Prevalence and associated factors of chronic venous disease among the modern Iranian urban population

Mohammadreza Babaei; Arya Afrooghe; Ali Rafati; Bahram Mohebbi; Jamal Moosavi; Narges Ghadri; Bahareh Mohajer Koohestani; Shahin Rahimi; Mohammadreza Baay; Mohammad Javad Alemzadeh-Ansari; Zahra Hosseini; Shabnam Boudagh; Ehsan Khalilipur; Zahra Ghaemmaghami; Yeganeh Pasebani; Parisa Firoozbakhsh; Hamidreza Pouraliakbar; Hooman Bakhshandeh; Parham Sadeghipour

doi:10.1016/j.jvsv.2023.06.005

Prevalence and associated factors of chronic venous disease among the modern Iranian urban population

J Vasc Surg Venous Lymphat Disord. 2023 Nov;11(6):1098-1106.e10. doi: 10.1016/j.jvsv.2023.06.005. Epub 2023 Sep 9.

Authors

Mohammadreza Babaei¹, Arya Afrooghe¹, Ali Rafati², Bahram Mohebbi³, Jamal Moosavi³, Narges Ghadri⁴, Bahareh Mohajer Koohestani⁴, Shahin Rahimi⁵, Mohammadreza Baay³, Mohammad Javad Alemzadeh-Ansari³, Zahra Hosseini³, Shabnam Boudagh⁶, Ehsan Khalilipur³, Zahra Ghaemmaghami³, Yeganeh Pasebani⁵, Parisa Firoozbakhsh⁵, Hamidreza Pouraliakbar⁵, Hooman Bakhshandeh⁵, Parham Sadeghipour⁷

Affiliations

¹ Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran; School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
² Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran; Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
³ Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
⁴ Rajaie Cardiovascular Medical and Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
⁵ Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
⁶ Echocardiography Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
⁷ Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran. Electronic address: psadeghipour@hotmail.com.

PMID: 37690625
DOI: 10.1016/j.jvsv.2023.06.005

Abstract

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 owing to different population characteristics and measurement methods. This study aimed to estimate the prevalence of CVD among the modern Iranian urban population and determine its associated risk factors.

Methods: The Heart Assessment and Monitoring in Rajaie Hospital 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 to 75 years with no overt cardiovascular diseases in Tehran. Two instructed interventional cardiologists performed CVD evaluation using the Clinical-Etiology-Anatomy-Pathophysiology classification. CVD was graded as C1 to C6, and chronic venous insufficiency (CVI) as C3 to C6. A multivariable regression model was used to analyze the association between CVD and prespecified covariates of age, sex, body mass index (≥30 kg/m²), smoking, hypertension, diabetes mellitus, physical activity, dyslipidemia, and delivery method.

Results: CVD prevalence among 1176 participants was 36.5% (95% confidence interval [CI], 33.8-39.3) and was higher in women than men (44.2% vs 23.5%). CVI prevalence was only 0.7% (95% CI, 0.3-1.3). Multivariable analysis showed that advanced age (odds ratio [OR], 1.06; 95% CI, 1.04-1.08), female sex (OR, 2.98; 95% CI, 2.14-4.14), and body mass index of ≥30 (OR, 1.36; 95% CI, 1.03-1.81) were independently associated with CVD. Physical activity (OR, 0.77; 95% CI, 0.58-1.02) 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.

Keywords: Cardiovascular disease risk factors; Chronic venous disease; Chronic venous insufficiency; Varicose veins.