Chronic Venous Disease, a "Silent Epidemic"

Tired legs at the end of the day, socks that leave marks, a mild itch that recurs every evening. These are common signs that many people normalize or attribute to fatigue or heat. However, behind these symptoms may be chronic venous disease (CVD), a highly prevalent condition that remains underdiagnosed and, too often, undertreated.

With the aim of improving its early detection, from May 4 to 14, nearly forty health centers across Spain will host the second edition of VenDETECTA, a campaign promoted by Laboratorios Servier España under the slogan "Stopping Chronic Venous Disease Starts with You". The initiative includes training for professionals, informational spaces for the public, and rapid screening tests. It is estimated that 60% of the adult population shows some sign or symptom of CVD, and most are unaware of it.

The disease originates when the veins' valves, which help return blood to the heart, weaken or fail. The consequence is a progressive stagnation of blood in the lower extremities, which increases venous pressure, dilates the vessels, and promotes the appearance of varicose veins. "This column of blood causes the veins to dilate more and more, eventually causing tissue damage," explains David Pérez Barreno, advanced practice nurse in complex chronic wounds in the Málaga-Valle del Guadalhorce District and president of the Spanish Association of Vascular Nursing and Wounds.

Venous ulcers represent the most visible stage, but the onset is usually subtle, with feelings of heaviness, night cramps, burning, or swelling in the ankles. Symptoms that rarely prompt a consultation and whose remedies do not go beyond temporary relief. "It is recommended to elevate the legs or apply cold water, measures that temporarily improve, but do not address the cause of the problem," warns Pérez Barreno.

In recent years, focus has also been placed on the cardiovascular risks associated. Large varicose veins can slow blood flow and promote the formation of blood clots. In certain cases, these clots can move and trigger a pulmonary embolism. "All this reinforces the need to stop considering it a minor or purely aesthetic condition. Moreover, it is not a pathology that evolves quickly, so it often goes unnoticed for a long time."

Trivialization is one of the main obstacles. "Often the visible sign is treated, not the disease," points out Pérez Barreno. If the underlying alteration is not corrected, the lesions reappear. "The result is a fragmented care approach that allows the pathology to continue advancing," he adds.

Among the risk factors are sedentarism and obesity. Added to these are pregnancy, age, genetic predisposition, and certain work conditions that involve long periods of standing or sitting without movement.

The health system is also not immune to difficulties. "One of the main problems is access to medical-grade compression stockings, considered a cornerstone of treatment," says the expert. Currently, they are not generally funded by the public system, which represents a high cost for many patients. "The expense can exceed 400 euros every six months, a barrier difficult to assume, especially for older people or those with fewer resources," the expert points out. Only in cases like lymphedema is there public funding.

This limitation is compounded by a shortage of specialists in vascular surgery in certain areas, resulting in long waiting lists for surgery, sclerotherapy, or essential diagnostic tests such as Doppler ultrasound. "CVD is a very prevalent pathology, but not urgent, and that means it is not given the necessary priority, despite its impact on the quality of life and long-term costs," summarizes Pérez Barreno.

In this context, nursing plays a key role. From health education to early detection and patient follow-up, their intervention is crucial. "We are in continuous contact with the population," emphasizes the specialist, who highlights "the importance of training primary care teams to identify the disease in its initial phases."

The approach, he insists, must be comprehensive and coordinated. "It's like a table with four legs: compression, surgical treatment, lifestyle changes, and medication. If one fails, the system suffers." The VenDETECTA campaign and the strategic document that accompanies it seek to reinforce this multidisciplinary approach and improve the system's response to this disease.