Transpersonal aspects of venous disease, an opportunity to improve its management

Multiple studies have been carried out on the pathophysiology of chronic venous disease, but very few consider the influence of environmental causes and family inheritance in the presentation or not of the disease and how they affect the healing of venous ulcers. In this review we address the transpersonal aspects that could be related to it, such as the psychological, social, spiritual or transcendental aspect. A wide review topic was conducted, related to transpersonal aspects: genetic, epigenetic, psychological, mind-body therapies, social and spiritual. It was founded that genetic aspects have not been directly linked to chronic venous disease (CVD); however, several epigenetic aspects have been correlated, specifically epigenetic markers such as histone deacetylases (HDACs) and DNA methyltransferases (DNMTs), which are overexpressed in venous endothelial cells in response to blood reflux. There are several reports about how psychological factors affect wound healing and the production of inflammatory factors in several ways, especially in venous ulcers. Aspects such as mind-body therapies and the importance of the social factor as a modulator in the family transmission of various conditions are explored. Other medical currents (China and Ayurvedic) and the importance of the spirituality role in the human being is discussed. It is analyzed that transpersonal medicine allows, with a broad scientific criterion but above all humanistic, to use therapeutic methods and concepts which final objective is the well-being of the patient taking into consideration all the factors that surround him. In this sense, the doctor must prepare himself from a more human point of view. Therefore, it is essential for health professionals to consider the spiritual dimension in patient care, as this integrated approach improves not only the clinical prognosis, but also contributes to the overall well-being of the individual. CVD should be seen as an imbalance (rather than a disease) that manifests itself through epigenetic mechanisms, involving not only the vein itself but everything that makes the circulatory system function: heart, the arteries, capillaries, muscles, joints, immune system and other organs and conditions. It is not only related to the function or structure of the vein, but to multiple factors in the biological sphere. It is predisposed and modified by genetic, epigenetic, familial, environmental, social, psychological and emotional factors. The complete management of the patient with venous insufficiency should include the acceptance of the doctor himself as a bio-psycho-socio-spiritual being and as a part of a great universe and the recognition of the need of a constant preparation and the daily application of these concepts to achieve personal wellbeing, that of his family, of society and especially of his patient.