Babaei Mohammadreza, Afrooghe Arya, Rafati Ali, Mohebbi Bahram, Moosavi Jamal, Ghadri Narges, Koohestani Bahareh Mohajer, Rahimi Shahin, Baay Mohammadreza, Alemzadeh-Ansari Mohammad Javad, Hosseini Zahra, Boudagh Shabnam, Khalilipur Ehsan, Ghaemmaghami Zahra, Pasebani Yeganeh, Firoozbakhsh Parisa, Pouraliakbar Hamidreza, Bakhshandeh Hooman, Sadeghipour Parham
Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran; School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
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.
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.
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.
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/m), smoking, hypertension, diabetes mellitus, physical activity, dyslipidemia, and delivery method.
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.
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.
下肢慢性静脉疾病（CVD）是不同人群中常见的静脉疾病之一，临床表现广泛，由于人群特征和测量方法不同，其确切患病率尚未确定。本研究旨在估计现代伊朗城市人群中CVD的患病率，并确定其相关危险因素。
拉贾伊医院心脏评估与监测研究是一项基于人群的纵向队列研究，旨在调查德黑兰30至75岁无明显心血管疾病的成年人群中心血管疾病的基线患病率和10年发病率以及相关危险因素。两名受过指导的介入心脏病专家使用临床-病因-解剖-病理生理分类法进行CVD评估。CVD分为C1至C6级，慢性静脉功能不全（CVI）分为C3至C6级。使用多变量回归模型分析CVD与预先指定的年龄、性别、体重指数（≥30kg/m²）、吸烟、高血压、糖尿病、体力活动、血脂异常和分娩方式等协变量之间的关联。
1176名参与者中CVD患病率为36.5%（95%置信区间[CI]，33.8-39.3），女性高于男性（44.2%对23.5%）。CVI患病率仅为0.7%（95%CI，0.3-1.3）。多变量分析显示，高龄（比值比[OR]，1.06；95%CI，1.04-1.08）、女性（OR，2.98；95%CI，2.14-4.14）和体重指数≥30（OR，1.36；95%CI，1.03-1.81）与CVD独立相关。体力活动（OR，0.77；95%CI，0.58-1.02）几乎具有保护作用，而其他因素，包括传统心血管危险因素，与CVD无显著关联。
我们的研究结果表明，CVD在现代伊朗城市人群中普遍存在。然而，考虑到该疾病较高阶段的患病率极低，大规模筛查的益处值得商榷，应研究更好的风险判别指标。
