Frequency of Peripheral Arterial Disease in Patients With Chronic Venous Insufficiency

Abstract

Background:It is estimated that about 15% (10% - 30% in most of the studies) of the total adult population has some aspects of the Chronic Venous Insufficiency (CVI). Frequency of the Peripheral Arterial Disease (PAD) in the adult population is 3% - 4%. Studies dealing with etiopathogenesis of leg ulcers show that between 10% and 18% of all ulcers are of mixed, arterial-venous origin.Objectives:The purpose of this study was to find out if there is a higher frequency of PAD among CVI patients in comparison with the control group, as well as to discover some common risk factors for CVI and PAD.Patients and Methods:This cross-sectional descriptive study was conducted at the dermatovenereological clinic, clinical center of Vojvodina, Serbia. A total of 162 examinees were included. All patients were examined for the existence of CVI and staged according to CEAP (Clinical, etiology, anatomy and patophysiology) classification. In this way, 3 groups were formed: Patients with the mild forms of CVI (stage 1 - 4 by CEAP classification), 57 patients; patients with the severe forms of CVI (stage 5 and 6 by CEAP classification), 55 patients; control group (no CVI), 50 patients. Also, the Ankle Brachial Pressure Index (ABPI) was assessed in all subjects, and its value of ≤ 0.9 was set as criteria for diagnosis of PAD. The same sample was divided according to the presence of PAD into two groups. The most important risk factors for CVI and PAD were identified for each patient through complete examination, medical record and appropriate questionnaire.Results:Our results showed that the risk factors for CVI were high Body Mass Index (BMI), hypertension, predominantly standing position during work and positive family history for CVI. In the same sample it was found that 28 (17.28%) patients had PAD. Relevant risk factors for PAD in the present study were: high BMI, hypertension, diabetes and a positive family history for PAD. Comparison of frequency of PAD among patients with severe forms of CVI and control group showed that this difference was statistically significant (P = 0.0275; OR 3.375; 95% CI 1.125 - 10.12). After multivariate analyses, adjusted odds ratio OR was still statistically significant.Conclusions:The peripheral arterial disease is more frequent in patients with the severe form of CVI, than in patients without CVI. Concomitant risk factors for CVI and PAD were high BMI and hypertension. In each patient with severe CVI it is necessary to determine the ABPI, in order to exclude the presence of PAD.

A systematic review on risk factors in developing a first‐time Venous Leg Ulcer

“…Eventually, five studies, two case–control and three cross‐sectional studies, were included in the qualitative synthesis. Heterogeneity of the studies prevented us from doing a meta‐analysis.…”

“…Moreover, in each of the included studies, the comparability of cases and controls differed. Some studies adjusted for age and gender in a multivariate analysis, while another study conducted a univariate analysis only, or did not show the multivariate analysis . In addition, one study did not report a non‐response rate, two studies used medical records only so non‐response was not possible; in one study there was a rate difference of 17% in the non‐respondents and in one study a large amount of cases and controls could not be contacted because of missing phone numbers.…”

Comorbidity of hypertension and chronic venous disease in men

“…На вероятную связь АГ и варикозного поражения вен указал Mäkivaara LA, который обнаружил более высокую распространенность поражения вен у лиц с сердечнососудистыми заболеваниями, в т. ч. при АГ [16]. B. Matić в 2016г выявил у пациентов с АГ и хронической венозной недостаточности нижних конечностей общие факторы риска [17]. Таким образом, полученные нами данные указывают, что АГ чаще сочетается с признаками ХЗВ и нарушениями венозного кровотока нижних конечностей.…”

Concomitant chronic venous insufficiency in patients with peripheral artery disease: insights from MR angiography

“…Most published investigations on this topic focused on patients with leg ulcerations and found that mixed (arterial and venous) aetiology is found in 10-18% of ulcer patients [10,[12][13][14][15]. One study performed in a cohort of patients with CVI found that 17% of patients with CVI also have co-existing PAD [10]. A higher risk for PAD in CVI patients has also been observed in population-based studies [11,[15][16][17].…”

“…There is scarce data on the prevalence of co-existing PAD and CVI [10,11]. Most published investigations on this topic focused on patients with leg ulcerations and found that mixed (arterial and venous) aetiology is found in 10-18% of ulcer patients [10,[12][13][14][15]. One study performed in a cohort of patients with CVI found that 17% of patients with CVI also have co-existing PAD [10].…”