Index of Herbs

Concern guide

Herbs for Heart and Circulation

Psyllium, horse chestnut, garlic, hawthorn and more as support for a heart-healthy lifestyle, with what research shows.

9 herbs reviewed

Updated October 7, 2026

Heart and circulation concerns range from silent risk factors to everyday discomfort. High blood pressure and high cholesterol usually cause no symptoms for years while quietly raising the risk of heart attack and stroke. Heart failure, angina and abnormal heart rhythms can cause breathlessness, chest pain, fatigue or palpitations. On the vein side, chronic venous insufficiency brings heavy, aching, swollen legs and varicose veins.

Herbs can be a supportive part of a heart-healthy lifestyle built on not smoking, staying active and eating well. Prescribed medicines such as statins and blood pressure drugs are the proven way to reduce heart attacks and strokes, and the herbs here are best used alongside them, with your prescriber in the loop. Several have encouraging trial results: psyllium lowers LDL cholesterol, horse chestnut eases heavy, swollen legs, and garlic and hawthorn, two well-loved traditional heart herbs, show promising effects on cholesterol, blood pressure or heart failure symptoms. Never stop or reduce a statin, blood pressure medicine or blood thinner on your own, and tell the prescriber about any herb, because several here interact with heart drugs.

The list starts with the herbs that have the strongest evidence, then those with earlier or more traditional support, ordered by how widely each is used. Each rating applies to the specific use described, whether cholesterol, blood pressure, heart failure symptoms or vein comfort, rather than to heart health in general. Most trials are short and use particular extracts, so choosing a product like the one studied gives you the best idea of what to expect.

02 The shortlist

The herbs, from best studied to time-honored

How to read the ratings

  • Good clinical evidence
  • Promising clinical evidence
  • Early or mixed evidence
  • Long traditional use

Ratings show how much research backs each herb for this particular concern. Every herb links to its full monograph, with preparations, safety notes, and sources.

  1. 01 Psyllium

    Good clinical evidence

    Plantago ovata

    Psyllium husk is a soluble fiber that EMA accepts, alongside diet, for high cholesterol, and the FDA allows a heart health claim for foods containing it. Pooled data from 28 trials found that about 10 g a day lowered LDL cholesterol by roughly 13 mg/dL, and it may add to the effect of a statin, though no trials have yet measured heart attacks or deaths. Take it with plenty of liquid and half an hour to an hour apart from other medicines.

    Read the psyllium monograph →

  2. 02 Horse Chestnut

    Good clinical evidence

    Aesculus hippocastanum

    Standardized horse chestnut seed extract is the best-studied herb for chronic venous insufficiency, the cause of heavy, aching, swollen legs. A Cochrane review of 17 short trials found less leg pain, swelling and itching than with placebo, and EMA accepts specified extracts as well-established for these symptoms, although larger trials would still help. It is used alongside compression stockings and a check for clots, not instead of them. Raw seeds, bark and leaves are poisonous, and rare liver injury has been reported.

    Read the horse chestnut monograph →

  3. 03 Garlic

    Promising clinical evidence

    Allium sativum

    Garlic is one of the best-loved traditional heart herbs. Meta-analyses suggest supplements can lower total and LDL cholesterol by around 10% in people with raised levels, and can modestly lower blood pressure in people who already have hypertension. Results vary between studies, and a careful Stanford trial found no cholesterol benefit from raw garlic, garlic powder or aged extract. Garlic can increase bleeding, and EMA advises stopping it seven days before surgery.

    Read the garlic monograph →

  4. 04 Black Seed

    Promising clinical evidence

    Nigella sativa

    Black seed (Nigella sativa) is a revered remedy in Islamic and South Asian traditional medicine with a growing body of research. Meta-analyses report LDL cholesterol about 14 mg/dL lower across 17 trials and blood pressure about 3 mmHg lower across 11 trials, though the trials are small and short and blood pressure results vary. It can add to the effects of blood pressure and diabetes medicines, and laboratory data suggest it could raise warfarin levels.

    Read the black seed monograph →

  5. 05 Butcher's Broom

    Promising clinical evidence

    Ruscus aculeatus

    Butcher’s broom root is a traditional European remedy for heavy legs from minor vein problems. A 12-week trial in 166 women with chronic venous insufficiency found less leg swelling and some symptom relief compared with placebo, though EMA wanted more evidence before going beyond traditional use, and many larger reviews test a combination with hesperidin methylchalcone and vitamin C. MSKCC advises people with diabetes not to take it.

    Read the butcher's broom monograph →

  6. 06 Hawthorn

    Early or mixed evidence

    Crataegus monogyna

    Hawthorn leaf and flower is Europe’s classic heart herb, and EMA accepts it as a traditional remedy for nervous palpitations once a doctor has ruled out heart disease. A Cochrane review of small add-on trials found better exercise tolerance and less breathlessness and fatigue in heart failure, though the large SPICE trial found no effect on cardiac events and EMA no longer accepts heart failure as an indication. Because it overlaps with digoxin, it should be used only with a cardiologist’s agreement.

    Read the hawthorn monograph →

  7. 07 Ginkgo

    Early or mixed evidence

    Ginkgo biloba

    Ginkgo is popular for circulation, cold hands and feet, and leg pain on walking (intermittent claudication), and EMA lists traditional use for heavy legs and cold extremities. Trials have not yet shown a clear benefit, with a 2013 Cochrane review finding no clinically important improvement in walking pain. Ginkgo adds to bleeding risk with anticoagulants and antiplatelet drugs and should be stopped before surgery.

    Read the ginkgo monograph →

  8. 08 Cinnamon

    Early or mixed evidence

    Cinnamomum verum

    Cinnamon is a much-loved spice studied mostly for blood sugar, and one meta-analysis also reported lower total and LDL cholesterol and triglycerides. Results vary, as another found no change in blood lipids, and NCCIH says research does not yet clearly support cinnamon for any condition. Most trials used cassia, which contains enough coumarin that about 2 g a day reaches the tolerable intake for an adult, and hepatitis has been reported when a cinnamon supplement was taken with a statin.

    Read the cinnamon monograph →

  9. 09 Fenugreek

    Early or mixed evidence

    Trigonella foenum-graecum

    Fenugreek is a maple-scented spice whose seed is studied mainly for blood sugar. A 2023 meta-analysis of 10 trials in type 2 diabetes or prediabetes found improvements in total cholesterol, triglycerides and HDL cholesterol, though not LDL, and EMA felt the newer lipid trials were too short and small to be conclusive. It is a legume allergen, is not safe in pregnancy above food amounts, and can add to diabetes medicines and possibly warfarin.

    Read the fenugreek monograph →

03 Caution

Using these herbs safely

Most of these herbs are well tolerated at the doses used in trials, and a few sensible precautions help them sit safely alongside heart care. First, know the emergency signs. Call emergency services (911 in the US) for chest pain, pressure or tightness, especially if it spreads to the arm, neck or jaw; severe shortness of breath; fainting or collapse; or signs of stroke, remembered as FAST: face drooping, arm weakness, speech problems, time to call. Stroke symptoms that pass quickly still need urgent help. A swollen, painful calf or sudden swelling of one leg can be a deep vein thrombosis (DVT) and needs same-day medical care. New palpitations, swelling of the ankles or breathlessness on exertion also need a medical check, not an herb.

Keep taking statins, blood pressure medicines and blood thinners as prescribed, and do not stop or reduce them without the prescriber. Bleeding is the most common interaction concern, so it is worth checking with a pharmacist. Garlic and ginkgo both have antiplatelet effects and add to bleeding risk with warfarin, other anticoagulants and antiplatelet drugs; both should be stopped before surgery. Black seed may raise warfarin levels, and fenugreek has case reports of a stronger warfarin effect. Hawthorn acts on the same target as digoxin and has been presumed to add to beta-blockers, nitrates and other blood pressure drugs; trials did not show this, but it has not been ruled out. Psyllium can slow the absorption of digoxin and warfarin, so take it at least half an hour to an hour apart from them.

A few herbs are best avoided with heart conditions. Licorice root containing glycyrrhizin raises blood pressure and lowers potassium, can cause dangerous heart rhythms, undermines blood pressure medicines and is particularly hazardous with diuretics and digoxin; the FDA has warned that 2 ounces of black licorice a day for two weeks can cause heart rhythm problems in adults over 40. Deglycyrrhizinated licorice (DGL) removes most of the glycyrrhizin. Yohimbe raises heart rate and blood pressure and has been linked to hypertensive crisis, arrhythmia and heart attack, especially in stimulant stacks. St. John’s wort lowers blood levels of many drugs, including digoxin, ivabradine, warfarin and simvastatin, and the EU contraindicates it with warfarin. Products sold as tejocote (Mexican hawthorn) root have been found to contain toxic yellow oleander.

Medicinal doses of garlic, hawthorn, horse chestnut, butcher’s broom, black seed, cinnamon and fenugreek are not recommended in pregnancy or breastfeeding, and none should be given to children for heart or vein problems. Product form matters too: garlic powder, aged garlic extract and fresh cloves have different chemistry, hawthorn trials used leaf-and-flower extracts rather than berries, horse chestnut evidence applies to extracts standardized to escin, and much cinnamon sold in North America is cassia rather than low-coumarin Ceylon cinnamon. Single-herb, clearly labeled products are easier to use safely than unlabeled “circulation” blends, which make it impossible to know which ingredient caused a problem.

04 Questions

Frequently Asked Questions

Psyllium has the most consistent evidence: about 10 g a day of the husk lowered LDL cholesterol by roughly 13 mg/dL in pooled trials, and it may add to the effect of a statin. Garlic and black seed also show encouraging, if smaller or less consistent, effects. None has yet been shown to prevent heart attacks, so herbs are a complement to a statin when one is prescribed, not a replacement.

Many people do, and some herbs, such as psyllium, have been studied alongside statins, but always with your prescriber’s knowledge. Statins and blood pressure medicines have been shown to reduce heart attacks, strokes and deaths, so never stop or reduce them in favor of an herb. Your prescriber also needs to know about supplements, because garlic, hawthorn and others can interact with heart medicines.

Only with the cardiologist’s knowledge. Hawthorn is generally well tolerated, but it acts on the same target as digoxin, which has a narrow safety margin. A study in eight healthy volunteers found no change in digoxin levels, and large heart failure trials reported no interactions, but that is not enough to rule one out. People with heart failure should not start hawthorn on their own, given a trial signal of earlier worsening.

The clearest risks are licorice root containing glycyrrhizin, which raises blood pressure and lowers potassium; yohimbe, which raises heart rate and blood pressure; and St. John’s wort, which lowers levels of digoxin, warfarin, some statins and other drugs. Anyone on a blood thinner should also check before taking garlic or ginkgo supplements.

It can ease the symptoms. Standardized horse chestnut seed extract reduced leg pain, swelling and itching compared with placebo in short trials of chronic venous insufficiency, and one trial found it comparable to compression stockings for swelling. It will not make varicose veins disappear, and compression remains standard care alongside it. Sudden swelling of one leg, especially with pain, needs urgent assessment for a blood clot.

05 References

Sources

These references support the claims in this guide. Each herb’s monograph carries its own full source list.

  1. Effect of psyllium (Plantago ovata) fiber on LDL cholesterol and alternative lipid targets, non-HDL cholesterol and apolipoprotein B: a systematic review and meta-analysis of randomized controlled trials

    American Journal of Clinical Nutrition (PubMed 30239559), 2018

    Pooled 28 trials showing that about 10 g of psyllium a day lowers LDL cholesterol by about 0.33 mmol/L, the basis for its good rating.

  2. Horse chestnut seed extract for chronic venous insufficiency

    Cochrane Database of Systematic Reviews (PubMed 23152216), 2012

    Review of 17 trials finding short-term improvements in leg pain, swelling and itch with standardized horse chestnut extract.

  3. Garlic: usefulness and safety

    National Center for Complementary and Integrative Health (NIH), 2025

    Supports the small cholesterol and blood pressure effects of garlic described here, mainly in people with raised readings.

  4. The efficacy and safety of Crataegus extract WS 1442 in patients with heart failure: the SPICE trial

    European Journal of Heart Failure (PubMed 19019730), 2008

    The 2,681-patient trial in which hawthorn extract had no effect on time to first cardiac event in heart failure.

  5. Ginkgo biloba for intermittent claudication

    Cochrane Database of Systematic Reviews (PubMed 23744597), 2013

    Found no clinically important benefit of ginkgo over placebo for leg pain on walking.

  6. Heart attack

    NHS, 2026

    Lists heart attack symptoms that need an emergency call, including chest pain spreading to the arm, neck or jaw and severe breathlessness.

  7. Symptoms of a stroke

    NHS

    Explains the FAST signs of stroke and advises urgent help even if symptoms stop.

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