Support for the Health of Veins and Arteries

Section 3 - About Blood Vessels, Orthostatic Hypotension & Glycation

Many of the problems which can afflict the veins are often lumped together under the heading of chronic venous insufficiency.  Varicose veins, hemorrhoids, heavy legs, pooling of fluid in the lower legs, and so on are all aspects of chronic venous insufficiency. 

The arteries and veins form the complex "plumbing" of the body.  This inner passageway carries oxygen, nutrients and various messengers to the tissues and cells.  In exchange, the veins also carry away carbon dioxide and waste products.  Both blood cells and the clear serum play important roles in these processes.  The arteries to carry blood away from the heart and toward the capillaries; veins return this blood to the central pump so that the process can begin anew.

Technically speaking, there are three types of blood vessels.  These are the arteries, the veins and the capillaries.  The arteries, such as the aorta, leave the heart and empty into progressively smaller vessels until the blood enters the arterioles.  The arterioles control the passage of blood into the capillaries, which are microscopic in size.  These are the smallest blood-carrying vessels in the body and may be only large enough to allow the transit of a single red blood cell at a time.  Via the capillary beds, the blood passes nutrients and gases, such as oxygen, into the tissues while accepting waste products in exchange.  The blood then drains from the capillary beds into the small venules, which eventually merge to form veins.  The process of the arteries now reverses itself and the blood returns to the heart.

The arteries (in red) channel blood away from the heart and to the extremities.  The veins (in blue) return blood to the heart for recirculation.

Varicose veins appear primarily in the lower body.  One-way valves, which should prevent the blood from flowing backwards, are damaged in varicosities.  In surgery, these veins are tied off.

The capillaries are very simple vessels which consist of a single layer of cells, the capillary membrane.  The arteries and veins each have three primary layers and an elastic membrane.  Aside from the inner layer of cells, the endothelium, there is a middle layer of smooth muscle cells and then an outer covering.  The intima is surfaced with the endothelial cells on its inner side and consists of a mixture of connective tissue and some muscle cells.  The middle muscular layer is thicker in the arteries than it is in the veins because it must withstand the force of the heart’s pumping action.  Layers of elastic tissues separate the musclaris from the smooth muscle and connective tissue which make up the adventitia.

The veins are special in that most of them contain small one-way valves which prevent blood from flowing back in the direction of the capillaries.  In varicose veins, these small valves typically are damaged.  Free radical damage can take place in all three types of blood vessels, although most medical attention has been focused upon changes in the arteries which lead to the development of plaques which narrow the passages and impede the flow of blood.

Orthostatic Hypotension

One form of low blood pressure, chronic orthostatic hypotension (OH), is frequently a severely debilitating disease.  It affects large groups of the population with autonomic insufficiency, that is, a dysfunction which involves one of the two halves of the nervous system’s regulatory machinery.  OH especially presents a problem for the elderly, patients with diabetes, Parkinson's disease, chronic fatigue syndrome, and anyone on drugs that affect the autonomic nervous system.  Ruscus aculeatus, the active component of VEINOPHIL™, possesses vasoconstrictive and venotonic properties which make it ideally suited to treat the pooling of blood in the limbs, lack of venous tone, and lack of neurally mediated vasoconstriction which frequently characterize OH.  (Redman DA. Ruscus aculeatus (butcher's broom) as a potential treatment for orthostatic hypotension, with a case report.  J Altern Complement Med 2000 Dec;6(6):539-49 )

Advanced Glycation End Products (AGEs)

Recent studies have revealed that reducing sugars, such as glucose, react with proteins through non-enzymatic glycosylation to form irreversible, cross-linked proteins known as advanced glycation endproducts (AGEs).  Furthermore, it has been demonstrated that this naturally occurring process, accelerated in diabetics due to hyperglycaemia, impairs biological functions leading to cardiovascular disorders, as well as diabetic and age-related complications.  (Cerami A, Ulrich P.  Pharmaceutical intervention of advanced glycation endproducts.  Novartis Found Symp.  2001;235:202-12; discussion 212-6, 217-20.  ) Elevated glucose levels have a negative impact on macrovascular and microvascular endothelial cells.  Similarly, the reaction of eye lens proteins with sugars over time results in the formation of protein-bound advanced glycation end products.

Pharmaceutical intervention to prevent or reverse these complications have focused on inhibiting the formation of AGEs.  Amongst the numerous co-adjuvant therapies which could influence the incidence and progression of diabetic complications, antioxidants and flavonoids are currently being tested in various clinical trials.  Presently available results suggest that the flavonoid-induced decrease in glycation is associated with an increase in the antioxidant component dependent on the levels and activities of thiol-containing proteins such as glutathione peroxidase.  One mechanism which could explain these effects is the protection of vitamin C and E from consumption by oxidative processes.  (Manuel y Keenoy B, Vertommen J, De Leeuw I.  The effect of flavonoid treatment on the glycation and antioxidant status in Type 1 diabetic patients.  Diabetes Nutr Metab 1999 Aug;12(4):256-63.)

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