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Incidence and risk factors for venous reflux in the general population: Edinburgh Vein Study.

Abstract

OBJECTIVE/BACKGROUND

Chronic venous disease (CVD) is common, but the incidence of venous reflux, a precursor to this condition, is unknown. This study measured the incidence of venous reflux and associated risk factors, and examined the association between venous reflux and the incidence of CVD.

METHODS

In the Edinburgh Vein Study, a random sample of 1566 men and women aged 18-64 years were examined at baseline. Eight hundred and eighty of these patients were followed up 13 years and underwent an examination comprising clinical classification of CVD and duplex scanning of the deep and superficial systems to measure venous reflux ≥0.5 s.

RESULTS

The 13-year incidence of reflux was 12.7% (95% confidence interval [CI] 9.2-17.2), equivalent to an annual incidence of 0.9% (95% CI 0.7-1.3). The 13-year incidence of isolated superficial, isolated deep, and combined deep and superficial reflux was 8.8% (95% CI 5.6-12.0), 2.6% (95% CI 1.2-5.0), and 1.3% (95% CI 0.4-3.2), respectively. The highest incidence was in the great saphenous vein in the lower thigh (8.1%, 95% CI 5.4-11.8). There were no age or sex differences (p > .050). The risk of developing reflux was associated with being overweight (odds ratio [OR] 2.1, 95% CI 1.0-4.4) and with history of deep vein thrombosis (OR 11.3, 95% CI 1.0-132.3). Venous reflux at baseline was associated with new varicose veins at follow up (p < .001): the age- and sex-adjusted OR was 4.4 (95% CI 1.8-10.8) in those with isolated superficial reflux and 7.3 (95% CI 2.6-22.5) in those with combined deep and superficial reflux.

CONCLUSION

For every year of follow-up, around 1% of this adult population developed venous reflux. In two thirds of cases, the superficial system was affected. Venous reflux increased the risk of developing varicose veins, especially when combined deep and superficial reflux was present.

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  • Authors+Show Affiliations

    ,

    Centre for Population Health Sciences, Medical School, Teviot Place, University of Edinburgh, Edinburgh EH8 9AG, UK. Electronic address: lindsay.robertson@ed.ac.uk.

    ,

    Centre for Population Health Sciences, Medical School, Teviot Place, University of Edinburgh, Edinburgh EH8 9AG, UK.

    ,

    Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.

    ,

    Radiology Department, Royal Infirmary of Edinburgh, Edinburgh, UK.

    ,

    University of Edinburgh, Edinburgh, UK.

    Centre for Population Health Sciences, Medical School, Teviot Place, University of Edinburgh, Edinburgh EH8 9AG, UK.

    Source

    MeSH

    Adolescent
    Adult
    Chi-Square Distribution
    Chronic Disease
    Female
    Humans
    Incidence
    Male
    Middle Aged
    Obesity
    Odds Ratio
    Predictive Value of Tests
    Prospective Studies
    Risk Factors
    Scotland
    Time Factors
    Ultrasonography, Doppler, Duplex
    Varicose Veins
    Venous Insufficiency
    Venous Thrombosis
    Young Adult

    Pub Type(s)

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

    Language

    eng

    PubMed ID

    24951373

    Citation

    Robertson, L A., et al. "Incidence and Risk Factors for Venous Reflux in the General Population: Edinburgh Vein Study." European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery, vol. 48, no. 2, 2014, pp. 208-14.
    Robertson LA, Evans CJ, Lee AJ, et al. Incidence and risk factors for venous reflux in the general population: Edinburgh Vein Study. Eur J Vasc Endovasc Surg. 2014;48(2):208-14.
    Robertson, L. A., Evans, C. J., Lee, A. J., Allan, P. L., Ruckley, C. V., & Fowkes, F. G. (2014). Incidence and risk factors for venous reflux in the general population: Edinburgh Vein Study. European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery, 48(2), pp. 208-14. doi:10.1016/j.ejvs.2014.05.017.
    Robertson LA, et al. Incidence and Risk Factors for Venous Reflux in the General Population: Edinburgh Vein Study. Eur J Vasc Endovasc Surg. 2014;48(2):208-14. PubMed PMID: 24951373.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Incidence and risk factors for venous reflux in the general population: Edinburgh Vein Study. AU - Robertson,L A, AU - Evans,C J, AU - Lee,A J, AU - Allan,P L, AU - Ruckley,C V, AU - Fowkes,F G R, Y1 - 2014/06/18/ PY - 2014/02/04/received PY - 2014/05/14/accepted PY - 2014/6/22/entrez PY - 2014/6/22/pubmed PY - 2014/9/10/medline KW - Cohort KW - Incidence KW - Risk factors KW - Venous reflux SP - 208 EP - 14 JF - European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery JO - Eur J Vasc Endovasc Surg VL - 48 IS - 2 N2 - OBJECTIVE/BACKGROUND: Chronic venous disease (CVD) is common, but the incidence of venous reflux, a precursor to this condition, is unknown. This study measured the incidence of venous reflux and associated risk factors, and examined the association between venous reflux and the incidence of CVD. METHODS: In the Edinburgh Vein Study, a random sample of 1566 men and women aged 18-64 years were examined at baseline. Eight hundred and eighty of these patients were followed up 13 years and underwent an examination comprising clinical classification of CVD and duplex scanning of the deep and superficial systems to measure venous reflux ≥0.5 s. RESULTS: The 13-year incidence of reflux was 12.7% (95% confidence interval [CI] 9.2-17.2), equivalent to an annual incidence of 0.9% (95% CI 0.7-1.3). The 13-year incidence of isolated superficial, isolated deep, and combined deep and superficial reflux was 8.8% (95% CI 5.6-12.0), 2.6% (95% CI 1.2-5.0), and 1.3% (95% CI 0.4-3.2), respectively. The highest incidence was in the great saphenous vein in the lower thigh (8.1%, 95% CI 5.4-11.8). There were no age or sex differences (p > .050). The risk of developing reflux was associated with being overweight (odds ratio [OR] 2.1, 95% CI 1.0-4.4) and with history of deep vein thrombosis (OR 11.3, 95% CI 1.0-132.3). Venous reflux at baseline was associated with new varicose veins at follow up (p < .001): the age- and sex-adjusted OR was 4.4 (95% CI 1.8-10.8) in those with isolated superficial reflux and 7.3 (95% CI 2.6-22.5) in those with combined deep and superficial reflux. CONCLUSION: For every year of follow-up, around 1% of this adult population developed venous reflux. In two thirds of cases, the superficial system was affected. Venous reflux increased the risk of developing varicose veins, especially when combined deep and superficial reflux was present. SN - 1532-2165 UR - https://www.unboundmedicine.com/medline/citation/24951373/Incidence_and_risk_factors_for_venous_reflux_in_the_general_population:_Edinburgh_Vein_Study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1078-5884(14)00271-8 DB - PRIME DP - Unbound Medicine ER -