Recent findings on Ruscus Aculeatus (Butchers Bro
Ruscus aculeatus (butcher’s broom) as a potential
treatment for orthostatic hypotension, with a case
report.
Redman DA. J Altern Complement Med 2000;6:539-549.
CONTEXT: Chronic orthostatic hypotension (OH) is
frequently a severely debilitating disease that
affects large groups of the population with autonomic
insufficiency‹the elderly; patients with
<<<<<DIABETES,>>>>> Parkinson’s disease, and chronic
fatigue syndrome; and anyone on drugs that affect the
autonomic nervous system. Unfortunately, even though
more than 60 medications are currently being used to
treat OH, none of them is particularly or consistently
effective. Ruscus aculeatus, a phytotherapeutic agent
that is well known in Europe, may, however, change
this. Its vasoconstrictive and venotonic properties
make it ideally suited to treat the pooling of blood
in the limbs, lack of venous tone, and lack of
neurally mediated vasoconstriction that frequently
characterize OH. Although it has never been suggested
as a treatment for OH, it already has a long, proven
record of use in Europe for treating a variety of
circulatory disorders. OBJECTIVE: To provide evidence
for what appears to be an effective, safe, inexpensive
botanical therapy for OH and encourage further studies
on the efficacy of Ruscus for OH patients. DESIGN:
Review of OH and therapies currently available for OH
and evaluation of the properties of Ruscus aculeatus,
its mechanism of action, and its suitability as a
therapeutic agent for treatment of OH. RESULTS: A
review of the many pharmacologic and nonpharmacologic
agents for treating OH reveals that all of the drug
therapies are disappointing and marginally useful.
Although nonpharmacologic management is preferred, in
the many cases in which OH becomes debilitating,
pharmacologic intervention becomes a last resort. But
drug therapy may not always be necessary, because
Ruscus aculeatus, a phytotherapeutic agent containing
ruscogenins and flavonoids, may prove useful for the
treatment of OH if denervation is not so advanced that
it has compromised receptor activity at the venous
wall. Ruscus aculeatus is an alpha-adrenergic agonist
that causes venous constriction by directly activating
postjunctional alpha1- and alpha2-receptors, in turn
stimulating the release of noradrenaline at the level
of the vascular wall. It also possesses venotonic
properties: it reduces venous capacity and pooling of
blood in the legs and exerts protective effects on
capillaries, the vascular endothelium, and smooth
muscle. Its flavonoid content strengthens blood
vessels, reduces capillary fragility, and helps
maintain healthy circulation. Unlike most of the drug
therapies used to treat OH, Ruscus aculeatus does not
cause supine hypertension. It also appears to do
something no other therapy can offer‹alleviate the
worsening effects of OH in environmentally hot
conditions. Finally, it is an extremely safe,
inexpensive, over-the-counter botanical medicine.
CONCLUSION: With proven phlebotherapeutic properties,
including vasoconstrictive action and venotonic
properties, Ruscus aculeatus shows great promise for
ameliorating the symptoms of OH and improving the
quality of life for large groups in the population. It
clearly deserves to be the object of wider research
and study as a treatment for OH.