Chronic venous insufficiency, cardiovascular disease, and mortality: a population study

Prochaska, Jürgen H.; Arnold, Natalie; Falcke, Andrea; Kopp, Sabrina; Schulz, Andreas; Buch, Gregor; Moll, S.M. Ribero; Panova‐Noeva, Marina; Jünger, Claus; Eggebrecht, Lisa; Pfeiffer, Norbert; Beutel, Manfred E.; Binder, Harald; Grabbe, Stephan; Lackner, Karl J.; Cate‐Hoek, Arina J. ten; Espinola‐Klein, Christine; Münzel, Thomas; Wild, Philipp S.

doi:10.1093/eurheartj/ehab495

Cited by 43 publications

(32 citation statements)

References 29 publications

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“…Severe VV have been found to be associated with increased risk of major adverse cardiovascular events (including heart failure, acute coronary syndrome and ischaemic stroke) and mortality compared with matched controls. Similar concerns were echoed in a large population‐based study carried out by Prochaska et al ., who found that the higher CEAP score was associated with a higher ‘predicted 10‐year risk for incident cardiovascular disease’ 37 . These findings suggest that long‐term cardiovascular monitoring of patients with CVI is needed 36,37 …”

Section: Chronic Venous Disease and Major Adverse Cardiovascular Eventsmentioning

confidence: 99%

“…Similar concerns were echoed in a large population‐based study carried out by Prochaska et al ., who found that the higher CEAP score was associated with a higher ‘predicted 10‐year risk for incident cardiovascular disease’ 37 . These findings suggest that long‐term cardiovascular monitoring of patients with CVI is needed 36,37 …”

Section: Chronic Venous Disease and Major Adverse Cardiovascular Eventsmentioning

confidence: 99%

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Chronic venous disease. Part 1: pathophysiology and clinical features

Kumar¹,

Khan

Das

et al. 2022

Clin Experimental Derm

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Chronic venous disease (CVD) is a commonly encountered condition in the dermatology outpatient department. If untreated, CVD may progress to chronic leg ulcer causing serious morbidity to the patient. It also affects the quality of life of the affected patient and contributes to loss of work productivity. The spectrum of clinical manifestations for CVD is myriad, ranging from asymptomatic varicose veins and pigmentation to ulceration and scarring. Awareness of spectrum of clinical presentations is required to identify, diagnose and manage CVD. Long-standing cases may develop ankle joint stiffness, fixed flexion deformity, periostitis and even Marjolin ulcer. Increased venous hypertension, thought to result from valve incompetence and failure of the calf muscle pump, is central to the pathophysiology of the development of CVD. Tissue oedema, hypoxia and subsequent fibrosis are major immediate contributing factors responsible for the clinical manifestations of CVD. Localized, chronic inflammation is now increasingly being recognized as a key player, directly responsible for stasis dermatitis and hypercoagulable state. The complete ramifications of persistent inflammation in CVD are yet to be understood and serious systemic morbidities such as arterial and cardiac disease are increasingly being recognized in association with CVD.

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Section: Chronic Venous Disease and Major Adverse Cardiovascular Eventsmentioning

confidence: 99%

Section: Chronic Venous Disease and Major Adverse Cardiovascular Eventsmentioning

confidence: 99%

Chronic venous disease. Part 1: pathophysiology and clinical features

Kumar¹,

Khan

Das

et al. 2022

Clin Experimental Derm

View full text Add to dashboard Cite

show abstract

“…But during angioedema or inflammation the capillary wall becomes more permeable to plasma, leading to an increased source of interstitial fluid even when the capillary pressure is normal. Alternatively, trans-wall flow from the capillaries can be increased by higher capillary pressure when the venous valves fail to prevent back flow—a condition known as venous insufficiency 8 – 10 —which affects more than 36% in the general population over age 40 with increasing prevalence with age 11 .…”

Section: Introductionmentioning

confidence: 99%

The effects of gravity and compression on interstitial fluid transport in the lower limb

Baish

Padera

Munn

2022

Sci Rep

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Edema in the limbs can arise from pathologies such as elevated capillary pressures due to failure of venous valves, elevated capillary permeability from local inflammation, and insufficient fluid clearance by the lymphatic system. The most common treatments include elevation of the limb, compression wraps and manual lymphatic drainage therapy. To better understand these clinical situations, we have developed a comprehensive model of the solid and fluid mechanics of a lower limb that includes the effects of gravity. The local fluid balance in the interstitial space includes a source from the capillaries, a sink due to lymphatic clearance, and movement through the interstitial space due to both gravity and gradients in interstitial fluid pressure (IFP). From dimensional analysis and numerical solutions of the governing equations we have identified several parameter groups that determine the essential length and time scales involved. We find that gravity can have dramatic effects on the fluid balance in the limb with the possibility that a positive feedback loop can develop that facilitates chronic edema. This process involves localized tissue swelling which increases the hydraulic conductivity, thus allowing the movement of interstitial fluid vertically throughout the limb due to gravity and causing further swelling. The presence of a compression wrap can interrupt this feedback loop. We find that only by modeling the complex interplay between the solid and fluid mechanics can we adequately investigate edema development and treatment in a gravity dependent limb.

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“…In recent years, average body mass index (BMI) values have increased in Western countries, 7 with obesity being a known risk factor of CVI. 8 Furthermore, smoking, lack of physical activity, and often associated hypertension 9 are other factors that promote the occurrence of CVI.…”

Section: Introductionmentioning

confidence: 99%