Varicose veins are extended, convoluted veins commonly visible on the lower extremities. The risk factors for the development of varicose veins include: chronic cough, constipation, family history of venous disorders, female gender, obesity, old age, pregnancy and standing for too long. The main pathophysiology of varicose vein is still debated; however, genetic predisposition, inadequacy of the valves, weakness of vessel walls and increase in intravenous pressure are involved. The symptoms of varicose vein include: feeling of weight and pain, itching or burning sensation and aggravation of symptoms after standing for too long. The potential complications of varicose veins include infection, ulcer in legs, changes due to stasis of blood and thrombosis.
Some of the common therapeutic measures include: avoiding standing for too long and exhaustion, raising the affected limb, exercise, external pressure, medical procedures, balancing cardiovascular risk factors, reduction of peripheral edema and weight loss. However, more aggressive measures also exist: laser, sclerotherapy and surgery. The choice of treatment depends on several factors, including the symptoms, the preference of the patient, cost and the skills of the physician.
Chronic Venous Insufficiency (CVI) is mostly caused by venous hypertension and secondary capillary hypertension to impairment in venous return, which results in persistent and chronic venous stasis in the skin of the lower extremities, which explicitly shows itself upon change in position.
In a study of the effect of grape extract on capillary resistance disorders in patients with high blood pressure and diabetes, 150 mg grape extract per day was well tolerated and the resistance of the capillaries considerably improved (p<0.0005 and p<0.005).
In an open study to assess the safety and tolerance of horse chestnut in the treatment of CVI, the patients took for 8 weeks, 2 times per day, each time a 50 mg horse chestnut tablet. In the second and third examinations, the patients reported the tolerance level for the drug as good and fairly good (in 90 and 95% of the cases, respectively). The difference of the average symptoms assessed before the treatment and at the time of the third examination was statistically considerable and the perimeter of the ankles and the lower legs diminished. Most of the patients reported the efficacy of the drug as very good or good. The results of this study showed that horse chestnut 50 mg tablets are efficacious for stage I and II of Widmer scale CVI, and its use is safe and well tolerated.
Grape is used as a source for Oligomeric Pro-Anthocyanins (OPCs) and in practice is used as an alternative for pycnogenol. In one study, the daily use of 45 mg grape OPCs reduced the symptoms of CVI, especially the heaviness in lower extremities, in 108 patients. In a placebo-controlled, double blind study on 219 patients with CVI, the daily use of 360 or 720 mg extract of vine leaves was considerably more efficient that the placebo in the reduction of edema, alleviation of pain and other symptoms of the disorder. The researchers reported that the improvement with 720 mg extract of vine leaves was higher and more durable. In this study, the adverse effects were mostly mild gastrointestinal distress and sometimes headache, and the blood tests and physical examination did not manifest any adverse effect. In another study on 39 patients with CVI, with the use of 360 mg extract of vine leaves divided into two doses, after 2 weeks of treatment, considerable improvement was observed in the patients’ criteria and reduction in the size of lower extremities. Also, in a cross study on 71 patients with CVI, the daily use of 360 mg extract of vine leaves resulted in reduction in the perimeter of the lower extremities and increase in microvascular blood flow.
The combination of horse chestnut and grape is an outstanding antioxidant which protects the health of veins, capillaries and the blood circulation system. Aescin (the active ingredient in horse chestnut) causes robustness of the veins and prevents leakage of fluids out of blood vessels, and so prevents edema.