Chronic venous insufficiency in heart failure: exploring a reciprocal influence on cardiovascular health

Chronic venous insufficiency (CVI) is a prevalent disorder, arising from venous valve incompetence and vein wall weakness, which impairs blood return and leads to venous stasis and hypertension in the lower extremities. This condition, affecting up to 40% of older adults, has been primarily considered a peripheral issue. However, growing evidence indicates its systemic impacts, notably its contribution to cardiovascular dysfunction and heart failure (HF). CVI exacerbates central venous pressure and cardiac preload, placing strain on the right heart and predisposing at-risk patients to HF. Moreover, a feedback loop exists where HF worsens CVI through increased venous stasis and fluid overload, highlighting a complex bidirectional relationship. Emerging research reveals that CVI-driven inflammation and endothelial dysfunction may accelerate adverse cardiac dysfunction. This review provides a comprehensive analysis of CVI's systemic effects, emphasizing the need for integrated cardiovascular and venous management strategies to address the reciprocal influences of CVI and HF. Such an approach could reduce disease progression and enhance outcomes for affected patients.