Effective Treatment for Poor Leg Circulation in Elderly
Policosanol, a substance derived from sugar cane wax, is more effective than lovastatin (Mevacor®) in treating intermittent claudication (IC), according to a new study in Angiology (2003;54:25–38). Those taking policosanol also had significant decreases in total cholesterol and low-density lipoprotein (LDL, “bad”) cholesterol levels and an increase in high-density lipoprotein (HDL, “good”) cholesterol, suggesting an overall decreased risk of cardiovascular disease.
IC is a common condition in elderly people, usually caused by atherosclerosis (hardening of the arteries) in the arteries that supply blood to the legs. Symptoms include pain with walking, numbness, tingling, and swelling in the legs. It can become disabling in severe cases, limiting one’s ability to stand for prolonged periods of time or to walk long distances. Risk factors for IC include cigarette smoking, high blood pressure, high cholesterol, diabetes, and elevated blood levels of homocysteine and fibrinogen (a molecule that plays a role in blood clotting). Some studies suggest IC is a risk factor for atherosclerosis in other areas of the body, so treatment for IC may lower the risk of having a heart attack or stroke.
In the new study, 28 adults aged 35 to 80 years with moderate to severe IC were randomly assigned to receive 10 mg per day of policosanol or 20 mg per day of lovastatin (a cholesterol-lowering medication) for 20 weeks. Pain-free walking distance on a treadmill and quality of life questionnaires were measured initially and after 10 weeks and 20 weeks of treatment. Blood levels of total cholesterol, LDL cholesterol, HDL cholesterol, and fibrinogen were also measured at the same intervals. All participants were permitted to continue their regular medications, with the exception of blood-thinning drugs.
Those taking policosanol had a 34% increase in pain-free walking distance, while no change was observed in those taking lovastatin. Quality of life was also reported as being significantly better in the policosanol group compared with the lovastatin group. Both treatment groups had significant reductions in total cholesterol and LDL cholesterol. However, participants taking policosanol had a significant 32% increase in HDL cholesterol and a 6% decrease in fibrinogen, while these parameters remained unchanged in those receiving lovastatin.
Policosanol is a novel treatment for IC that has a proven safety record. Several studies have shown that it reduces cholesterol levels, prevents damage to the lining of arteries and contributes to blood-thinning activity. The authors suggest the blood-thinning properties of policosanol account for its effectiveness in treating IC. No adverse side effects have ever been reported with policosanol treatment.
Pain in the legs with walking may be a sign not only of IC, but also of potentially serious conditions such as a blood clot in the deep veins of the legs. Therefore, people with intermittent leg pain should be evaluated by a physician before taking policosanol.
Darin Ingels, ND, MT (ASCP), received his bachelor’s degree from Purdue University and his Doctorate of Naturopathic Medicine from Bastyr University in Kenmore, WA. Dr. Ingels is the author of The Natural Pharmacist: Lowering Cholesterol (Prima, 1999) and Natural Treatments for High Cholesterol (Prima, 2000). He currently is in private practice at New England Family Health Associates located in Southport, CT, where he specializes in environmental medicine and allergies. Dr. Ingels is a regular contributor to Healthnotes and Healthnotes Newswire.
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