Correlation of obesity & comorbid conditions with chronic venous insufficiency

Abstract

Background & objectives:Chronic venous insufficiency (CVI) is a common clinical problem among obese patients. This study was conducted to evaluate the impact of body mass index (BMI) and associated morbidities such as diabetes, hypertension and hypothyroidism on venous disease clinical scores as per Clinical, Etiological, Anatomical, Pathological (CEAP) classification.Methods:In this study, adult patients with BMI more than 30 kg/m2 with signs of CVI were evaluated clinically and by using Duplex ultrasonography of venous system. The patients with C0, C1, C2, C3 and C4, C5, C6 clinical scores in CEAP classification were grouped as lower and higher clinical scores of CVI, respectively.Results:Of the 200 enrolled patients, 147 (73.5%) were males and were associated with higher grades of clinical scores (P=0.051). Superficial venous system was involved in 96 per cent patients and 91 per cent patients had reflux in the sapheno-femoral junction. A negative association was observed between hypertension and male gender (P=0.001). Higher BMI was associated with higher clinical scoring (P=0.053). BMI >40 kg/m2 was associated with primary aetiology (P=0.007) of CVI. There was no correlation between superficial, deep or perforator incompetence with BMI (P=0.506). Duplex-confirmed significant reflux was observed in patients with higher BMI (P=0.006). Age and BMI were positively correlated with clinical score (r=0.176; P=0.013 & r=0.140; P=0.049), respectively.Interpretation & conclusions:Our findings indicated that elderly male patients with high BMI seemed to be at a higher risk of advanced clinical grades of CVI. The impact of comorbid conditions such as diabetes, hypertension and hypothyroidism on CVI could not reach at significance in the present study.

Patient‐reported reasons for and predictors of noncompliance with compression stockings in a randomized trial of stockings to prevent postthrombotic syndrome

“…Higher BMI has been associated with less willingness to adhere to general health care requests/recommendations and to wear custom‐made footwear to prevent diabetic ulcers than patients with lower BMIs, and among patients with chronic venous insufficiency, BMI was significantly associated with less compliance with compression therapy . Conversely, as patients with higher BMI are more likely to have preexisting or to develop higher‐grade chronic venous insufficiency, it is possible that higher‐BMI patients in our study were more compliant with ECSs due to greater chronic venous symptom burden.…”

Study of chronic venous insufficiency in relation with body mass index

“…The most frequent complications are superficial thrombophlebitis, acute bleeding originating in one of the thin-walled varices, eczema and skin ulceration. 9 A high BMI is a critical risk factor for CVI. 1 In this study, it was established that a patient with a high BMI (>25kg/m 2 ) had a higher probability of developing CVI in Another study done by Matic et al showed a correlation between patients with a BMI of >30 (kg/m 2 ) and its effects on the development of CVI.…”

Expanding Criteria for Limb Salvage in Comorbid Patients with Nonhealing Wounds: The MedStar Georgetown Protocol and Lessons Learned after 200 Lower Extremity Free Flaps

“…The complex factors that lead to vascular dysfunction in diabetes and peripheral vascular disease can also affect the venous system, resulting in incompetence of the lower extremity venous valves. 47 In fact, prior work from our group has linked venous reflux to peripheral vascular disease, which remains the major cause of lower limb amputation in diabetic patients. 2,19,[48][49][50] In our population, the overall rate of deep vein thrombosis in the lower extremity was 3.8 percent compared to the general inpatient rate of 1 percent.…”