Can atherosclerosis lead to venous insufficiency?

From the Guidelines

Atherosclerosis does not directly cause venous insufficiency, as these are two distinct vascular conditions affecting different parts of the circulatory system. Atherosclerosis primarily affects arteries, causing plaque buildup in arterial walls that can lead to conditions like coronary artery disease, peripheral arterial disease, and stroke, as noted in the study by 1. Venous insufficiency, on the other hand, occurs in veins when valves that prevent backward blood flow become damaged or weakened, most commonly in the legs. The primary causes of venous insufficiency include age-related valve deterioration, deep vein thrombosis, obesity, pregnancy, prolonged standing or sitting, and genetic factors, as discussed in the studies by 1 and 1.

Some key points to consider in the relationship between atherosclerosis and venous insufficiency include:

• Atherosclerosis is a marker of systemic atherosclerosis, affecting the arteries and leading to conditions such as peripheral arterial disease, as stated in the study by 1.
• Venous insufficiency is a condition affecting the veins, typically caused by valve dysfunction, and its treatment approaches differ significantly from those for atherosclerosis, as outlined in the studies by 1 and 1.
• While a person can have both conditions simultaneously due to shared risk factors like smoking, obesity, and sedentary lifestyle, atherosclerosis in arteries does not directly cause the valve dysfunction that leads to venous insufficiency.
• Treatment approaches for these conditions differ significantly, with atherosclerosis often requiring cholesterol management and antiplatelet medications, while venous insufficiency typically requires compression therapy, leg elevation, and sometimes surgical interventions, as discussed in the studies by 1 and 1.

In terms of morbidity, mortality, and quality of life, it is essential to address both conditions separately but also consider their potential impact on each other, given shared risk factors. The study by 1 highlights the importance of managing atherosclerosis to reduce the risk of cardiovascular events and improve quality of life. Similarly, the studies by 1 and 1 emphasize the need for appropriate treatment of venous insufficiency to alleviate symptoms and reduce the risk of complications. Therefore, a comprehensive approach to managing vascular health should include strategies to prevent and treat both atherosclerosis and venous insufficiency, taking into account their distinct pathophysiologies and treatment requirements.

From the Research

Atherosclerosis and Venous Insufficiency

• Atherosclerosis is associated with an increased risk of venous thrombosis, as shown in a study published in The New England Journal of Medicine 2.
• The study found that patients with spontaneous thrombosis had a higher prevalence of carotid plaques, indicating a possible link between atherosclerosis and venous thrombosis.
• Another study published in the International Angiology journal found that symptoms of chronic venous disease in the lower extremities were associated with cardiovascular risk factors, including markers of preclinical atherosclerosis in middle-aged women 3.

Venous Insufficiency and Atherosclerosis

• Chronic venous insufficiency (CVI) is a condition characterized by functional abnormalities of the venous system, producing advanced symptoms like edema, skin changes, or leg ulcers 4.
• Atherosclerosis may induce venous thrombosis, or the two conditions may share common risk factors, as suggested by the study published in The New England Journal of Medicine 2.
• The association between CVI and atherosclerosis is supported by the findings of the study published in the International Angiology journal, which found that women with symptoms of CVI had a higher prevalence of cardiovascular risk factors, including markers of preclinical atherosclerosis 3.

Treatment and Management

• The treatment of varicose veins and CVI has changed dramatically in recent years, with the rise of minimally invasive endovascular techniques 5, 6.
• Endovenous laser ablation (EVLA) and radiofrequency ablation (RFA) are recommended as first-line treatments for varicose veins, with EVLA being the most cost-effective option 6.
• Compression therapy and correction of venous refluxes by surgery or endovenous procedures are also essential for the management of CVI 4.