Intermittent Claudication https://greenmedinfo.com/taxonomy/term/2825/all en A combination of GLA and EPA may have therapeutic value in peripheral arterial disease. https://greenmedinfo.com/article/combination-gla-and-epa-may-have-therapeutic-value-peripheral-arterial-disease PMID:  Clin Nutr. 1998 Dec;17(6):265-71. PMID: 10205349 Abstract Title:  Randomized controlled trial of gamma-linolenic acid and eicosapentaenoic acid in peripheral arterial disease. Abstract:  BACKGROUND AND AIMS: epidemiological studies suggest polyunsaturated fatty acids protect against the development of atherosclerosis. The aim of this study was to perform a randomized controlled trial of gamma-linolenic and eicosapentaenoic acids in patients with lower limb atherosclerosis. Main outcome measures were: cholesterol and lipoprotein concentrations; haemostatic and rheological variables; the ankle brachial pressure index; walking distance; and cardiovascular events and death. METHODS: 120 men and women with stable intermittent claudication were randomized to 2 years treatment with either a combination of gamma-linolenic and eicosapentaenoic acids, or placebo. RESULTS: 39 (65.0 cent) of those taking fatty acids and 36 (60.0 cent) of those taking placebo completed the trial. Lipid concentrations did not differ significantly during the trial. In those taking fatty acids, haematocrit was significantly higher than in the placebo group after 6 months (46.1 cent compared with 44.6 cent, P https://greenmedinfo.com/article/combination-gla-and-epa-may-have-therapeutic-value-peripheral-arterial-disease#comments Arteriosclerosis EPA (Eicosapentaenoic Acid) Intermittent Claudication Peripheral Arterial Disease Human Study Mon, 25 Jan 2010 22:46:23 +0000 greenmedinfo 50025 at https://greenmedinfo.com A proprietary ginkgo biloba extract is safe and effective in the treatment of patients with intermittent claudication. https://greenmedinfo.com/article/proprietary-ginkgo-biloba-extract-safe-and-effective-treatment-patients-interm PMID:  J Nutr. 2008 Feb;138(2):332-7. PMID: 9612115 Abstract Title:  Demonstration of the efficacy of ginkgo biloba special extract EGb 761 on intermittent claudication--a placebo-controlled, double-blind multicenter trial. Abstract:  BACKGROUND: A multicentric, randomized, placebo-controlled double-blind study on ginkgo biloba special extract EGb 761 (Tebonin forte) in patients suffering from peripheral occlusive arterial disease (POAD) in Fontaine stage II b was carried out in order to prove its clinical efficacy in this indication according to guidelines of European Community authorities and the German Angiological Society and to confirm the results of former clinical studies with EGb 761. PATIENTS AND METHODS: In total, 111 patients with angiographically proven POAD in Fontaine stage II b and intermittent claudication (pain-free walking distance < 150 m on the treadmill) were recruited in 5 centers and treated with either EGb 761 or placebo at a daily dose of 3 times 1 film-coated tablet over a duration of 24 weeks following a 2-week placebo run-in period. The primary response variable was the difference of the pain-free walking distance between the start of treatment and after 8, 16 and 24 weeks as measured on the treadmill (walking speed 3 km/h and slope of 12%) under standardized conditions. RESULTS: At the start of the treatment period, the mean pain-free walking distances were very similar with 108.5 m in the EGb 761 group and 105.2 m in the placebo group. At the end of the treatment period these values increased to 153.2 m and 126.6 m, respectively. The group differences were statistically significant at all three control visits with p = 0.017, p = 0.007, and p = 0.016. The differences for the maximum walking distance and the relative increases of the pain-free walking distance and the maximum distance were also significantly higher in the EGb 761 group with p-values < 0.05 each. In both groups Doppler indices remained nearly unchanged during therapy. The subjective assessment of the patients demonstrated an amelioration of complaints in both groups. Tolerability was very good with no adverse events under EGb 761 and one case of heartburn and gastric pain in the placebo group. CONCLUSIONS: It can be concluded from the results of this study that treatment with EGb 761 in POAD patients with Fontaine stage II b is very safe and causes a significant and therapeutically relevant prolongation of the patients' walking distance. https://greenmedinfo.com/article/proprietary-ginkgo-biloba-extract-safe-and-effective-treatment-patients-interm#comments Ginkgo biloba Intermittent Claudication Peripheral Vascular Diseases Human Study Thu, 30 Jul 2009 10:51:37 +0000 greenmedinfo 46256 at https://greenmedinfo.com A proprietary ginkgo biloba extract is safe and effective in the treatment of patients with intermittent claudication. - Article 2 https://greenmedinfo.com/article/proprietary-ginkgo-biloba-extract-safe-and-effective-treatment-patients-inte-0 PMID:  Vasa. 1996;25(3):265-74. PMID: 8967154 Abstract Title:  [Placebo-controlled double-blind study of the effectiveness of Ginkgo biloba special extract EGb 761 in trained patients with intermittent claudication]. Abstract:  This monocenter, randomized, placebo-controlled double-blind study with parallel-group comparison was carried out in order to demonstrate the efficacy of Ginkgo biloba special extract EGb 761 on objective and subjective parameters of the walking performance in trained patients suffering from peripheral arterial occlusive disease in Fontaine stage IIb. In total 60 patients were recruited (42 men; aged 47-82 years) with angiographically proven peripheral arterial occlusive disease of the lower extremities and an intermittent claudication existing for at least 6 months. No improvement had been shown despite consistent walking training and a maximum pain-free walking distance on the treadmill of less than 150 m was recorded at the beginning of the study. The therapeutic groups were treated with either Ginkgo biloba special extract EGb 761 at a dose of 3 times 1 film-coated tablet of 40 mg per day by oral route or placebo over a duration of 24 weeks following a two-week placebo run-in phase. The main outcome measure was the difference of the walking distance between the start of treatment and after 8, 16 and 24 weeks of treatment as measured on the treadmill (walking speed 3 km/h and slope of 12%). As secondary parameters the corresponding differences for the maximum walking distance, the relative increase of the pain-free walking distance, the Doppler index and the subjective evaluation of the patients were analyzed. The absolute changes in the pain-free walking distance in treatment weeks 8, 16 and 24 as against the treatment beginning (median values with 95% confidence interval) led to the following values for the patients treated with Ginkgo biloba special extract EGb 761:19 m (14, 33), 34 m (18, 50) and 41 m (26, 64). The corresponding values in the placebo group were as follows: 7 m (-4, 12), 12 m (5, 22) and 8 m (-1, 21). The advantage of the EGb 761-treated group as compared to the placebo group could be verified statistically at the 3 time points with p < 0.0001, p = 0.0003 and p < 0.0001. The test for the presence of a clinically relevant difference of 20% between EGb 761 and placebo also produced a statistically significant result (p = 0.008). The Doppler index remained unchanged in both therapeutic groups: A corresponding statistically significant advantage for the EGb 761 group was observed on a descriptive level for the other parameters tested. The tolerance of the treatment was very good. The results of this placebo-controlled study show that treatment with Ginkgo biloba special extract EGb 761 produces a statistically highly significant and clinically relevant improvement of the walking performance in trained patients suffering from intermittent claudication with very good tolerance of the study preparation. https://greenmedinfo.com/article/proprietary-ginkgo-biloba-extract-safe-and-effective-treatment-patients-inte-0#comments Ginkgo biloba Intermittent Claudication Peripheral Arterial Disease Human Study Thu, 30 Jul 2009 10:53:06 +0000 greenmedinfo 46257 at https://greenmedinfo.com A Tibetan herbal formula, Padma 28, is well tolerated and effective in patients with intermittent claudication - Article 2 https://greenmedinfo.com/article/tibetan-herbal-formula-padma-28-well-tolerated-and-effective-patients-interm-0 PMID:  Ugeskr Laeger. 1994 Oct 17;156(42):6207-9. PMID: 7998359 Abstract Title:  [Padma-28, a herbal preparation, increases walking distance in patients with intermittent claudication]. Abstract:  Thirty-six patients with stable intermittent claudication were randomized in a doubleblind study either to treatment with two tablets of Padma-28 twice daily (containing 340 mg dried herbal mixture composed according to an ancient lamaistic prescription) or placebo for four months. Effect of treatment was quantified by measurements of systemic and peripheral systolic blood pressures, and pain-free and maximal walking distances on a tread-mill. The actively treated group attained a significant increase in pain-free walking distance from 115 m (72-218) to 227 m (73- >1000, p < 0.05). The placebo group did not show significant changes in either pain-free or maximal walking distance. Significant changes in systemic or peripheral blood pressures could not be demonstrated in any of the groups. In conclusion, our study has shown that treatment with Padma-28 over a four month period significantly increases the walking distance in patients with stable intermittent claudication of long duration. https://greenmedinfo.com/article/tibetan-herbal-formula-padma-28-well-tolerated-and-effective-patients-interm-0#comments Intermittent Claudication Tibetan Herbal Formula: Padma 28 Thu, 30 Jul 2009 11:11:04 +0000 greenmedinfo 46266 at https://greenmedinfo.com A Tibetan herbal formula, Padma 28, is well tolerated and effective in patients with intermittent claudication. https://greenmedinfo.com/article/tibetan-herbal-formula-padma-28-well-tolerated-and-effective-patients-intermit PMID:  Schweiz Med Wochenschr. 1985 Jun 1;115(22):752-6. PMID: 3892663 Abstract Title:  [Effects of the Tibetan herbal preparation Padma 28 in intermittent claudication]. Abstract:  In a placebo-controlled double blind study the effect of Padma 28, a Tibetan herbal prescription, on patients with intermittent claudication was investigated. After two weeks without vasoactive therapy 23 patients were treated by Padma 28 and 20 by placebo. The patients had a disease history of at least 8 months, a steady state for symptoms (maximum walking distance below 250 m), and were distributed randomly in the two groups. After 16 weeks the patients treated with Padma 28 exhibited on standardized ergometry an increase of some 100% (p less than 0.01) in the maximum as well as painfree walking distance. The control patients showed increases of 21% in maximum (p less than 0.05 as compared to Padma 28), and 46% in painfree walking distance. The drug was well tolerated and no drop-out ensued because of side effects. https://greenmedinfo.com/article/tibetan-herbal-formula-padma-28-well-tolerated-and-effective-patients-intermit#comments Intermittent Claudication Tibetan Herbal Formula: Padma 28 Human Study Thu, 30 Jul 2009 11:09:31 +0000 greenmedinfo 46265 at https://greenmedinfo.com Exercise (treadmill walking) improves walking capacity in patients with intermittent claudication. https://greenmedinfo.com/article/exercise-treadmill-walking-improves-walking-capacity-patients-intermittent-cla PMID:  Angiology. 2009 Feb-Mar;60(1):36-41. Epub 2008 May 27. PMID: 18505746 Abstract Title:  Effects of supervised treadmill walking training on calf muscle capillarization in patients with intermittent claudication. Abstract:  The aim of this study was to evaluate the effects of supervised treadmill walking training on the calf muscle capillarization in patients with intermittent claudication. The first 12-week period was a non-exercise, within-subject control stage, and the second 12-week period was an exercise training stage. Calf muscle biopsy and functional capacity measurement were performed at baseline, preexercise and postexercise training. In all, 11 subjects completed all procedures. Their average age was (mean +/- standard deviation) 73.9 +/- 5.5 years and resting ankle-to-brachial systolic blood pressure index was 0.57 +/- 0.11. After exercise training, the difference between the pretraining and posttraining capillaries in contact with type IIx and IIa muscle fibers for each subject was significantly correlated with an improved pain-free walking time, r = 0.69 and r = 0.62 (both P < .05), respectively. This finding suggests that the change in calf muscle capillarization might contribute to the improved walking capacity following supervised treadmill walking training in patients with intermittent claudication. https://greenmedinfo.com/article/exercise-treadmill-walking-improves-walking-capacity-patients-intermittent-cla#comments Intermittent Claudication Exercise Human Study Thu, 30 Jul 2009 10:47:42 +0000 greenmedinfo 46255 at https://greenmedinfo.com Fish oil supplementation improves walking distaince in peripheral arterial disease. https://greenmedinfo.com/article/fish-oil-supplementation-improves-walking-distaince-peripheral-arterial-diseas PMID:  Prostaglandins Leukot Essent Fatty Acids. 2007 Jun;76(6):331-40. Epub 2007 Jun 27. PMID: 17600695 Abstract Title:  Fish oil induced increase in walking distance, but not ankle brachial pressure index, in peripheral arterial disease is dependent on both body mass index and inflammatory genotype. Abstract:  Peripheral arterial disease (PAD) is an atherosclerotic disease. Evidence suggests that atherosclerosis is an inflammatory condition and long chain n-3 fatty acids, found in oily fish and fish oils, have been shown to reduce inflammation. Genetic and lifestyle factors such as body mass index (BMI) also influence inflammation. In this study we have examined the effect of fish oil in patients with claudication secondary to PAD. Fish oil supplementation, providing 1g EPA and 0.7 g DHA per day for 12 weeks, increased walking distance on a treadmill set at 3.2 km/h with a 7% incline. Walking distance to first pain increased from 76.2+/-8.5 m before fish oil to 140.6+/-25.5 m after fish oil (mean+/-SEM, p=0.004) and total distance walked increased from 160.0+/-21.5 m before fish oil to 242.1+/-34.5 m after fish oil (p=0.002). Fish oil supplementation also improved ankle brachial pressure index (ABPI) from 0.599+/-0.017 before fish oil to 0.776+/-0.030 after fish oil (p<0.001). The increase in walking distance was dependent on both BMI and genotype for single nucleotide polymorphisms in the genes encoding the pro-inflammatory cytokines tumour necrosis factor-alpha and interleukin (IL)-1beta and the anti-inflammatory cytokine IL-10 (detected using amplification refractory mutation system polymerase chain reaction). Neither BMI nor any of the genotypes examined affected the ability of fish oil to increase ABPI. The mechanisms by which fish oil affects walking distance and ABPI do not appear to be the same. https://greenmedinfo.com/article/fish-oil-supplementation-improves-walking-distaince-peripheral-arterial-diseas#comments DHA (Docosahexaenoic Acid) EPA (Eicosapentaenoic Acid) Fish Oil Intermittent Claudication Peripheral Arterial Disease Human Study Thu, 30 Jul 2009 10:55:25 +0000 greenmedinfo 46258 at https://greenmedinfo.com Garlic has a therapeutic effect in intermittent claudication. https://greenmedinfo.com/article/garlic-has-therapeutic-effect-intermittent-claudication PMID:  Clin Investig. 1993 May;71(5):383-6. PMID: 8508009 Abstract Title:  Effects of garlic coated tablets in peripheral arterial occlusive disease. Abstract:  For the first time, a weak clinical efficacy of a 12-week therapy with garlic powder (daily dose, 800 mg) is demonstrated in patients with peripheral arterial occlusive disease stage II. The increase in walking distance in the verum group by 46 m (from 161.0 +/- 65.1 to 207.1 +/- 85.0 m) was significantly higher (P < 0.05) than in the placebo group (by 31 m, from 172.0 +/- 60.9 to 203.1 +/- 72.8). Both groups received physical therapy twice a week. The diastolic blood pressure, spontaneous thrombocyte aggregation, plasma viscosity, and cholesterol concentration also decreased significantly. Body weight was maintained. It is quite interesting that the garlic-specific increase in walking distance did not appear to occur until the 5th week of treatment, connected with a simultaneous decrease in spontaneous thrombocyte aggregation. Therefore, garlic may be an appropriate agent especially for the long-term treatment of an incipient intermittent claudication. https://greenmedinfo.com/article/garlic-has-therapeutic-effect-intermittent-claudication#comments Garlic Intermittent Claudication Peripheral Vascular Diseases Human Study Thu, 30 Jul 2009 12:29:29 +0000 greenmedinfo 46278 at https://greenmedinfo.com High intakes of antioxidant vitamins may be protective against intermittent claudication. https://greenmedinfo.com/article/high-intakes-antioxidant-vitamins-may-be-protective-against-intermittent-claud PMID:  Am J Epidemiol. 2000 May 1;151(9):892-901. PMID: 10791562 Abstract Title:  Prospective study of diet, lifestyle, and intermittent claudication in male smokers. Abstract:  The association between dietary and lifestyle factors and intermittent claudication was investigated in the Finnish Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study. The cohort comprised 26,872 male smokers aged 50-69 years who were free of claudication at study entry. At baseline (1985-1988), subjects completed a diet history questionnaire. During a median follow-up period of 4 years (ending in spring 1993), 2,578 men reported symptoms of claudication on the Rose questionnaire, which was administered annually. Smoking status was assessed every 4 months. Smoking, systolic blood pressure, serum total cholesterol, and diabetes mellitus were positively associated with risk for claudication, whereas serum high density lipoprotein cholesterol, education, and leisure time exercise were inversely associated with risk. Dietary carbohydrates, fiber, and n-6 polyunsaturated fatty acids were inversely associated with risk for claudication, as were some dietary and serum antioxidants: dietary vitamin C (highest quartile vs. lowest: relative risk (RR) = 0.86; 95% confidence interval (CI): 0.77, 0.97), dietary gamma-tocopherol (RR = 0.89; 95% CI: 0.79, 1.00), dietary carotenoids (RR = 0.82; 95% CI: 0.73, 0.92), serum alpha-tocopherol (RR = 0.88; 95% CI: 0.77, 1.00), and serum beta-carotene (RR = 0.77; 95% CI: 0.68, 0.86). Smoking cessation reduced subsequent risk for claudication (RR = 0.86; 95% CI: 0.75, 0.99). The authors conclude that classical risk factors for atherosclerosis are associated with claudication. High intakes of antioxidant vitamins may be protective. Further research is needed before antioxidants can be recommended for the prevention of intermittent claudication. https://greenmedinfo.com/article/high-intakes-antioxidant-vitamins-may-be-protective-against-intermittent-claud#comments Antioxidant formulas Intermittent Claudication Review Thu, 30 Jul 2009 12:19:50 +0000 greenmedinfo 46274 at https://greenmedinfo.com L-arginine improves symptoms of intermittent claudication in patients with arterial occlusive disease. https://greenmedinfo.com/article/l-arginine-improves-symptoms-intermittent-claudication-patients-arterial-occlu PMID:  J Am Coll Cardiol. 1998 Nov;32(5):1336-44. PMID: 9809945 Abstract Title:  Restoring vascular nitric oxide formation by L-arginine improves the symptoms of intermittent claudication in patients with peripheral arterial occlusive disease. Abstract:  BACKGROUND: Administration of L-arginine improves nitric oxide (NO) formation and endothelium-dependent vasodilation in atherosclerotic patients. OBJECTIVES: We investigated in this double-blind, controlled study whether prolonged intermittent infusion therapy with L-arginine improves the clinical symptoms of patients with intermittent claudication, as compared with the endothelium-independent vasodilator prostaglandin E1, and control patients. METHODS: Thirty-nine patients with intermittent claudication were randomly assigned to receive 2 x 8 g L-arginine/day, or 2 x 40 microg prostaglandin E1 (PGE1)/day or no hemodynamically active treatment, for 3 weeks. The pain-free and absolute walking distances were assessed on a walking treadmill at 3 km/h, 12% slope, and NO-mediated, flow-induced vasodilation of the femoral artery was assessed by ultrasonography at baseline, at 1, 2 and 3 weeks of therapy and 6 weeks after the end of treatment. Urinary nitrate and cyclic guanosine-3', 5'-monophosphate (GMP) were assessed as indices of endogenous NO production. RESULTS: L-Arginine improved the pain-free walking distance by 230+/-63% and the absolute walking distance by 155+/-48% (each p < 0.05). Prostaglandin E1 improved both parameters by 209+/-63% and 144+/-28%, respectively (each p < 0.05), whereas control patients experienced no significant change. L-Arginine therapy also improved endothelium-dependent vasodilation in the femoral artery, whereas PGE1 had no such effect. There was a significant linear correlation between the L-arginine/asymmetric dimethylarginine (ADMA) ratio and the pain-free walking distance at baseline (r=0.359, p < 0.03). L-Arginine treatment elevated the plasma L-arginine/ADMA ratio and increased urinary nitrate and cyclic GMP excretion rates, indicating normalized endogenous NO formation. Prostaglandin E1 therapy had no significant effect on any of these parameters. Symptom scores assessed on a visual analog scale increased from 3.51+/-0.18 to 83+/-0.4 (L-arginine) and 7.0+/-0.5 (PGE1; each p < 0.05), but did not significantly change in the control group (4.3+/-0.4). CONCLUSIONS: Restoring NO formation and endothelium-dependent vasodilation by L-arginine improves the clinical symptoms of intermittent claudication in patients with peripheral arterial occlusive disease. https://greenmedinfo.com/article/l-arginine-improves-symptoms-intermittent-claudication-patients-arterial-occlu#comments Arginine Intermittent Claudication Peripheral Arterial Disease Human Study Thu, 30 Jul 2009 12:22:40 +0000 greenmedinfo 46275 at https://greenmedinfo.com L-arginine may improve walking speed in patients with peripheral arterial disease. https://greenmedinfo.com/article/l-arginine-may-improve-walking-speed-patients-peripheral-arterial-disease PMID:  Vasc Med. 2005 Nov;10(4):265-74. PMID: 16444855 Abstract Title:  A pilot study of L-arginine supplementation on functional capacity in peripheral arterial disease. Abstract:  Peripheral arterial disease (PAD) impairs walking capacity and is often associated with a profound endothelial vasodilator dysfunction, characterized by reduced bioactivity and/or synthesis of endothelium-derived nitric oxide (NO). Previous studies have suggested that dietary supplementation of L-arginine, the precursor of NO, improves endothelium-dependent vasodilation, limb blood flow and walking distance. However, these studies have been small, and have used large intravenous doses of L-arginine. The optimal dose of L-arginine has not been determined. Accordingly, this pilot study was conducted to establish the lowest effective oral dose of L-arginine to improve walking distance in preparation for the definitive study. Patients with PAD and intermittent claudication (n = 80) participated in this study. Eligibility criteria included: (1) ankle-brachial index (ABI) at restor = 25%; and (3) difference in absolute claudication distance of https://greenmedinfo.com/article/l-arginine-may-improve-walking-speed-patients-peripheral-arterial-disease#comments Arginine Intermittent Claudication Peripheral Vascular Diseases Human Study Mon, 25 Jan 2010 21:02:49 +0000 greenmedinfo 50017 at https://greenmedinfo.com Policosanol demonstrates long-term usefulness in the treatment of patients with intermittent claudication. https://greenmedinfo.com/article/policosanol-demonstrates-long-term-usefulness-treatment-patients-intermittent- PMID:  J Nutr. 2009 Nov;139(11):2061-6. Epub 2009 Sep 23. PMID: 11228084 Abstract Title:  A long-term study of policosanol in the treatment of intermittent claudication. Abstract:  Policosanol is a cholesterol-lowering drug with concomitant antiplatelet effects. This study was undertaken to investigate the long-term effects of policosanol administered to patients with moderately severe intermittent claudication. The study consisted of a 6-week single-blind, placebo-controlled run in phase, followed by a 2-year double-blind, randomized treatment step. Fifty-six patients who met study entry criteria were randomized to receive placebo or policosanol 10 mg twice daily. Walking distances on a treadmill (constant speed 3.2 km/h, slope 10 degrees, temperature 25 degrees C) were assessed before and after 6, 12, 18, and 24 months of treatment. Both groups were similar at randomization. After 6 months of therapy, policosanol significantly increased (p < 0.01) the initial claudication distance from 125.9 +/- 8.7 m to 201.1 +/- 24.8 m and the absolute claudication distance from 219.5 +/- 14.1 m to 380.7 +/- 50.2 m. Both variables remained unchanged in the placebo group (p < 0.01). These effects did not wear off but improved after long-term therapy, so that final values were 333.5 +/- 28.6 m (initial claudication distance) and 648.9 +/- 54.1 m (absolute claudication distance); both significantly greater (p < 0.0001) than those obtained in the placebo group, which showed values of 137.9 +/- 21.8 m (initial claudication distance) and 237.7 +/- 28.1 m (absolute claudication distance), respectively. At study completion, 21 policosanol and 5 placebo patients attained increases in claudication distance values > 50% (p < 0.001). Policosanol, but not placebo, significantly increased the ankle/arm pressure index. In addition, from month 6 up to study completion, the frequency of patients reporting improvement of lower limb symptoms was greater in the policosanol group than in the placebo group. The treatment was tolerated well. There were 16 withdrawals (12 placebo, 4 policosanol) from the study. Eight patients in the placebo group experienced a total of 10 serious adverse events, 8 of which were vascular events, compared with none in the policosanol group (p < 0.01). In addition, 3 patients in the policosanol group and 3 patients in the placebo group reported mild adverse events during the study. The present results demonstrate the long-term usefulness of policosanol therapy to treat patients with intermittent claudication. https://greenmedinfo.com/article/policosanol-demonstrates-long-term-usefulness-treatment-patients-intermittent-#comments Intermittent Claudication Policosanol Human Study Thu, 30 Jul 2009 10:44:57 +0000 greenmedinfo 46254 at https://greenmedinfo.com Policosanol is superior to lovastatin in patients with intermittent claudication. https://greenmedinfo.com/article/policosanol-superior-lovastatin-patients-intermittent-claudication PMID:  Angiology. 2003 Jan;54(1):25-38. PMID: 12593493 Abstract Title:  Effects of policosanol and lovastatin in patients with intermittent claudication: a double-blind comparative pilot study. Abstract:  Policosanol is a cholesterol-lowering drug with concomitant antiplatelet effects. The present study was undertaken to compare the effects of policosanol and lovastatin on patients with moderately severe intermittent claudication. The study had a 4-week baseline step, followed by a 20-week double blinded, randomized treatment period. Twenty-eight patients who met study entry criteria were randomized to policosanol 10 mg or lovastatin 20 mg tablets once daily. Walking distances in a treadmill (constant speed 3.2 km/hr, slope 10 degrees, temperature 25 degrees C) were assessed before and after 20 weeks of treatment. Both groups were similar at randomization. Compared with baseline, policosanol increased significantly (p < 0.01) the initial claudication distance (ICD) from 160.39 +/- 15.82 m to 211.31 +/- 21.48 m (+33.7%) and the absolute claudication distance (ACD) (p < 0.001) from 236.39 +/- 25.44 m to 288.09 +/- 28.47 m (+24.3%); meanwhile both variables remained unchanged after lovastatin therapy. Changes in ICD and ACD were significantly larger in the policosanol than in the lovastatin group (p < 0.01). Policosanol, but not lovastatin, significantly increased (p < 0.05) the ankle/arm index, although between-group differences were not significant. The frequency of patients reporting improvement on quality of life domains was greater in the policosanol than in the lovastatin group. Policosanol significantly (p < 0.001) lowered total cholesterol (TC) and low-density lipoprotein-cholesterol (LDL-C) by 17.5% and 31.0%, respectively, and meanwhile increased (p < 0.01) high-density lipoprotein-cholesterol (HDL-C) levels by 31.5%. Lovastatin reduced (p < 0.01) TC (18.0%), LDL-C (22.6%), and (p < 0.05) triglycerides (9.8%). In addition, policosanol, but not lovastatin, moderately, but significantly, reduced (p < 0.05) fibrinogen levels, so that final values and percent changes in both groups were different (p < 0.01). Treatments were well tolerated. Only 1 lovastatin patient withdrew from the study because of a nonfatal myocardial infarction. Five lovastatin patients, but none from the policosanol group, experienced 6 adverse events (AE) (p < 0.01). The present results indicate that policosanol, but not lovastatin, is a suitable alternative to manage patients with intermittent claudication because of pleiotropic properties beyond its cholesterol-lowering effects. https://greenmedinfo.com/article/policosanol-superior-lovastatin-patients-intermittent-claudication#comments Intermittent Claudication Policosanol Superiority of Natural Substances versus Drugs Human Study Thu, 30 Jul 2009 10:43:09 +0000 greenmedinfo 46253 at https://greenmedinfo.com Policosanol is superior to ticlopidine in patients with intermittent claudication. https://greenmedinfo.com/article/policosanol-superior-ticlopidine-patients-intermittent-claudication PMID:  Angiology. 2004 Jul-Aug;55(4):361-71. PMID: 15258682 Abstract Title:  Effects of policosanol and ticlopidine in patients with intermittent claudication: a double-blinded pilot comparative study. Abstract:  Policosanol is a cholesterol-lowering drug with concomitant antiplatelet effects. The present study was undertaken to compare the effects of policosanol and ticlopidine in patients with moderately severe intermittent claudication (IC). The study had a 4-week baseline step, followed by a 20-week double-blinded, randomized treatment period. Twenty-eight eligible patients were randomized to policosanol 10 mg or ticlopidine 250 mg tablets twice daily (bid). Walking distances in a treadmill (constant speed 3.2 km/hr, slope 10 degrees, temperature 25 degrees C) were assessed before and after 20 weeks of treatment. Both groups were similar at baseline. Compared with baseline, policosanol significantly increased (p < 0.01) mean values of initial (ICD) and absolute (ACD) claudication distances from 162.1 to 273.2 m and from 255.8 to 401.0 m, respectively. Ticlopidine also raised significantly (p < 0.01) ICD (166.2 to 266.3 m) and ACD (252.9 to 386.4 m). Comparisons between groups did not show significant differences. Policosanol, but not ticlopidine, significantly (p < 0.05), but modestly, increased the ankle/arm pressure ratio. After 10 weeks, policosanol significantly (p < 0.001) lowered low-density lipoprotein-cholesterol (LDL-C), total cholesterol (TC) (p < 0.01), and TC/HDL-C and raised (p < 0.05) high-density lipoprotein-cholesterol (HDL-C). At study completion, policosanol lowered (p < 0.001) LDL-C (30.2%), TC (16.9%), and TC/HDL-C (33.9%), increased (p < 0.01) HDL-C (+31.7%), and left triglycerides unchanged. Ticlopidine did not affect the lipid profile variable. Policosanol induced modest, but significant, reductions (p < 0.01) of fibrinogen levels compared with baseline and ticlopidine. Treatments were well tolerated and did not impair safety indicators. Three ticlopidine patients (21.4%) withdrew from the trial, only 1 owing to a serious adverse experience (AE) (unstable angina). Three other ticlopidine patients experienced mild AE (headache, diarrhea, and acidity). It is concluded that policosanol (10 mg bid) can be as effective as ticlopidine (250 mg bid) for improving walking distances of claudicant patients, and it could be advantageous for the global risk of these individuals owing to its cholesterol-lowering effects. This study is, however, just a pilot comparison, so that further studies in larger sample sizes are needed for definitive conclusions of the comparative effects of both drugs on patients with IC. https://greenmedinfo.com/article/policosanol-superior-ticlopidine-patients-intermittent-claudication#comments Intermittent Claudication Policosanol Superiority of Natural Substances versus Drugs Human Study Thu, 30 Jul 2009 10:41:35 +0000 greenmedinfo 46252 at https://greenmedinfo.com Propionyl-L-carnitine improves exercise performance and functional status in patients with claudication. https://greenmedinfo.com/article/propionyl-l-carnitine-improves-exercise-performance-and-functional-status-pati PMID:  Am J Med. 2001 Jun 1;110(8):616-22. PMID: 11382369 Abstract Title:  Propionyl-L-carnitine improves exercise performance and functional status in patients with claudication. Abstract:  PURPOSE: We tested the hypothesis that propionyl-L-carnitine would improve peak walking time in patients with claudication. Secondary aims of the study were to evaluate the effects of propionyl-L-carnitine on claudication onset time, functional status, and safety. SUBJECTS AND METHODS: In this double-blind, randomized, placebo-controlled trial, 155 patients with disabling claudication from the United States (n = 72) or Russia (n = 83) received either placebo or propionyl-L-carnitine (2g/day orally) for 6 months. Subjects were evaluated at baseline and 3 and 6 months after randomization with a graded treadmill protocol at a constant speed of 2 miles per hour, beginning at 0% grade, with increments in the grade of 2% every 2 minutes until maximal symptoms of claudication forced cessation of exercise. Questionnaires were used to determine changes in functional status. RESULTS: At baseline, peak walking time was 331 +/- 171 seconds in the placebo group and 331 +/- 187 seconds in the propionyl-L-carnitine group. After 6 months of treatment, subjects randomly assigned to propionyl-L-carnitine increased their peak walking time by 162 +/- 222 seconds (a 54% increase) as compared with an improvement of 75 +/- 191 seconds (a 25% increase) for those on placebo (P <0.001). Similar improvements were observed for claudication onset time. Propionyl-L-carnitine treatment significantly improved walking distance and walking speed (by the Walking Impairment Questionnaire), and enhanced physical role functioning, reduced bodily pain, and resulted in a better health transition score (by the Medical Outcome Study SF-36 Questionnaire). The incidence of adverse events and study discontinuations were similar in the two treatment groups. CONCLUSIONS: Propionyl-L-carnitine safely improved treadmill exercise performance and enhanced functional status in patients with claudication. https://greenmedinfo.com/article/propionyl-l-carnitine-improves-exercise-performance-and-functional-status-pati#comments Carnitine: propionyl-L-carnitine Intermittent Claudication Human Study Thu, 30 Jul 2009 11:35:15 +0000 greenmedinfo 46273 at https://greenmedinfo.com