The epidemiology of chronic venous diseases

Objective: To review the prevalence of and risk factors for varicose veins, chronic venous insufficiency (CVI) and venous leg ulcers. Data sources: MEDLINE was searched for the terms prevalence and varicose ve ins, chronic venous insufficiency, or venous leg ulcers. Study selection: The extant world literature (1966-1999) with a minimum of an available English abstract was collected. Ninety-nine studies were revie wed. Data extraction: Data were extracted on prevalence of diseases of the veins in the lower limb, age and gender of the subject populations, and other ri sk factors for those diseases examined by the original researchers. Data synthesis: The two most prominent risk factors for venous disease are increasing age and female gender. Additional risk factors for venous diseas e with at least some documentation in the literature include dietary patter ns, obesity, physical activity, standing occupations, constrictive clothing , connective tissue laxity, and hormonal differences, including pregnancy. Family history is also a prominent risk factor, suggesting a genetic compon ent. Conclusions: Varicose veins are found more commonly in women, and with incr eased age. The increase with age is linear, suggesting a constant incidence and cumulative prevalence. CVI is also more common in women and increases with age, but data are limited. Venous leg ulcers are much less common than varicose veins or CVI and show less of a female preponderance, but increas e exponentially with age, suggesting a true increasing incidence with age.