title: Chronic venous insufficiency: clinical and duplex correlations. The Edinburgh Vein Study of venous disorders in the general population.
abstract: OBJECTIVE
  The objective of this study was to determine the prevalence of chronic venous insufficiency (CVI) in the general population and to correlate its clinical features with sonographically proven venous reflux.
  
  
  METHODS
  The study design was a cross-sectional survey of the general population.
  
  
  METHODS
  Ambulatory men and women, aged 18-64 years, were selected randomly from 12 general practices. Subjects were examined for CVI. Eight segments of the deep and superficial veins were assessed for reflux by means of duplex scanning.
  
  
  RESULTS
  A total of 1566 subjects were screened (867 women, mean age 44.8 years; 699 men, mean age 45.8 years) of whom 124 were diagnosed as having CVI: 95, grade 1; 19, grade 2; and 10, grade 3. The age-adjusted prevalence for the whole population was 9.4% in men and 6.6% in women. Prevalence of CVI correlated closely with age and sex, being 21.2% in men >50 years and 12.0% in women >50 years. Heaviness and tension, and a feeling of swelling, aching, and itching, were significantly associated with worsening grade of CVI. CVI was significantly associated with reflux in all deep and superficial segments. The frequency of reflux in both superficial and deep segments increased with the clinical severity of disease. In 30.8% of subjects with CVI in the left leg, reflux was limited to the superficial system.
  
  
  CONCLUSIONS
  The prevalence of CVI rises steeply with age. There is a strong correlation between venous symptoms and the presence and severity of CVI. CVI is associated in approximately one third of the subjects with incompetence limited to the superficial system and in these a good therapeutic outcome could be expected from surgery to the superficial veins. The severity of clinical features, including Basle CVI grade 1, correlates significantly with prevalence of valvular reflux in the deep and superficial systems. If leg ulcers are to be prevented by timely intervention, a better understanding of the natural history of the association between presenting features and disordered hemodynamics is required.
authors.affiliation: Vascular Surgery Unit and the Department of Medical Imaging, Royal Infirmary of Edinburgh, Scotland.
authors.forename: C Vaughan
authors.initials: CV
authors.lastname: Ruckley
authors.forename: Christine J
authors.initials: CJ
authors.lastname: Evans
authors.forename: Paul L
authors.initials: PL
authors.lastname: Allan
authors.forename: Amanda J
authors.initials: AJ
authors.lastname: Lee
authors.forename: F Gerald R
authors.initials: FG
authors.lastname: Fowkes
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D005260:Female; D006349:Heart Valve Diseases / Q000150:complications / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011897:Random Allocation; D012606:Scotland / Q000453:epidemiology; D012737:Sex Factors; D018616:Ultrasonography, Doppler, Duplex; D014689:Venous Insufficiency / Q000150:complications / Q000000981:diagnostic imaging* / Q000453:epidemiology*