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

Background Varicose veins occur commonly in the general population but the aetiology is not well established. Varicosities are associated frequently w ith reflux of blood in the leg veins due to valvular incompetence. Our aim was to determine in the general population which lifestyle factors were rel ated 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 we re sampled randomly from the general population in the city of Edinburgh, S cotland, and had duplex scans to measure reflux in eight venous segments in each leg. A self-administered questionnaire enquired about occupation, mob ility at work, smoking, obstetric history, dietary fibre intake and bowel h abit. A bowel record form was completed subsequently. Results In women, venous reflux was associated with decreased sitting at wo rk (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 s uperficial 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, sitt ing 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 superf icial 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 li festyle risk factors for venous reflux although previous pregnancy, lower u se of oral contraceptives, obesity and mobility at work in women and height and straining at stool in men may be implicated.