To find out how the arteries are, pay attention (also) to the veins of the legs
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Legs that swell every night. Itching, and sometimes pain, especially when fatigued. Varicose veins drawing the calves. Eczema which can deepen to create a real ulcer on the skin. Anyone who thinks that these signs of pain in the leg veins are just “trivial” problems, to be considered from an aesthetic point of view, will probably have to think again. In the most serious forms of chronic venous disease, in fact, it is no longer just the legs that are at risk, but also the arteries, including those that carry blood to the heart, i.e. the coronary arteries.
The Gutenberg study, which appeared in European Heart Journal, who studied for the first time in the general population when chronic venous insufficiency is associated with classic cardiovascular pathologies. The research analysis, coordinated by Jurgen H. Prochaskashows that the more the chronic venous disease grows in terms of severity, the greater the cardiovascular risk appears as well as mortality from all causes.
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The connections between veins and arteries
Explaining this association between venous pathology of the legs and cardiovascular risk for the whole organism is not simple. But the relationships exist. And they are not limited to the presence of a common factor that endangers the health of the vessels, namely inflammation.
“The two pathologies share some risk factors such as age, smoking, diabetes mellitus, obesity and being overweight, which are associated with endothelial dysfunction, chronic inflammation and thrombosis which is due to slow flow and the consequent hypercoagulability which constitute the pathophysiological bases – he comments Leonard DeLuca, general secretary of the National Association of Hospital Cardiologists (ANMCO), who works at the UOC of Cardiology of the San Camillo-Forlanini Hospital in Rome. The risk is that thrombi form which can embolize (ie “move” to other areas of the vascular system) in the pulmonary field or create local complications at the level of the deep venous system”.
Observational studies highlight in the long term a five times higher risk of deep vein thrombosis and almost three times higher risk of pulmonary embolism in patients with chronic venous disease compared to those without this pathology. And we must not forget that other pathologies have a correlation with venous disease, such as heart failure and arteriosclerotic disease affecting the various arterial vessels, therefore also coronary and cerebrovascular.
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How to deal with chronic venous disease
We must not trivialize the suffering of the veins of the legs. Sometimes the picture can get serious. And it is essential to refer to the doctor, given that the pathology tends to become chronic if not treated adequately. “Under normal conditions, the movement of blood from the lower limbs towards the heart takes place thanks to the venous valves and the pressure exerted by the leg muscles. When this process is interrupted, the blood goes to lean on the valve flaps causing a dilation of the walls of the veins, making them larger and more evident to the naked eye.
“Leg observation is critical for diagnosing chronic venous disease, but the presence of varicose veins, edema, skin changes, and ulcers should be considered a potential red flag of cardiovascular disease,” concludes Dr. Romeo Martini, president of the Italian Society of Angiology and Vascular Pathology – . Even today, in fact, the patient with this condition is started on a diagnostic-therapeutic path (PDTA) limited only to the pathology of the lower limbs. It would be time to define PDTA taking into account the suggestions of the Gutenberg study, namely, to provide additional and simple vascular screening for patients with chronic venous disease in the most advanced stages”.
In short, looking at the legs can save the heart. And it is essential for the doctor to carry out simple checks, from palpation of the arterial pulses to the measurement of the ankle/arm pressure index and the dosage of LDL cholesterol, to highlight who is at greater cardiovascular risk. And take the appropriate countermeasures.
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