Risk factors for varicose veins

Headnote

Aim. To determine the prevalence of varicose veins in the German population and specify possible risk factors the data of the Duesseldorf/Essen civil servants study were analysed.

Methods. From December 1989 to July 1993 a total of 9 935 employees were recruited. All volunteers filled out a questionnaire regarding familiy history and risk factors and were clinically examined. Venous findings were classified and adapted to the CEAP-classification. For the analysis of risk factors only volunteers classified as CEAP-class 0 or as CEAP-class II were considered: 4 250 men, 10% belonged to CEAP-class II and 2 380 women including 16% CEAP-class II.

Results. In general, age and gender were the most relevant risk factors for varicose veins. Odds ratio age: male: 3.4 (95%-CI: 2.6-4.4), age female 6.5 (95%-CI: 5.0-8.5), gender 2.3 (95%-CI 1.9-2.7). In addition in females the most frequent risk factors were oral contraception and in both genders a predominately sitting posture at work. Regarding the family history, varicose veins by the mother was most frequent compared to varicose veins by the father or both. After adjusting for age and gender heridity became the most important risk factor with an odds ratio of 5.2 (95%-CI:3.77.3-4.50) in case of varicose veins present in both parents, followed by a standing posture at work 2.2 (95%-CI: 1.23.9). In contrast, smoking also reached a significant level, but with a decreased odds ratio of 0.66 (95%-CI: 0.57-0.77) indicating a protective effect.

Conclusion. In addition to age and gender a family history of varicose veins is the most important risk factor in the total population. Despite significant influence of other risk factors their relevance for varicose veins in the investigated population is low either due to low frequencies or low odds ratios.

[Int Angiol 2004;23:29-34]

Key words: Varicose veins * Risk factors * Posture

Varicose veins are common in humans. In most countries half of the adult population shows signs of venous disease that are considered to be disfiguring (women 50-55%, men 40-50%), but fewer than half of these will have visible varicose veins (women 20-25%, men 10-15%).1,2 Alterations of the vessel wall preceeding valve changes have been shown to occur in patients with varicose veins.3, 4 Risk factors such as age and familial transmission, number of pregnancies, obesity...