Сhronic Venous Disease as Part of Continuum of Cardiovascular Disease – Shared Pathophysiology, Risk Factors and Novel Pharmacological Treatment Paradigms
DOI:
https://doi.org/10.52340/GBMN.2026.01.01.149Keywords:
Cardiovascular diseases (CVDs), chronic venous diseases (CVeD), diosmin, endothelial dysfunction, micronized purified flavonoid fraction (MPFF) formulation, oxidative stress, systemic inflammationAbstract
Chronic venous diseases (CVeD) are widely recognized as serious medical and social problems. They are a common, progressive group of diseases that have a significant negative influence on patients' quality of life and put an immense burden on healthcare systems around the world. An increasing number of studies in recent years have indicated that CVeD is more than just a local vein concern. Instead, it may sit on a broader cardiovascular continuum—reflecting systemic vascular dysfunction, sharing many of the same risk factors, and potentially flagging a higher risk of serious cardiac events. Both CVeD and cardiovascular diseases (CVDs) involve endothelial dysfunction, systemic inflammation, and oxidative stress. All these mechanisms are interconnected and mutually mediate. There is a need for a better understanding of the biological pathways shared by CVeD and other cardiovascular diseases to prevent and treat them more effectively. Understanding these common mechanisms can help develop new treatments that improve outcomes for both conditions, as well as more integrated preventive strategies. New research will be needed to prove, on the one hand, that modern pharmacotherapy of chronic venous diseases has not only regional but also systemic significance and, on the other hand, based on the similarity of pathogenesis, that in these diseases, neurohormonal and other therapies can also have the same beneficial effect as in several cardiovascular diseases.References
Gregory A. Roth, MD, MPH,a George A. Mensah, MD, b Catherine O. Johnson, PHD, MPH,c Giovanni Addolorato, MD,dEnrico Ammirati, MD, P HD, e Larry M. Baddour, MD,f Noël C. Barengo, MD, P HD, MP H,g Andrea Z. Beaton, MD,hEmelia J. Benjamin, MD, SC M,i Catherine P. Benziger, MD,j Aimé Bonny, MD, MS C,k Michael Brauer, SCD, et all Global Burden of Cardiovascular Diseasesand Risk Factors, 1990–2019JACCVOL.76,NO.25, 2020:2982–3021.
Shinji Tomita's ''A New Perspective: The Relationship between Chronic Venous Insufficiency and Cardiovascular Disease" published in Phlebology 2025;36(1):19-"23.
Arshiya S. Anwar Husaini, Aseela Fathima, Dunia Halawa, Nada Aakel, Gian Luca Erre, Roberta Giordo, Hatem Zayed, Gianfranco Pintus. Exploring endothelial dysfunction in major rheumatic diseases: current trends and future directions. Journal of Molecular Medicine (2025) 103:635–649.
Maximilian Jonathan Herzog, Patrick Müller, Katharina Lechner, Marvin Stiebler, Philipp Arndt, Matthias Kunz, Dörte Ahrens, Alexander Schmeißer, Stefanie Schreiber and Ruediger C. Braun-Dullaeus. Arterial stiffness and vascular aging: mechanisms, prevention, and therapy. Signal Transduction and Targeted Therapy (2025) 10:282.
Komarów W., Hawro P., Lekston A., Urbanek T., Zagrodzki P. Endothelial dysfunction in patients with chronic venous disease: an evaluation based on the flow-mediated dilatation test International Angiology 2015 February;34(1):36-42.
Hristo Abrashev, Despina Abrasheva, Nadelin Nikolov, Julian Ananiev and Ekaterina Georgieva. A Systematic Review of Endothelial Dysfunction in Chronic Venous Disease—Inflammation, Oxidative Stress, and Shear Stress Int. J. Mol. Sci. 2025, 26, 3660.
Ciapponi A, Laffaire E, Roque M. Calcium dobesilate for chronic venous insufficiency: a systematic review. Angiology 2004;55: 147e54.
Rabe E, Ballarini S, Lehr L, Doxium EDXSG. A randomized, double-blind, placebo-controlled, clinical study on the efficacy and safety of calcium dobesilate in the treatment of chronic venous insufficiency. Phlebology 2016;31:264e74.
Maria Lourdes Del Río-Solá, MD, PhD,a Noelia Cenizo-Revuelta, MD, PhD,a Laura Saiz Viloria, MD, PhD,a Miguel Martin Pedrosa, MD, PhD,a and Jose Antonio González-Fajardo, MD, PhD The cardiovascular impact of chronic venous disease: A systematic review and meta-analysis. Journal of Vascular Surgery: Venous and Lymphatic Disorders January 2026.
Naomi M. Hamburg. The legs are a pathway to the heart: connections between chronic venous insufficiency and cardiovascular disease European Heart Journal (2021) 42, 4166–4168.
Clinical practice guideline document. Editor’s Choice – European Society for Vascular Surgery (ESVS) 2022 Clinical Practice Guidelines on the Management of Chronic Venous Disease of the Lower Limbs. Eur J Vasc Endovasc Surg (2022) 63, 184e267.
Kalus U, Koscielny J, Grigorov A, Schaefer E, Peil H, Kiesewetter H. Improvement of cutaneous microcirculation and oxygen supply in patients with chronic venous insufficiency by orally administered extract of red vine leaves AS 195: a randomised, double-blind, placebo-controlled, crossover study. Drugs R D 2004;5:63e71.
Martinez-Zapata MJ, Moreno RM, Gich I, Urrutia G, Bonfill X, Chronic Venous Insufficiency Study Group. A randomized, doubleblind multicentre clinical trial comparing the efficacy of calcium dobesilate with placebo in the treatment of chronic venous disease.
Flota-Cervera F, Flota-Ruiz C, Trevino C, Berber A. Randomized, double blind, placebo-controlled clinical trial to evaluate the lymphagogue effect and clinical efficacy of calcium dobesilate in chronic venous disease. Angiology 2008;59:352e6.
Andrew Niocolaides, Stavros Kakkos, Niels Baekgaard, Anthony Vomerota, Mariam de maeseneer, Bo Eklof, Athanasios D Diannoukas, Marzia Lugli, Osxar Maleti, Ken Myers, Olle Nelzen, Hugo Partsch, Micheil Perrin Management of Chronic venous disorders of the lowe limbs. Guidelines According tu scientific Evidence. Part I. Practice Int Angiol. 2018 Jun;37(3):181-254.
