Risk factors for the development of venous ulcers

Venous ulcers are the most common type of chronic lower extremity ulcers, affecting 1% to 3% of the U.S. population. Venous hypertension as a result of venous reflux (incompetence) or obstruction is thought to be the primary underlying mechanism for venous ulcer formation .

Risk factors for the development of venous ulcers include

1.Age 55 years or older,

2.Family history of Chronic venous insufficiency,

3. Higher body mass index,

4.History of pulmonary embolism or superficial/deep venous thrombosis,

5. Lower extremity skeletal or joint disease,

6.Higher number of pregnancies,

7.Parental history of ankle ulcers,

8.Physical inactivity,

9.History of ulcers,

10.Severe lipodermatosclerosis, and

11. Venous reflux in deep veins.

Bonkemeyer Millan S, Gan R, Townsend PE. Venous Ulcers: Diagnosis and Treatment.

Am Fam Physician. 2019 Sep 1;100(5):298-305

Effects of smoking on blood vessels – can we reverse them?

The effects of nicotine replacement therapy (NRT)-aided smoking cessation on vascular function are not fully clarified. We investigated 100 healthy smokers who were motivated to quit and received NRT for a 3-month period. Vascular endothelial function (measured by reactive hyperemia-peripheral arterial tonometry [RH-PAT]), arterial stiffness (measured by augmentation index [AI] and brachial-ankle pulse wave velocity [baPWV]), and systemic inflammation markers (including serum soluble intercellular adhesion molecule-1 [sICAM-1] and interleukin-1β [IL-1β]) were assessed at baseline and 3 and 12 months of follow-up. After 3 months of intervention, endothelial function, arterial stiffness, and inflammatory markers significantly improved (RH-PAT increased, AI and baPWV decreased, sICAM-1 and IL-1β decreased, all P < .05) for the participants who abstained from smoking completely, but for those who did not abstained completely, RH-PAT, AI, baPWV, and IL-1β remained unchanged. At 12 months follow-up, endothelial function (RH-PAT), arterial stiffness (AI and baPWV), and inflammatory markers (sICAM-1 and IL-1β) were further improved in participants who abstained from smoking (P < .001), while the above parameters deteriorated in continued smokers (P < .05). In conclusion, vascular dysfunction can be reversible after NRT-aided smoking cessation in healthy smokers and vascular function could be further damaged if they continue smoking[1].

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[1]. Xue C1, Chen QZ1, Bian L1, Yin ZF1, Xu ZJ1, Zhang AL1, Xie YS1, Zhang HL1, Du R2, Wang CQ1. Effects of Smoking Cessation with Nicotine Replacement Therapy on Vascular Endothelial Function, Arterial Stiffness, and Inflammation Response in Healthy Smokers. Angiology. 2019 Sep;70(8):719-725