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Lifestyle risk factors for lower limb venous reflux in the general population: Edinburgh Vein Study.

Abstract

BACKGROUND

Varicose veins occur commonly in the general population but the aetiology is not well established. Varicosities are associated frequently with reflux of blood in the leg veins due to valvular incompetence. Our aim was to determine in the general population which lifestyle factors were related to reflux and thus implicated in the aetiology of varicose veins.

METHODS

In the Edinburgh Vein Study, 1566 men and women aged 18-64 years were sampled randomly from the general population in the city of Edinburgh, Scotland, and had duplex scans to measure reflux in eight venous segments in each leg. A self-administered questionnaire enquired about occupation, mobility at work, smoking, obstetric history, dietary fibre intake and bowel habit. A bowel record form was completed subsequently.

RESULTS

In women, venous reflux was associated with decreased sitting at work (odds ratio [OR] = 0.76, 95% CI : 0.61-0.94), previous pregnancy (OR = 1.20, 95% CI : 0.93-1.54), and a lower prior use of oral contraceptives (OR = 0.84, 95% CI : 0.66-1.06). Mean body mass index was greater in women with superficial reflux compared to those with no reflux: 26.2 kg/m(2) (95% CI : 25.5-27.0) versus 25.2 kg/m(2) (95% CI : 24.8-25.6). On age adjustment, sitting at work remained related to reflux (OR = 0.78, 95% CI : 0.63-0.98) and prior use of oral contraceptives to superficial reflux (OR = 0.71, 95% CI : 0.50-1.01). In age-adjusted analyses in men, height was related to reflux, (OR = 1.13, 95% CI : 1.02-1.26) and straining at stool was related to superficial reflux (OR = 1.94, 95% CI : 1.12-3.35). No associations were found in either sex between reflux and social class, lifetime cigarette consumption, dietary fibre intake and intestinal transit time.

CONCLUSIONS

This population study did not identify strong and consistent lifestyle risk factors for venous reflux although previous pregnancy, lower use of oral contraceptives, obesity and mobility at work in women and height and straining at stool in men may be implicated.

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  • Authors+Show Affiliations

    ,

    Wolfson Unit for Prevention of Peripheral Vascular Diseases, Public Health Sciences, Department of Medical Radiology, University of Edinburgh, Edinburgh, UK.

    , , , ,

    Source

    MeSH

    Adult
    Blood Flow Velocity
    Chi-Square Distribution
    Cross-Sectional Studies
    Female
    Humans
    Leg
    Life Style
    Male
    Middle Aged
    Registries
    Risk Factors
    Scotland
    Surveys and Questionnaires
    Ultrasonography, Doppler, Duplex
    Urban Population
    Varicose Veins
    Venous Insufficiency

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    11511615

    Citation

    Fowkes, F G., et al. "Lifestyle Risk Factors for Lower Limb Venous Reflux in the General Population: Edinburgh Vein Study." International Journal of Epidemiology, vol. 30, no. 4, 2001, pp. 846-52.
    Fowkes FG, Lee AJ, Evans CJ, et al. Lifestyle risk factors for lower limb venous reflux in the general population: Edinburgh Vein Study. Int J Epidemiol. 2001;30(4):846-52.
    Fowkes, F. G., Lee, A. J., Evans, C. J., Allan, P. L., Bradbury, A. W., & Ruckley, C. V. (2001). Lifestyle risk factors for lower limb venous reflux in the general population: Edinburgh Vein Study. International Journal of Epidemiology, 30(4), pp. 846-52.
    Fowkes FG, et al. Lifestyle Risk Factors for Lower Limb Venous Reflux in the General Population: Edinburgh Vein Study. Int J Epidemiol. 2001;30(4):846-52. PubMed PMID: 11511615.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Lifestyle risk factors for lower limb venous reflux in the general population: Edinburgh Vein Study. AU - Fowkes,F G, AU - Lee,A J, AU - Evans,C J, AU - Allan,P L, AU - Bradbury,A W, AU - Ruckley,C V, PY - 2001/8/21/pubmed PY - 2002/1/5/medline PY - 2001/8/21/entrez SP - 846 EP - 52 JF - International journal of epidemiology JO - Int J Epidemiol VL - 30 IS - 4 N2 - BACKGROUND: Varicose veins occur commonly in the general population but the aetiology is not well established. Varicosities are associated frequently with reflux of blood in the leg veins due to valvular incompetence. Our aim was to determine in the general population which lifestyle factors were related to reflux and thus implicated in the aetiology of varicose veins. METHODS: In the Edinburgh Vein Study, 1566 men and women aged 18-64 years were sampled randomly from the general population in the city of Edinburgh, Scotland, and had duplex scans to measure reflux in eight venous segments in each leg. A self-administered questionnaire enquired about occupation, mobility at work, smoking, obstetric history, dietary fibre intake and bowel habit. A bowel record form was completed subsequently. RESULTS: In women, venous reflux was associated with decreased sitting at work (odds ratio [OR] = 0.76, 95% CI : 0.61-0.94), previous pregnancy (OR = 1.20, 95% CI : 0.93-1.54), and a lower prior use of oral contraceptives (OR = 0.84, 95% CI : 0.66-1.06). Mean body mass index was greater in women with superficial reflux compared to those with no reflux: 26.2 kg/m(2) (95% CI : 25.5-27.0) versus 25.2 kg/m(2) (95% CI : 24.8-25.6). On age adjustment, sitting at work remained related to reflux (OR = 0.78, 95% CI : 0.63-0.98) and prior use of oral contraceptives to superficial reflux (OR = 0.71, 95% CI : 0.50-1.01). In age-adjusted analyses in men, height was related to reflux, (OR = 1.13, 95% CI : 1.02-1.26) and straining at stool was related to superficial reflux (OR = 1.94, 95% CI : 1.12-3.35). No associations were found in either sex between reflux and social class, lifetime cigarette consumption, dietary fibre intake and intestinal transit time. CONCLUSIONS: This population study did not identify strong and consistent lifestyle risk factors for venous reflux although previous pregnancy, lower use of oral contraceptives, obesity and mobility at work in women and height and straining at stool in men may be implicated. SN - 0300-5771 UR - https://www.unboundmedicine.com/medline/citation/11511615/Lifestyle_risk_factors_for_lower_limb_venous_reflux_in_the_general_population:_Edinburgh_Vein_Study_ L2 - https://academic.oup.com/ije/article-lookup/doi/10.1093/ije/30.4.846 DB - PRIME DP - Unbound Medicine ER -