The aging venous system: from varicosities to vascular cognitive impairment

Abstract

Aging-induced pathological alterations of the circulatory system play a critical role in morbidity and mortality of older adults. While the importance of cellular and molecular mechanisms of arterial aging for increased cardiovascular risk in older adults is increasingly appreciated, aging processes of veins are much less studied and understood than those of arteries. In this review, age-related cellular and morphological alterations in the venous system are presented. Similarities and dissimilarities between arterial and venous aging are highlighted, and shared molecular mechanisms of arterial and venous aging are considered. The pathogenesis of venous diseases affecting older adults, including varicose veins, chronic venous insufficiency, and deep vein thrombosis, is discussed, and the potential contribution of venous pathologies to the onset of vascular cognitive impairment and neurodegenerative diseases is emphasized. It is our hope that a greater appreciation of the cellular and molecular processes of vascular aging will stimulate further investigation into strategies aimed at preventing or retarding age-related venous pathologies.

Age related increase in internal jugular vein size parallels temporal development of periventricular white matter hyperintensities

“…There is evidence that the femoral veins demonstrate increase in size with age (Keiler et al, 2019), and resulting alteration in the venous flow dynamics contribute ultimately to venous insufficiency (Fronek et al, 2001). Age related changes to the arterial system have been long‐understood and extensively studied, however, we only recently started to understand the process behind venous aging (Molnár et al, 2021). Age related dysfunction of the endothelial cells, smooth muscle and connective tissue occur both in the arterial and venous systems (Molnár et al, 2021).…”

“…Age related dysfunction of the endothelial cells, smooth muscle and connective tissue occur both in the arterial and venous systems (Molnár et al, 2021). In addition, venous valvular dysfunction, due to cusp thickening, and exacerbated hemodynamic failure, due to reduction in vessel compliance with wall thickening, both contribute to age related venous dysfunction (Molnár et al, 2021). The current study demonstrates for the first time age‐related venous changes in the neck characterized by age‐related increase in size of the IJVs.…”

“…Age related changes to the arterial system have been long‐understood and extensively studied, however, we only recently started to understand the process behind venous aging (Molnár et al, 2021). Age related dysfunction of the endothelial cells, smooth muscle and connective tissue occur both in the arterial and venous systems (Molnár et al, 2021). In addition, venous valvular dysfunction, due to cusp thickening, and exacerbated hemodynamic failure, due to reduction in vessel compliance with wall thickening, both contribute to age related venous dysfunction (Molnár et al, 2021).…”

Cardiac and Respiratory Influences on Intracranial and Neck Venous Flow, Estimated Using Real-Time Phase-Contrast MRI

“…For intracranial drainage, we considered the superior sagittal sinus (SSS), this being the largest dural venous sinus and receiving venous blood from different superficial cortical veins in both the cerebral hemispheres [ 16 , 17 ], and given its fundamental role in cerebrospinal fluid drainage and waste removal [ 18 ]. The study of brain drainage is fundamental due to its implications in the neurological field, as venous abnormalities, cerebral blood flow, and cerebrospinal fluid flow alterations have been described in neurodegenerative [ 19 , 20 , 21 , 22 , 23 ] and neuroinflammatory diseases [ 22 , 24 , 25 , 26 , 27 , 28 ]. Moreover, the link between the age-related brain’s venous circulation alterations and the pathogenesis of vascular cognitive impairment and dementia is an open issue that is gaining much scientific interest [ 29 ].…”

Features of Expression of Growth Mediators and Matrix Metalloproteinases at the Local Level in Patients With Lower Limb Varicose Veins, Clinical Class C4 - C6

“…Traditionally, this growth mediator is considered a key stimulator of angiogenesis and cell proliferation, which makes it possible to consider it as a potential marker of LLVV. VEGF producers are macrophages, fibroblasts, lymphocytes, polymorphonuclear cells, osteoblasts, endothelial cells, SMCs (smooth muscle cells), mesangial cells of the renal glomerulus, platelets and keratinocytes [11,12,13]. It is well known that VEGF plays an important role in the formation of vasa vasorum [14].…”