Chronic Venous Disease in an Ethnically Diverse Population: The San Diego Population Study.
Criqui, Michael H. 1,2; Jamosmos, Maritess 1; Fronek, Arnost 3,4; Denenberg, Julie O. 1; Langer, Robert D. 1; Bergan, John 4; Golomb, Beatrice A. 2
[Article] American Journal of Epidemiology. 158(5):448-456, September 2003.

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In a 1994-1998 cross-sectional study of a multiethnic sample of 2,211 men and women in San Diego, California, the authors estimated prevalence of the major manifestations of chronic venous disease: spider veins, varicose veins, trophic changes, and edema by visual inspection; superficial and deep functional disease (reflux or obstruction) by duplex ultrasonography; and venous thrombotic events based on history. Venous disease increased with age, and, compared with Hispanics, African Americans, and Asians, non-Hispanic Whites had more disease. Spider veins, varicose veins, superficial functional disease, and superficial thrombotic events were more common in women than men (odds ratio (OR)=5.4, OR=2.2, OR=1.9, and OR=1.9, respectively; p < 0.05), but trophic changes and deep functional disease were less common in women (OR=0.7 for both; p < 0.05). Visible (varicose veins or trophic changes) and functional (superficial or deep) disease were closely linked; 92.0% of legs were concordant and 8.0% discordant. For legs evidencing both trophic changes and deep functional disease, the age-adjusted prevalences of edema, superficial events, and deep events were 48.2%, 11.3%, and 24.6%, respectively, compared with 1.7%, 0.6%, and 1.3% for legs visibly and functionally normal. However, visible disease did not invariably predict functional disease, or vice versa, and venous thrombotic events occurred in the absence of either.

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