Chronic venous insufficiency and cardiovascular risk: Marker or bystander?

Chronic Venous Insufficiency (CVI) is a complex condition resulting from venous valve dysfunction or a loss of structural integrity in the vein walls, affecting 60% of the general population. Although traditionally regarded as a localized peripheral pathology, emerging evidence suggests that CVI may serve as an early indicator of systemic vascular disease. Our comprehensive review aims to analyzes the pathophysiological links between CVI and global cardiovascular risk, evaluating the clinical impact of venous disease on cardiovascular morbidity and mortality. The current literature highlights shared mechanisms between CVI and arterial diseases, including chronic low-grade inflammation, oxidative stress, and endothelial dysfunction. Clinical studies indicate that CVI is an independent predictor of major adverse cardiovascular events (MACE) and all-cause mortality. CVI should be reinterpreted as a peripheral marker of systemic vascular frailty. The integration of proactive cardiovascular screening is proposed for the management of patients with advanced CVI to improve long-term prognosis and reduce the risk of fatal events.