Risk factors for chronic venous insufficiency: A dual case-control study

Scott, Thayer E.; LaMorte, Wayne W.; Gorin, Daniel R.; Menzoı́an, James O.

doi:10.1016/s0741-5214(95)70050-1

Cited by 266 publications

(223 citation statements)

References 18 publications

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“…These results were found to be below the average determined by Nelzen et al 9 (Switzerland), in whose sample 85% were over the age of 64 years with a mean age of 76 years for women and 78 for men. By contrast, the results were similar to Scott et al 10 These difference are justified by different techniques used to collect data, in addition to socioeconomic, cultural and geographic differences characteristic of each sample.…”

Section: Discussionsupporting

confidence: 78%

“…This result is above the 1:1.4 ratio established by Scott et al,10 which is probably associated with a younger population. It has already been reported that below the age of 60 years, the incidence of leg ulcers is greater in men (1.4:1), while above that age it is 1:1.2.…”

Section: Discussioncontrasting

confidence: 39%

“…It has already been reported that below the age of 60 years, the incidence of leg ulcers is greater in men (1.4:1), while above that age it is 1:1.2. 10 Furthermore, most patients were observed to have a very low monthly income (R$84.00) for a family with 3.7 persons on average, 87% of them receiving low monthly wages (lower than the sum of three minimal wages).…”

Section: Discussionmentioning

confidence: 99%

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Úlcera de perna: um estudo de casos em Juiz de Fora-MG (Brasil) e região

Frade

Cursi

Andrade

et al. 2005

An. Bras. Dermatol.

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BACKGROUND: Leg ulcers are characterized as tissue loss in the lower extremities, generally caused by vascular dysfunction. OBJECTIVES: Verify the clinical and epidemiological profiles of the population sample with leg ulcers treated at the health centers of Juiz de Fora (Brazil). MATERIAL AND METHODS: 124 leg-wound patients were evaluated between January 1999 and August 2001 and submitted to a clinical protocol. RESULTS: The mean age was 64 years, with females in the majority (65.3%). The mean family composition was 3.7 persons, and family income was around US$200.00 (86.8%). Venous insufficiency (90.3%), systemic arterial hypertension (54%), obesity (20.2%) and diabetes mellitus (16.1%) were the most frequent events associated with the ulcers. An association of venous insufficiency and arterial hypertension was frequent in 43.7% of the sample, and significant (p<0.01) to predisposition to the ulcers. These were classified as venous (79%), hypertensive (15.4%), mixed and other (5.6%). The ulcers were generally localized in the distal third of legs (90%) and considered large (>5 cm) in about 90% of the sample, with means of 8.7 cm and 9.6 cm to vertical and horizontal axes, respectively. The ulcers were accompanied mainly by hyperpigmentation (92.7%), lipodermatosclerosis (68.5%) and varicose veins (66.9%), with a mean duration of 94.2 months and 50% of them recurrent. CONCLUSIONS: The data suggested that leg ulcer is an important chronic disease in the elderly and poor population of Juiz de Fora and region. Keywords: Aged; Income; Family income; Leg ulcers/ epidemiology; Varicose veins. Resumo: FUNDAMENTOS: Úlcera de perna (UP) caracteriza-se por perda do tegumento nas extremidades dos membros inferiores causada geral

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Section: Discussionsupporting

confidence: 78%

Section: Discussioncontrasting

confidence: 39%

Section: Discussionmentioning

confidence: 99%

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Úlcera de perna: um estudo de casos em Juiz de Fora-MG (Brasil) e região

Frade

Cursi

Andrade

et al. 2005

An. Bras. Dermatol.

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“…10 More than 50% of venous ulcers require prolonged therapy lasting Ͼ1 year. 5 The socioeconomic impact of venous ulceration is dramatic, resulting in an impaired ability to engage in social and occupational activities, thus reducing the quality of life and imposing financial constraints. Disability related to venous ulcers leads to loss of productive work hours, estimated at 2 million workdays/year, and may cause early retirement, which is found in up to 12.5% of workers with venous ulcers.…”

mentioning

confidence: 99%

Chronic Venous Insufficiency

2005

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C hronic venous disease is often overlooked by primary and cardiovascular care providers because of an underappreciation of the magnitude and impact of the problem. The importance of chronic venous disease is related to the number of people with the disease and the socioeconomic impact of its more severe manifestations. Unfortunately, the literature concerning the prevalence and incidence of chronic venous disease has varied greatly because of differences in the methods of evaluation, criteria for definition, and the geographic regions analyzed. The most common manifestations of chronic venous disease are dilated cutaneous veins, such as telangiectases and reticular veins, and varicose veins. The term chronic venous insufficiency (CVI) describes a condition that affects the venous system of the lower extremities with venous hypertension causing various pathologies including pain, swelling, edema, skin changes, and ulcerations. Although the term CVI is often used to exclude uncomplicated varicose veins, varicose veins have incompetent valves with increased venous pressure leading to progressive dilation and tortuosity. We will use the term CVI to represent the full spectrum of manifestations of chronic venous disease.Varicose veins have an estimated prevalence between 5% to 30% in the adult population, with a female to male predominance of 3 to 1, although a more recent study supports a higher male prevalence. 1 The Edinburgh Vein Study screened 1566 subjects with duplex ultrasound for reflux finding CVI in 9.4% of men and 6.6% of women, after age adjustment, which rose significantly with age (21.2% in men Ͼ50 years old, and 12.0% in women Ͼ50 years old). 2 The San Valentino Vascular Screening Project found among the 30 000 subjects evaluated by clinical assessment and duplex ultrasound a prevalence of 7% for varicose veins and 0.86% for "symptomatic" CVI. 3 As in previous studies, CVI was more common with increasing age, but there was no significant sex difference. The rate of varicose vein development may be estimated from the Framingham Heart Study, which found an annual incidence of 2.6% in women and 1.9% in men. 4 Risk factors found to be associated with CVI include age, sex, a family history of varicose veins, obesity, pregnancy, phlebitis, and previous leg injury. 5,6 There also may be environmental or behavioral factors associated with CVI such as prolonged standing and perhaps a sitting posture at work. 6,7 Varicose veins have a significant impact on healthcare resources, with millions of people seeking medical attention for their cosmetic appearance annually. Although often minimized, the cosmetic consequences may adversely affect an individual's quality of life and are associated with other manifestations.The more serious consequences of CVI such as venous ulcers have an estimated prevalence of Ϸ0.3%, although active or healed ulcers are seen in Ϸ1% of the adult population. 8 It has been estimated that Ϸ2.5 million people have CVI in the United States, and of those, Ϸ20% develop venous ulcers. 9 The ov...

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“…JGIM ulcers in the community to be between 0.06% and 1%. 3,5,[16][17][18] These same studies have confirmed that leg ulcers are slightly more common in women, particularly in the older age groups, and there is a marked increase with advancing age. Venous ulcers are chronic and recurrent; according to patient recall, up to 50% of venous ulcers may be present for 7 to 9 months, between 8% and 34% may be present for more than 5 years, and between 67% and 75% of patients have recurrent ulcers.…”

Section: Epidemiology and Natural Historymentioning

confidence: 86%

Chronic Venous Insufficiency and Venous Ulceration

Alguire

Mathes

1997

J Gen Intern Med

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OBJECTIVE:To review and summarize the literature on the normal venous circulation of the leg, and the epidemiology, pathophysiology, and treatment of chronic venous insufficiency (CVI).DATA SOURCES: English-language articles identified through a MEDLINE search using the terms venous insufficiency or varicose ulcer and epidemiology, pathophysiology, diagnosis, and clinical trial (pt), and selected cross-references. STUDY SELECTION:Articles on epidemiology, pathophysiology, and treatment of CVI. Randomized, controlled studies were specifically sought for treatment efficacy. DATA EXTRACTION:Data were manually extracted from selected studies and reviews; emphasis was placed on information relevant to the general internist. pproximately 5 million people in the United States exhibit some evidence of chronic venous insufficiency (CVI) and between 400,000 and 500,000 of these individuals have or will develop a venous leg ulcer. 1-3 The signs of CVI include engorgement of the cutaneous veins and dependent edema in mildly affected patients to pigmentation, dermatitis, and ulceration in the more severe cases. Although most patients are asymptomatic, others have leg heaviness and aching or recurrent and recalcitrant leg ulcers punctuated by bouts of cellulitis. These more severe cases are associated with recurrent hospitalization, high health-care costs, and disability. 4,5 Venous insufficiency with trophic skin changes or ulceration is a frustrating problem, which many physicians approach with a sense of ennui. This may be due to the chronic and remitting nature of the problem, the need for lifestyle modification, inconvenient therapies, and contradictory information regarding medical and surgical management. Nevertheless, CVI, including ulceration, is a manageable problem. The purpose of this review is to present the normal anatomy and physiology of the venous circulation and to summarize the epidemiology, pathophysiology, and treatment of CVI. DATA SYNTHESIS: METHODSA MEDLINE search for relevant English-language articles published between 1966 and 1996 was completed using the following MeSH terms: venous insufficiency or varicose ulcer and epidemiology, pathophysiology, diagnosis, and clinical trial (pt). When selecting articles on treatment, randomized, controlled trials were reviewed whenever possible. Emphasis was placed on reviewing articles with clinical relevance for internal medicine physicians. ANATOMY AND NORMAL PHYSIOLOGYVenous blood from the skin and subcutaneous fat is collected in a system of superficial venules and veins that drain toward the deep venous system underneath the fascia via three major pathways: (1) through the long or short saphenous veins, which join the deep system at the saphenofemoral and saphenopopliteal junctions; (2) through the perforating veins originating from the long or short saphenous veins or their branches; or (3) directly into the deep venous system or bypass the deep system entirely and enter the pelvis. 6 Deep veins are categorized as either intramuscular or intermuscular; o...

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Risk factors for chronic venous insufficiency: A dual case-control study

Cited by 266 publications

References 18 publications

Úlcera de perna: um estudo de casos em Juiz de Fora-MG (Brasil) e região

Úlcera de perna: um estudo de casos em Juiz de Fora-MG (Brasil) e região

Chronic Venous Insufficiency

Chronic Venous Insufficiency and Venous Ulceration

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