Pine Bark for Blood Vessels Big and Small, Part 1 of 2
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A natural solution for high blood pressure, hemorrhoids, and varicose veins
At first glance, the ailments of high blood pressure, hemorrhoids, and varicose veins seem to have little in common. As any holistically trained healthcare provider knows, however, these conditions all share one common cause: poor vascular health. Also known as the circulatory system, the vascular system consists of the vessels that carry blood and lymph throughout the body.
A natural extract of the bark of the maritime pine tree (Pinus pinaster) has been studied and shown to be therapeutic for a variety of vascular conditions throughout the body. In fact, standardized pine bark extract (SPBE) is rich in procyanidins, bioflavonoids, and organic acids, constituents that strengthen the health and integrity of the blood vessels.
Let’s take a closer look at the vascular diseases that may be addressed with a daily dose of pine bark. Today’s post explores pine bark extract’s benefits for blood pressure, hemorrhoids, and varicose veins. Part 2 of this article explores pine bark’s merits in addressing the microangiopathies associated with diabetes, erectile dysfunction, and Raynaud syndrome.
Supplementation with SPBE (200 mg) has been shown to significantly improve systolic blood pressure (SBP) in patients with mild hypertension. (Systolic blood pressure is the top number in a blood pressure reading, which refers to the amount of pressure in the arteries during the contraction of the heart muscle.) In this study, SBP dropped from 140 mmHg (millimeters of mercury) at baseline to 133 mmHg after eight weeks of SPBE supplementation, while the SBP of those in the placebo group only changed from 140 to 139 mmHg. Even more dramatic benefits were observed in those with severe hypertension, with SBP readings dropping from 150 to 134 mmHg.
Supplementation with SPBE in conjunction with pharmaceutical medication has also been shown to decrease diastolic blood pressure (DBP), the bottom number in a blood pressure reading. (This number relates to the amount of pressure in the vessels between heartbeats.) SPBE was also found to significantly improve markers of kidney health in hypertensive patients with early signs of declining renal (kidney) function.
SPBE supplementation significantly reduces the need for blood pressure medications and maintains stable blood pressure.
SPBE has further been shown to help reduce the edema (water retention) sometimes experienced as a side effect of anti-hypertensive pharmaceuticals.
Hypertension is but one ailment in the cluster of conditions collectively known as metabolic syndrome. The other “birds of a feather” of metabolic syndrome include high blood sugar, excess body fat around the waist, and elevated cholesterol levels. Together and independently, these ailments increase one’s risk of heart disease, stroke, and type 2 diabetes. Thankfully, numerous human studies have shown that supplementation with SPBE (120 mg to 360 mg daily) can significantly lower total cholesterol and low-density lipoprotein (LDL) (aka “bad cholesterol”) levels., SPBE has also been shown to help reduce waist circumferences in both males and females with metabolic syndrome and promote the development of the healthier brown adipose (fat) tissue that protects against obesity and diabetes.
People tend to think of hemorrhoids, or piles, as an ailment of the digestive tract, but they are actually a vascular problem. A hemorrhoid is, after all, just a swollen and inflamed vein in the rectum, and can thus be treated much in the same way as other vascular conditions.
In a randomized, controlled study (RCT) investigating the effects of SPBE on hemorrhoidal attacks, 84 people were enrolled within two days of the onset of their symptoms. The treatment group received SPBE either by mouth or topically (applied directly on the inflamed tissue). Both administration routes led to significant improvements in hemorrhoidal signs and symptoms, and those who received SPBE both orally and topically experienced improvements even faster than those who only took SPBE by mouth. Bleeding was completely absent in all of the patients treated with SPBE for seven days and also at the 14 day follow up, while those in the control group still complained of bleeding throughout this time period.
SPBE may also heal hemorrhoids in women after pregnancy (the postpartum period). Women with third and fourth degree hemorrhoids after their second pregnancy took 150 mg of SPBE daily for six months, and fared significantly better than those who didn’t take SPBE. (Hemorrhoids are staged from first to fourth degree severity, with fourth being the worst.)
70% of the women who took pine bark extract were free of hemorrhoid symptoms at six months, compared to 36% of the women in the control group.
Of those with third degree hemorrhoids (hemorrhoids that bulge from the anus during defecation that must be digitally pushed back in), 75% of those who took SPBE became symptom free, compared to 56% of those who didn’t. For those with fourth degree hemorrhoids (hemorrhoids that protrude from the anus all the time), 70% of the women who took SPBE were symptom free at six months, compared to 36% of the women in the control group. No significant side effects were observed.
Varicose veins (chronic venous insufficiency)
Pregnancy can also lead to the development of varicose veins. Varicose veins are another type of angiopathy (disease of blood vessels) – the legs’ equivalent to hemorrhoids.
In a study comparing the efficacy of 100 mg per day of SPBE to elastic compression stockings in 133 postpartum women, SPBE was found to outperform elastic compression stockings in a variety of ways. Edema (swelling), spider veins, cramps, and other symptoms were improved in both groups, but more so in the SPBE-treated group. The women who took SPBE were also less likely to need sclerotherapy (injections) and surgery to treat their varicose veins, and they were more likely to report both satisfaction and compliance with the treatment. The benefits of SPBE also held at one-year follow up.
SPBE was found to outperform elastic compression stockings in reducing multiple symptoms of varicose veins.
SPBE may help treat varicose veins in other demographic groups as well, such as in non-pregnant females and men.
In a study of SPBE’s effects on chronic venous insufficiency (CVI) – improper functioning of the vein valves in the leg, leading to varicose veins – SPBE also was found to be more effective than compression stockings.
In a study examining the vessels surgically removed from the legs of patients with CVI, the veins of the patients who took SPBE (150 mg/d) for three months prior to surgery were found to be stronger and more resistant to stretching and other types of physical stress than those of the patients who didn’t take SPBE.
A similarly designed study compared the efficacy of SPBE (150 mg or 300 mg daily) to that of 1,000 mg per day of Daflon, a drug commonly used to treat CVI. Of the 86 patients enrolled in the study, those who took SPBE not only had significantly greater improvements, but also noticed them faster: four weeks into the study, most of the patients in the SPBE group had improvements in various measurements, whereas only six subjects in the Daflon group enjoyed such fast-acting benefits.
In another controlled study, 21 patients (ranging in age from 42 to 60 years) with severe CVI and a history of associated leg ulcers received 50 mg of SPBE three times daily (150 mg total per day) for eight weeks. These patients were compared to 18 control patients who received no treatment. Patients in both groups had CVI for an average of 5.7 years before enrolling in the study. There were no visible changes in the control patients, but at four and eight weeks all SPBE-treated patients were found to have improvements in microcirculation and decreases in skin flux, edema (swelling), capillary filtration, and symptom severity – all indicating improvement in their condition.
If left untreated, CVI can over time lead to venous ulcerations – open wounds on the skin of the legs that typically heal very slowly. In a six-week study of 18 patients with venous ulcerations, a combination treatment of oral and topical SPBE led to relatively speedy healing of the wounds – faster than oral treatment alone. Comparable outcomes were found in a similar study examining SPBE’s effects on diabetic ulcers.
These studies collectively confirm the significant role the SPBE may play in the management, treatment, and control of CVI and its associated varicose veins and ulcerations.
Standardized pine bark extract (SPBE) has been shown to support the health of blood vessels of all sizes. SPBE may help stave off and address not only hypertension, but also hemorrhoids and varicose veins.
Check out Part 2 of this post to learn about SPBE’s benefits in treating the smaller vessels of the body implicated in erectile dysfunction, diabetic retinopathy, and Raynaud syndrome.
Click here to see References
 Johns Hopkins Medicine. Overview of the vascular system [Internet]. Baltimore (MD): Johns Hopkins Medicine; 2020 [cited 2020 May 22]. Available from: https://www.hopkinsmedicine.org/health/conditions-and-diseases/overview-of-the-vascular-system
 Zibadi S, et al. Reduction of cardiovascular risk factors in subjects with type 2 diabetes by Pycnogenol supplementation. Nutr Res. 2008 May;28(5):315-20.
 Liu X, et al. Pycnogenol, French maritime pine bark extract, improves endothelial function of hypertensive patients. Life Sci. 2004 Jan 2;74(7):855-62.
 Madell R, Cherney K. Blood pressure readings explained [Internet]. San Francisco (CA): Healthline Media; 2020 [cited 2020 May 22]. Available from: https://www.healthline.com/health/high-blood-pressure-hypertension/blood-pressure-reading-explained
 Hosseini S, et al. A randomized, double-blind, placebo-controlled, prospective, 16 week crossover study to determine the role of Pycnogenol in modifying blood pressure in mildly hypertensive patients. Nutr Res. 2001 Sep 1;21(9):1251-60.
 Cesarone MR, et al. Kidney flow and function in hypertension: protective effects of pycnogenol in hypertensive participants-a controlled study. J Cardiovasc Pharmacol Ther. 2010 Mar;15(1):41-6.
 Belcaro G, et al. Control of edema in hypertensive subjects treated with calcium antagonist (nifedipine) or angiotensin-converting enzyme inhibitors with Pycnogenol. Clin Appl Thromb Hemost. 2006 Oct;12(4):440-4.
 Mayo Clinic. Metabolic syndrome [Internet]. Rochester (MN): Mayo Clinic; 2020 [cited 2020 May 22]. Available from: https://www.mayoclinic.org/diseases-conditions/metabolic-syndrome/symptoms-causes/syc-20351916
 D̆uračková Z, et al. Lipid metabolism and erectile function improvement by Pycnogenol®, extract from the bark of Pinus pinaster in patients suffering from erectile dysfunction-a pilot study. Nutr Res. 2003 Sep 1;23(9):1189-98.
 Devaraj S, et al. Supplementation with a pine bark extract rich in polyphenols increases plasma antioxidant capacity and alters the plasma lipoprotein profile. Lipids. 2002 Oct;37(10):931-4.
 Belcaro G, et al. Pycnogenol® supplementation improves health risk factors in subjects with metabolic syndrome. Phytother Res. 2013 Oct;27(10):1572-8.
 Cong H, et al. Pycnogenol® induces browning of white adipose tissue through the PKA signaling pathway in apolipoprotein E-deficient mice. J Diabetes Res. 2018;2018: 9713259.
 Cypess AM, Kahn CR. Brown fat as a therapy for obesity and diabetes. Curr Opin Endocrinol Diabetes Obes. 2010 Apr;17(2):143-9.
 Belcaro G, et al. Pycnogenol® treatment of acute hemorrhoidal episodes. Phytother Res. 2010 Mar;24(3):438-44.
 Belcaro G, et al. Pycnogenol® in postpartum symptomatic hemorrhoids. Minerva Ginecologica, 31 Jan 2014;66(1):77-84.
 Healthwise staff. Internal hemorrhoids: first- to fourth-degree [Internet]. Boise (ID): Healthwise Inc.; 2018 [cited 2020 May 25]. Available from: https://www.healthlinkbc.ca/health-topics/tp12884
 Belcaro G, et al. Postpartum varicose veins: supplementation with pycnogenol or elastic compression – a 12-month follow-up. Int J Angiol. 2017 Mar;26(1):12-9.
 Cesarone MR, et al. Improvement of signs and symptoms of chronic venous insufficiency and microangiopathy with Pycnogenol®: a prospective, controlled study. Phytomedicine. 2010 Sep;17(11):835-9.
 Belcaro G, et al. Improvements of venous tone with pycnogenol in chronic venous insufficiency: an ex vivo study on venous segments. Int J Angiol. 2014 Mar;23(1):47-52.
 Cesarone MR, et al. Comparison of Pycnogenol® and Daflon® in treating chronic venous insufficiency: a prospective, controlled study. Clin Appl Thromb Hemost. 2006 Apr;12(2):205-12.
 Cesarone MR, et al. Rapid relief of signs/symptoms in chronic venous microangiopathy with pycnogenol: a prospective, controlled study. Angiology. 2006 Oct-Nov;57(5):569-76.
 Belcaro G, et al. Venous ulcers: microcirculatory improvement and faster healing with local use of pycnogenol. Angiology. Nov-Dec 2005;56(6):699-705.
 Belcaro G, et al. Diabetic ulcers: microcirculatory improvement and faster healing with pycnogenol. Clin Appl Thromb Hemost. 2006 Jul;12(3):318-23.
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Dr. Erica Zelfand
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