Herb World News Online

Herb Research Foundation


 Top News  |  World  |  Science  |  Research Reviews  |  Politics  |  Industry  |  Features
 Research Reviews

Horse chestnut effective in chronic venous insufficiency

As part of the Journal of the American Medical Association yearly theme issue on alternative medicine, Archives of Dermatology (a sister journal) published a noteworthy review article on horse chestnut (Aesculus hippocastanum L., Hippocastanaceae). Derived from the seed of a fragrant flowering tree, horse chestnut extract is widely used in Germany for treating chronic venous insufficiency (CVI). Individuals with CVI often complain of an aching or tired feeling in their legs when standing or walking, symptoms that are caused by edema (accumulation of excess fluid) and inflammation of the veins. In this critical review of 13 clinical studies, the authors found horse chestnut superior to placebo and just as effective in improving the symptoms of CVI as O-(ß-hydroxyethyl)-rutosides, a mixture of flavonoid glycosides derived from buckwheat and other plants which is used to improve capillary function. Another study suggested therapeutic value equal to standard compression treatment, although this study was not double-blinded [Pittler and Ernst, 1998].

All of the studies chosen for this review were either placebo-controlled or compared the effects of horse chestnut to reference medications. In the eight placebo-controlled studies, subjects took one capsule twice daily of horse chestnut extract standardized to 50 to 75 mg aescin over a period of 20 days to two months. The pooled results showed that horse chestnut dramatically reduced edema, measured as a reduction in lower-leg volume and leg circumference at the calf and ankle. Subjects reported less pain, fatigue, tenseness, and pruritus (itching) in their legs by the end of treatment. One study suggested a 22 percent decline in the capillary filtration rate after use of horse chestnut. Positive results were evident within two weeks in several of the studies, with benefits lasting at least six weeks after treatment. Although there is no universally accepted classification of CVI, most of the studies were consistent in using a single classification system.

In five comparative studies, horse chestnut extract alleviated edema just as effectively as O-(ß-hydroxyethyl)-rutosides. Horse chestnut was associated with minor side effects in 0.9 percent to 3 percent of subjects, including stomach upset, calf spasm, dizziness, nausea, headache, and itching. Other symptomatic treatment options can cause stomach upset, nausea, and allergic skin reactions, and compression therapy has been linked to skin necrosis (death of skin cells) and ulcers.

One of the main active constituents of horse chestnut is the triterpenic saponin aescin (also spelled escin), which has been shown to protect the integrity of veins and capillaries in vitro by inhibiting the enzymes elastase and hyaluronidase. Horse chestnut may also reduce levels of leukocytes and proteoglycan hydrolases, which tend to be abnormally high in CVI-affected limbs. Using electron microscopy, researchers have confirmed a marked reduction in vascular leakage in animals after treatment with the botanical extract. Although laboratory studies show that horse chestnut increases venous pressure and flow, researchers have not yet confirmed these positive effects on vascular tone in humans. - Krista Morien (HRF)

Full article $20 - Review Order
[Pittler MH, Ernst E. Horse-chestnut seed extract for chronic venous insufficiency: a criteria-based systematic review. Arch Dermatol 1998; 134: 1356-1360.]

 Top News  |  World  |  Science  |  Research Reviews  |  Politics  |  Industry  |  Features

Back to the Herb World News Online Front Page

© 2003 by Herb Research Foundation, Boulder, CO, USA.

Main Page