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. 2025 Aug 14:S1078-5884(25)00786-5.
doi: 10.1016/j.ejvs.2025.08.028. Online ahead of print.

Prevalence and Risk Factors of Chronic Venous Disease in a General Population in The Netherlands: Results from the Rotterdam Study

Eveline R Y Scheerders  1 , Luba M Pardo  1 , Wendy S J Malskat  1 , Catherine van Montfrans  1 , Marie Josee E van Rijn  2 , Tamar Nijsten  1 , Renate R van den Bos  3
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Free article

Prevalence and Risk Factors of Chronic Venous Disease in a General Population in The Netherlands: Results from the Rotterdam Study

Eveline R Y Scheerders et al. Eur J Vasc Endovasc Surg. .
Free article

Abstract

Objective: Chronic venous disease (CVD) of the lower extremities is a common health problem, with moderate to severe symptoms such as leg pain and sensation of swelling, and potential severe complications such as venous ulcers. However, few population based, physician performed duplex ultrasound (DUS) studies on CVD prevalence and associated risk factors exist. This study aimed to assess the prevalence of the different CEAP (Clinical-Etiological-Anatomical-Pathophysiological) clinical classes, CVD CEAP clinical class C3 - C6, and superficial venous reflux in a Dutch population, along with associated risk factors.

Methods: This was population based, cross-sectional cohort study embedded in the Rotterdam Study. Participants aged ≥ 40 years from one Rotterdam district were invited. Baseline demographics, CEAP classification, and DUS outcomes for superficial venous reflux were recorded. Independent risk factors for superficial venous reflux and CVD CEAP clinical class C3 - C6 were identified with multivariable logistic regression analysis.

Results: Of 2 510 participants (1 441 females, 1 069 males; median age 54 years), 84.2% of participants were classified as C0 - C1, 12.7% as C2, 2.3% as C3, and 0.7% as C4 - 6. The prevalence of CVD CEAP clinical class C3 - C6 was 3.0%. Superficial venous reflux was present in 23.7%. Independent risk factors for CVD CEAP C3 - C6 included older age, female sex, and greater height. Risk factors for superficial venous reflux included older age, female sex, greater height, and high waist-hip ratio.

Conclusion: This study showed a prevalence of superficial venous reflux of 23.7% and of CVD CEAP clinical class C3 - C6 of 3.0% in a general Dutch population. The identified risk factors enable identification of people at risk and optimisation of preventive measures, which could result in reduced healthcare costs.

Keywords: Chronic venous insufficiency; General population; Prevalence; Superficial venous reflux; Varicose veins.

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