Varicose Veins Treatment, Cause - Horse Chestnut Extract

The condition of inadequate return of blood from the leg veins to the heart is called venous insufficiency.  Physiologically, the basis is elevated blood pressure in the veins of the leg.  The main cause is backflow of blood due to malfunction of the valves in the leg veins.  In varicose veins, the superficial leg veins lose tone, stretching both in length and width.  The elongation of the veins forces the valves apart that normally keep blood from flowing the wrong way, allowing reflux of blood, especially in a standing position.  Blood pools in the veins enlarging them even more.  The legs tend to ache, feel tired and sometimes itch.  There are many theories of how elevated venous pressure leads to edema, skin damage and sometimes ulceration.  A widely held theory is that increased capillary permeability leads to leakage of plasma proteins and fibrinogen, forming a "fibrin cuff" around the capillaries.  This cuff diminishes blood supply, and the supply of oxygen and nutrients to tissues.  Edema and inflammation also result.

The latest research traces these pathological changes to venous stasis -- the lack of proper blood flow in the veins.  It brings about hypoxia, or diminished oxygen supply.  This in turn, leads to changes in the cells of the inner blood vessel wall which then releases inflammatory substances that activate neutrophils.  The activated neutrophils adhere to these cells releasing free radicals and enzymes that degrade the extracellular matrix.  A cascade of events follows to bring about pathological changes in vein walls.  The activity of proteolytic enzymes (enzymes that break down proteins) increases and connective tissue in the vein wall deteriorates.

Horse chestnut counteracts these pathological processes in many ways.  First, it helps restore vein tone, the ability of the vein to contract dynamically to the correct size for any given venous pressure.  Secondly, horse chestnut helps correct the increased capillary permeability.  When an inflammatory stimulus is injected into the rat, it increases the permeability of the lympho-plasmatic barrier, doubling the lymphatic flow.  Escin, the key active constituent in horse chestnut, counteracts this effect, returning the permeability of the lympho-plasmatic barrier to normal.

Thirdly, horse chestnut inhibits two key steps in the degenerative cascade set off by hypoxia, the decrease in ATP content and the increase in the activity of phospholipase A(2), a pro-inflammatory enzyme.  Moreover, escin inhibits neutrophils from adhering to hypoxic cells on the inside vein wall.

Finally, horse chestnut counteracts the deleterious effects of free oxygen radicals, and helps stabilize connective tissue and preserve the integrity of the extracellular matrix.  It inhibits enzymes that degrade proteoglycans, which are essential to the stability and function of connective tissue.