Chronic venous insufficiency, cardiovascular disease, and mortality: a population study
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Chronic venous insufficiency, cardiovascular disease, and mortality: a population study. / Prochaska, Jürgen H; Arnold, Natalie; Falcke, Andrea; Kopp, Sabrina; Schulz, Andreas; Buch, Gregor; Moll, Sophie; Panova-Noeva, Marina; Jünger, Claus; Eggebrecht, Lisa; Pfeiffer, Norbert; Beutel, Manfred; Binder, Harald; Grabbe, Stephan; Lackner, Karl J; Ten Cate-Hoek, Arina; Espinola-Klein, Christine; Münzel, Thomas; Wild, Philipp S.
in: EUR HEART J, Jahrgang 42, Nr. 40, 21.10.2021, S. 4157-4165.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Chronic venous insufficiency, cardiovascular disease, and mortality: a population study
AU - Prochaska, Jürgen H
AU - Arnold, Natalie
AU - Falcke, Andrea
AU - Kopp, Sabrina
AU - Schulz, Andreas
AU - Buch, Gregor
AU - Moll, Sophie
AU - Panova-Noeva, Marina
AU - Jünger, Claus
AU - Eggebrecht, Lisa
AU - Pfeiffer, Norbert
AU - Beutel, Manfred
AU - Binder, Harald
AU - Grabbe, Stephan
AU - Lackner, Karl J
AU - Ten Cate-Hoek, Arina
AU - Espinola-Klein, Christine
AU - Münzel, Thomas
AU - Wild, Philipp S
N1 - Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2021. For permissions, please email: journals.permissions@oup.com.
PY - 2021/10/21
Y1 - 2021/10/21
N2 - AIMS: Evidence regarding the health burden of chronic venous insufficiency (CVI), its clinical determinants, and impact on outcome is scarce.METHODS AND RESULTS: Systematic phenotyping of CVI according to established CEAP (Clinical-Etiologic-Anatomic-Pathophysiologic) classification was performed in 12 423 participants (age range: 40-80 years) of the Gutenberg Health Study from April 2012 to April 2017. Prevalence was calculated age- and sex-specifically. Multivariable Poisson regression models were calculated to evaluate the relation of CVI with cardiovascular comorbidities. Survival analyses were carried out to assess the CVI-associated risk of death. Replication of findings was done in an independent cohort study (MyoVasc, NCT04064450). The prevalence of telangiectasia/reticular, varicose veins, and CVI was 36.5% [95% confidence interval (CI), 35.6-37.4%], 13.3% [12.6-13.9%], and 40.8% [39.9-41.7%], respectively. Age, female sex, arterial hypertension, obesity, smoking, and clinically overt cardiovascular disease were identified as clinical determinants of CVI. Higher CEAP classes were associated with a higher predicted 10-year risk for incident cardiovascular disease in individuals free of cardiovascular disease (n = 9923). During a mean follow-up of 6.4 ± 1.6 years, CVI was a strong predictor of all-cause death independent of the concomitant clinical profile and medication [hazard ratio (HR) 1.46 (95% CI 1.19-1.79), P = 0. 0003]. The association of CVI with an increased risk of all-cause death was externally validated in the MyoVasc cohort [HR 1.51 (95% CI 1.11-2.05), P = 0.009].CONCLUSION: Chronic venous insufficiency is highly prevalent in the population and is associated with the presence of cardiovascular risk factors and disease. Individuals with CVI experience an elevated risk of death, which is independent of age and sex, and present cardiovascular risk factors and comorbidities.
AB - AIMS: Evidence regarding the health burden of chronic venous insufficiency (CVI), its clinical determinants, and impact on outcome is scarce.METHODS AND RESULTS: Systematic phenotyping of CVI according to established CEAP (Clinical-Etiologic-Anatomic-Pathophysiologic) classification was performed in 12 423 participants (age range: 40-80 years) of the Gutenberg Health Study from April 2012 to April 2017. Prevalence was calculated age- and sex-specifically. Multivariable Poisson regression models were calculated to evaluate the relation of CVI with cardiovascular comorbidities. Survival analyses were carried out to assess the CVI-associated risk of death. Replication of findings was done in an independent cohort study (MyoVasc, NCT04064450). The prevalence of telangiectasia/reticular, varicose veins, and CVI was 36.5% [95% confidence interval (CI), 35.6-37.4%], 13.3% [12.6-13.9%], and 40.8% [39.9-41.7%], respectively. Age, female sex, arterial hypertension, obesity, smoking, and clinically overt cardiovascular disease were identified as clinical determinants of CVI. Higher CEAP classes were associated with a higher predicted 10-year risk for incident cardiovascular disease in individuals free of cardiovascular disease (n = 9923). During a mean follow-up of 6.4 ± 1.6 years, CVI was a strong predictor of all-cause death independent of the concomitant clinical profile and medication [hazard ratio (HR) 1.46 (95% CI 1.19-1.79), P = 0. 0003]. The association of CVI with an increased risk of all-cause death was externally validated in the MyoVasc cohort [HR 1.51 (95% CI 1.11-2.05), P = 0.009].CONCLUSION: Chronic venous insufficiency is highly prevalent in the population and is associated with the presence of cardiovascular risk factors and disease. Individuals with CVI experience an elevated risk of death, which is independent of age and sex, and present cardiovascular risk factors and comorbidities.
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Cardiovascular Diseases/epidemiology
KW - Chronic Disease
KW - Cohort Studies
KW - Female
KW - Humans
KW - Middle Aged
KW - Prevalence
KW - Varicose Veins
KW - Venous Insufficiency/epidemiology
U2 - 10.1093/eurheartj/ehab495
DO - 10.1093/eurheartj/ehab495
M3 - SCORING: Journal article
C2 - 34387673
VL - 42
SP - 4157
EP - 4165
JO - EUR HEART J
JF - EUR HEART J
SN - 0195-668X
IS - 40
ER -
