Venous hypertension includes a group of heterogeneous pathological conditions affecting the veins, usually lower extremities, unless specified otherwise, which share a common feature: elevated venous blood pressure. It has no direct association with the arterial hypertension, which is a consequence of decreased elasticity of the arterial walls due to their hardening from atherosclerotic plaque buildup. Commonly, as a description of venous disease of the lower extremities, venous hypertension is used interchangeably with other terms, such as hypertensive venopathy, chronic venous insufficiency, stasis venous vasculopathy, as well as others.
Generally, venous hypertension is subdivided into primary and secondary. The most common conditions responsible for the later one include cardiac and renal failure, both of which lead to excessive amount of intravascular fluid with subsequent venous overload and, therefore, their insufficiency. There are a number of other situations accountable for development of secondary venous hypertension, such as fluid overload during chemotherapy or after massive blood transfusion, as well as result of hemodynamic shock and many others. The former type of venous hypertension is caused by the internal venous problem. The most common cause of primary venous hypertension affecting the deep venous system is thrombosis and subsequent post-thrombotic syndrome. The superficial venous hypertension is almost always develops due to hereditary predisposition to venous insufficiency, which can further accentuated by a multitude of external factors, such as prolonged standing, heavy lifting and others. It is also not uncommon to see a combination of both subtypes.
Overall, venous hypertension of the lower extremities is a complex heterogeneous chronic disease with a protracted course and high potential for serious complications. Early diagnosis and aggressive treatment or prophylaxis are the key factors for good outcome.
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