Prevalence and Associated Factors of Chronic Venous Disease Among the Modern Iranian Urban Population.

OBJECTIVES: Chronic venous disease (CVD) of the lower extremities is one of the common venous diseases in different populations, with a wide range of clinical manifestations and undetermined exact prevalence due to different population characteristics and measurement methods. This study aimed to estimate the prevalence of chronic venous disease among the modern Iranian urban population and determine its associated risk factors.

METHODS: The HAMRAH study, a longitudinal population-based cohort, aims to investigate the baseline prevalence and the 10-year incidence of cardiovascular diseases and associated risk factors in the adult population aged 30-75 years with no overt cardiovascular diseases in Tehran. Two instructed interventional cardiologists performed CVD evaluation using the Clinical-Etiology-Anatomy-Pathophysiology (CEAP) classification. CVD was graded as C1-C6, and chronic venous insufficiency (CVI) as C3-C6. A multivariable regression model was used to analyze the association between CVD and pre-specified covariates of age, sex, body mass index (≥30 kg/m2 ), smoking, hypertension, diabetes mellitus, physical activity, dyslipidemia, and delivery.

RESULTS: CVD prevalence among 1176 participants was 36.5% (95% CI, 33.8 to 39.3) and was higher in women than men (44.2% vs. 23.5%). CVI prevalence was only 0.7% (95% CI, 0.3 to 1.3). Multivariable analysis showed that advanced age (OR, 1.06; 95% CI, 1.04 to 1.08), female sex (OR, 2.98; 95% CI, 2.14 to 4.14), and body mass index of ≥30 (OR, 1.36; 95% CI, 1.03 to 1.81) were independently associated with CVD. Physical activity (OR, 0.77; 95% CI, 0.58 to 1.02) was nearly protective, whereas other factors, including traditional cardiovascular risk factors, had no meaningful association with CVD.

CONCLUSIONS: Our findings showed that CVD was prevalent in the modern Iranian urban population. However, considering the very low prevalence of the higher stages of the disease, the benefit of mass screening is debatable, and better risk discriminators should be investigated.