergreen Botanicals, LLC, an herbal clinic and education center nestled in the pine forests of Bear Brook State Park in Allenstown, NH. She is certified by Michael Moore’s Southwest School of Botanical Medicine, a registered professional herbalist with the American Herbalists Guild, and has also completed Rosemary Gladstar’s advanced training program and Lichenwood Herbals’ flower essence practitioner training. Her business is devoted to education and empowerment via classes, health consultations, and writing with the foundational belief that good health grows in nature. She is the author of Body into Balance: An Herbal Guide to Holistic Self Care. Learn more about Maria and herbs at