The potential role of herbal medicines in the treatment of chronic stable angina pectoris: a review of key herbs, and as illustration, exploration of the Chinese herbal medicine approach

Herbal medicines have been used for centuries within different cultures to treat cardiovascular disease, including stable angina pectoris. However, the use of herbs varies within traditions of natural medicine, and how they are understood to work in systems such as Chinese medicine, for example, is vastly different from the pharmaceutical model that seeks to reduce herbs to their active constituents. This review first discusses, individually, key herbs used within Western, Indian, and Chinese herbalism to treat stable angina pectoris and their main active constituents and pharmacological actions. The second part of the paper then specifically explores how angina is treated traditionally with Chinese herbal medicine, a unique approach to the understanding of health and illness underpinned by philosophies and theories that describe the physiological functioning and pathological changes in the body in terms very different from those of biomedicine. A foundational account of the guiding theories of Chinese medicine is followed by a description of the cardiovascular system and the etiology and pathogenesis of angina from the Chinese medical perspective. This forms the basis for understanding the rationale for construction of Chinese herbal medicinal formulae for treating angina pectoris. The scientific evidence of the efficacy of some Chinese herbal formulae is discussed.