Prevalence of varicose veins and chronic venous insufficiency in men and women in the general population: Edinburgh Vein Study

Abstract

Study objective-To determine the prevalence of varicose veins and chronic venous insuYciency (CVI) in the general population. Design-Cross sectional survey. Setting-City of Edinburgh. Participants-Men and women aged 18-64 years selected randomly from age-sex registers of 12 general practices. Main results-In 1566 subjects examined, the age adjusted prevalence of trunk varices was 40% in men and 32% in women (p<0.01). This sex diVerence was mostly a result of higher prevalence of mild trunk varices in men. More than 80% of all subjects had mild hyphenweb and reticular varices. The age adjusted prevalence of CVI was 9% in men and 7% in women (p<0.05). The prevalence of all categories of varices and of CVI increased with age (p<0.001). No relation was found with social class. Conclusions-Approximately one third of men and women aged 18-64 years had trunk varices. In contrast with the findings in most previous studies, mainly conducted in the 1960s and 1970s, chronic venous insuYciency and mild varicose veins were more common in men than women. No evidence of bias in the study was found to account for this sex diVerence. Changes in lifestyle or other factors might be contributing to an alteration in the epidemiology of venous disease. (J Epidemiol Community Health 1999;53:149-153)

Avaliação da bomba muscular da panturrilha em pacientes portadores de varizes primárias dos membros inferiores através da pletismografia a ar

“…O ponto em que parece haver discordância é que, no nosso trabalho, mesmo não havendo sinais externos que possam levantar suspeita de hipertensão venosa, a FVR (que, para alguns autores 16,21 , se relaciona com a pressão venosa ambulatorial) ocorreu em 86,7% dos pacientes que apresentaram níveis acima de Figura 2 -Análise de correspondência para fração de ejeção da perna direita (efdircod), fração de ejeção da perna esquerda (efesqcod), fração do volume residual da perna direita (rvfdircod), fração do volume residual da perna esquerda (rvfesqcod) nos grupos com refluxo e sem refluxo 60%, sendo este dado estatisticamente relevante. Há, porém, concordância com a literatura quanto ao fato de que o VE não apresenta diferenças estatisticamente significativas para ambos os sexos 23 . Embora a complacência venosa esteja alterada, em função do refluxo encontrado, não há influência para a hemodinâmica venosa 24 .…”

Is vein damage the only cause of clinical signs of lower limb chronic venous insufficiency?

“…There are studies that claim that there is only a relationship between obesity and CVI, 3,6,24 or an association between varicose veins and BMI, among women, 1,5,14,25 and others that found no evidence of any relationship. 14,26 It does not appear likely that obesity could be a risk factor for one sex but not for the other, and it can be considered as an aggravating factor in venous disease.…”

“…This result contrasts with data reported by Andreozzi et al, 9 since they found a relationship between hypotonic phlebopathy and obesity, but it is in line with other results in the literature indicating that the association between BMI and varicose veins is stronger among women. 1,5,14,25 Another factor investigated was distribution by age group of the hypotonic phlebopathy patients. This analysis showed that the highest prevalence (64%) is among younger people aged < 30 years (2:1) and that prevalence reduces as age increases, as symptoms become more likely to be related to anatomic venous injuries.…”

“…1,2 It is responsible for considerable morbidity, reduces quality of life, causes sufferers to take time off from work and can even be responsible for early retirement. 3 As a result, CVI places a considerable financial burden on health services.…”

“…3 As a result, CVI places a considerable financial burden on health services. 1 The principal theory about the etiology and pathophysiology of CVI relates to secondary hypertension caused by reflux in, and/or obstruction of, the venous system and the conditions that lead to these changes are believed to be a combination of genetic predisposition and environmental stimuli. 4 Other risk factors have also been linked to development of CVI, including age, sex, family history, constipation, obesity, number of gestations and lack of physical activity.…”