Mok Yejin, Ballew Shoshana H, Kucharska-Newton Anna, Butler Kenneth, Henke Peter, Lutsey Pamela L, Salameh Maya, Hoogeveen Ron C, Ballantyne Christie M, Selvin Elizabeth, Matsushita Kunihiro
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Optimal Aging Institute, Department of Population Health, New York University Grossman School of Medicine, New York, New York.
Am J Prev Med. 2025 Apr;68(4):674-681. doi: 10.1016/j.amepre.2024.12.009. Epub 2024 Dec 17.
Varicose veins are common in older adults and are associated with adverse clinical outcomes such as deep venous thrombosis. Established risk factors for varicose veins include female sex, height, and obesity, but other risk factors are relatively uncharacterized.
This was a prospective cohort analysis of 6,241 participants aged 66-70 years from the Atherosclerosis Risk in Communities (ARIC) Study. Incident varicose veins were defined as two outpatient encounters (at least a week apart) or inpatient diagnoses through 2018 with ICD-9 code 454 or ICD-10 code I83. Participants with a history of clinically recognized varicose veins at baseline were excluded. Cox regression was used to evaluate established (e.g., female, height, BMI) and potential demographic and clinical risk factors.
During a median follow-up of 13 years, 349 (6%) of participants developed clinically recognized varicose veins. Consistent with prior research, female sex, taller height, and higher BMI were associated with incident varicose veins. After accounting for these, White race, prevalent heart failure, loop diuretic use, higher cardiac troponin T, and higher natriuretic peptide were independently associated with incident varicose veins.
In this community-based cohort study of older adults, known and newly identified risk factors, including cardiac function and heart failure, were independently associated with incidence of clinically recognized varicose veins. The potential usefulness of cardiac biomarkers for prevention and screening of varicose veins requires further investigations.
静脉曲张在老年人中很常见，并且与深静脉血栓形成等不良临床结局相关。已确定的静脉曲张危险因素包括女性、身高和肥胖，但其他危险因素相对尚不明确。
这是一项对社区动脉粥样硬化风险（ARIC）研究中6241名66至70岁参与者进行的前瞻性队列分析。新发静脉曲张定义为在2018年之前通过两次门诊就诊（至少间隔一周）或住院诊断，ICD-9编码为454或ICD-10编码为I83。排除基线时有临床确诊静脉曲张病史的参与者。采用Cox回归来评估已确定的（如女性、身高、体重指数）以及潜在的人口统计学和临床危险因素。
在中位随访13年期间，349名（6%）参与者出现了临床确诊的静脉曲张。与先前的研究一致，女性、身高较高和体重指数较高与新发静脉曲张相关。在考虑这些因素后，白人种族、心力衰竭患病率、使用袢利尿剂、较高的心肌肌钙蛋白T和较高的利钠肽与新发静脉曲张独立相关。
在这项基于社区的老年人队列研究中，已知和新发现的危险因素，包括心脏功能和心力衰竭，与临床确诊静脉曲张的发生率独立相关。心脏生物标志物在预防和筛查静脉曲张方面的潜在用途需要进一步研究。
