Abstract
The objectives of the study were to discover the main determinants for the prevalence of varicose veins in a general population, and to assess the possibilities for prevention of this common surgical disease. Varicose veins were evaluated in three defined cohorts of 3284 men and 3590 women aged 40, 50, and 60 years by using a validated questionnaire. The response rate was 75% among men and 86% among women, and varicose veins were determined by self-assessment. Increasing age, female sex, childbirths, standing posture at work, higher weight or height, and positive family history were significantly associated with varicose veins in a univariate analysis. These factors were further taken into a multivariate logistic regression analysis, and female gender (adjusted odds ratio, OR 2.2), increasing age (OR 2.2–2.8), a reported positive family history for varicose veins (OR 4.9), increasing number of births (OR 1.2–2.8), standing posture at work (OR 1.6), and higher weight (OR 1.2) and height (OR 1.4) were found to independent and significant risk indicators of varicose veins. Increasing age, positive family history of varicose veins, and child-births in women were the most important factors in terms of population etiologic fractions. Familial predisposition and pregnancy-related factors bear important associations with varicose veins. Thus prevention of varicose veins appears to be difficult. Varicose veins are nonlethal and, therefore, higher age is related to higher prevalence.
Résumé
Les objectifs de cette étude ont été de déterminer les facteurs favorisants des varices, si fréquentes dans la population générale, et d’évaluer la possibilité de leur prévention. Les varices ont été évaluées dans trois cohortes bien définies de 3284 hommes et 3590 femmes, âgés respectivement de 40, 50 et 60 ans, par l’intermédiaire d’un questionnaire validé au préalable. Le taux de réponse a été de 75% parmi les hommes et de 86% parmi les femmes; l’évaluation des varices a été réalisée par ê malade lui-même. Les principaux facteurs retrouvés en analyse univariée comprenaient l’âge, le sexe féminin, l’accouchement, la position debout au travail, le poids et la taille, ainsi qu’une histoire familiale. En analyse multivariée (régression logistique) les facteurs indépendants étaient le sexe féminin (rapport de côte ajusté (RCA): 2.2), l’âge (RCA: 2.2–2.8), l’antécédent familial (RCA: 4.9), un nombre élevé d’accouchements (RCA: 1.2–2.8), position debout au travail (RCA: 1.6) et un poids élevé (RCA: 1.2) et une grande taille (RCA: 1.4). En termes d’étiologies, les facteurs les plus importants étaient l’âge, des antécédents familiaux de varices, et un nombre élevé d’accouchements chez la femme. La prédisposition familiale et les facteurs en rapport avec la grossesse sont les facteurs les plus liés à l’apparition des varices. Ainsi, la prévention apparat comme étant difficile. Les varices étaint une maladie non létale, l’âge est donc un facteur de prévalence élevée.
Resumen
El objetivo de este estudio fue intentar averiguar los factores etiológicos más importantes causantes de varices para tratar así de prevenir esta tan frecuente afección quirúrgica. Empleando un cuestionario valoramos las varices en tres cohortes bien definidos que comprenden 3284 hombres y 3590 mujeres cuyas edades fueron 40, 50 y 60 años. El porcentaje de cuestionarios contestados fue del 75% para los hombres y 86% para las mujeres, que valoraran por sí mismos las características de sus varices. En un análisis uni y multivariante se constató que las varices: aumentaban con la edad; eran más frecuentes en las mujeres y guardaban una estrecha relación con el número de partos, la permanencia de pie en el trabajo, el peso y talla así como con antecedentes familiares de varices. Todos estos factores se analizaron mediante una regresión logística multivariante, registrándose como factores independientes y significativos indicadores de riesgo de desarrollar varices: el sexo femenino (cociente de odds ajustado: OR 2.2), el incremento de la edad (OR 2.2–2.8) antecedentes familiares positivos (OR 4.9) número de embarazos (OR 1.2–2.8), posición erecta en el trabajo (OR 1.6), sobrepeso (OR 1.2), elevada talla (OR 1.4). En las mujeres los factores etiológicos más importantes fueron: el envejecimiento, número de partos y los antecedentes familiares. La predisposición familiar y las alteraciones producidas por los embarazos son los factores más importantes en la génesis de venas varicosas. Por ello, la prevención parece difícil. Las varices no constituyen una afección letal y por tanto cuando mayor sea la edad mayor será la su frecuencia.
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References
Callam MJ. Epidemiology of varicose veins. Br. J. Surg. 1994:81:167–173
King ESJ. The genesis of varicose veins. Aust. N.Z. J. Surg. 1950:20:126–1333
Cotton L. Varicose veins: gross anatomy and development. Br. J. Surg. 1969;48:589–598
Abramson JH, Hopp C, Epstein LM. The epidemiology of varicose veins. A survey in western Jerusalem. J. Epidemiol. Community Health 1981;35:213–217
Brand FN, Dannenberg AL, Abbott RD, et al. The epidemiology of varicose veins: the Framinsham Study. Am. J. Prev. Med. 1988:4:96–101
Franks PJ, Wright DDI, Fletcher AE, et al. A questionnaire to assess the risk factors, quality of life, and use of health resources in patients with venous disease. Eur. J. Surs. 1992:158:149–155
Evans CJ, Fowkes FGR. Ruckley CV, et al. Prevalence of varicose veins and chronic venous insufficiency in men and women in the general population: Edinburgh Vein Study. J. Epidemiol. Community Health 1999;53:149–153
Coon WW, Willis PW, Keller JB. Venous thromboembolism and other venous diseases in the Tecumseh Community Health Study. Circulation 1973:48:839–846
Bobek K, Cajzl L, Cepelak V, et al. Etude de la frequence des maladies phlebologiques et de l’influence de quelques facteurs eticologiques. Phlebologie 1966;19:217–233
Beaglehole R, Prior IAM, Salmond CE, et al. Varicose veins in the South Pacific. Int. J. Epidemiol. 1975;4:295–299
Maffei FHA, Magaldi C, Pinho SZ, et al. Varicose veins and chronic venous insufficiency in Brazil: prevalence among 1755 inhabitants of a country town. Int. J. Epidemiol. 1986;15:210–217
Franks PJ, Wright DDI, Moffatt CJ, et al. Prevalence of venous disease: a community study in west London. Eur. J. Surg. 1992:158:143–1477
Kamber V, Widmer LK, Münst G. Prevalence. In Widmer LK, editor. Peripheral Venous Disorders, Bern, Hans Huber Publishers, 1978: 43–50
Malhotra SL. An epidemiological study of varicose veins in Indian railroad workers from the south and north of India, with special reference to the causation and prevention of varicose veins. Int. J. Epidemiol. 1972;1:177–183
Winkler M, Heinemann L. Zur Epidemiologie der Venenerkrankungen-Ergenbnisse einer epidemiologischen Studie. Z. Ges. Inn. Med. 1981;36:459–462
Mekky S, Schilling RSF, Walford J. Varicose veins in women cotton workers. An epidemiological study in England and Egypt. Br. Med. J. 1969;2:591–595
Hirai M, Naiki K, Nakayama R. Prevalence and risk factors of varicose veins in Japanese women. Angiology 1990;41:228–232
Ducimetiere P, Richard JL, Pequignot G, et al. Varicose veins: a risk factor for atherosclerotic disease in middle-aged men? Int. J. Epidemiol. 1981;10:329–335
Laurikka J, Sisto T, Auvinen O, et al. Varicose veins in a Finnish population aged 40–60. J. Epidemiol. Community Health 1993:47:355–357
Sisto T, Reunanen A, Laurikka J, et al. Prevalence and determinants of varicose veins in lower extremities: Mini-Finland Study. Eur. J. Surg. 1995;161:405–414
Arnoldi CC. The etiology of primary varicose veins. Dan. Med. Bull. 1957;4:102–107
Stanhope JM. Varicose veins in a population of lowland New Guinea. Int. J. Epidemiol. 1975;4:221–225
Laurikka J, Läärä E, Sisto T, et al. Misclassification in a questionnaire survey of varicose veins. J. Clin. Epidemiol. 1995;48:1175–1178
Engelman L. Stepwise logistic regression. In Dixon WJ, Brown MB, Engleman L, Hill MA, Jennrich RI, editors. BMDP Statistical Software Manual, Berkeley, University of California Press, 1988:941–969
Canónico S, Gallo C, Paolisso G, et al. Prevalence of varicose veins in an Italian elderly population. Angiology 1998;49:129–135
Proppe A. Varizenhàufigkeit und Körpergrösse. Cosmetologies 1970;19:85–88
Weddell JM. Varicose veins pilot survey, 1966. Br. J. Prev. Soc. Med. 1969;23:179–186
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Published Online: March 1, 2002
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Laurikka, J.O., Sisto, T., Tarkka, M.R. et al. Risk indicators for varicose veins in forty- to sixty-year-olds in the tampere varicose vein study. World J. Surg. 26, 648–651 (2002). https://doi.org/10.1007/s00268-001-0283-1
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DOI: https://doi.org/10.1007/s00268-001-0283-1