BMJ 1999;318:353-356 ( 6 February )

Papers

What are the symptoms of varicose veins? Edinburgh vein study cross sectional population survey

Andrew Bradbury, senior lecturer, b Christine Evans, clinical research fellow, a Paul Allan, senior lecturer, c Amanda Lee, research statistician, a C Vaughan Ruckley, professor, b F G R Fowkes, professor. a

a Wolfson Unit for Prevention of Peripheral Vascular Diseases, Public Health Sciences, University of Edinburgh, Edinburgh EH8 9AG, b Vascular Surgery Unit, University Department of Surgical and Clinical Sciences, Royal Infirmary, Edinburgh EH3 9YW, c Department of Medical Imaging, Royal Infirmary, Edinburgh

Correspondence to: Professor Fowkes gerry.fowkes{at}ed.ac.uk

Objective: To define the relations between age, sex, lower limb symptoms, and the presence of trunk varicose veins on clinical examination.
Design: Cross sectional population study.
Setting: 12 general practices with catchment areas geographically and socioeconomically distributed throughout Edinburgh.
Participants: An age stratified random sample of 1566 people (699 men and 867 women) aged 18-64 selected from the computerised age-sex registers of participating practices.
Main outcome measures: Self administered questionnaire on the presence of lower limb symptoms and physical examination to determine the presence and severity of varicose veins.
Results: Women were significantly more likely than men to report lower limb symptoms such as heaviness or tension, swelling, aching, restless legs, cramps, and itching. The prevalence of symptoms tended to increase with age in both sexes. In men, only itching was significantly related to the presence and severity of trunk varices (linear test for trend, P=0.011). In women there was a significant relation between trunk varices and the symptoms of heaviness or tension (P=<0.001), aching (P=<0.001), and itching (P=<0.005). However, the level of agreement between the presence of symptoms and trunk varices was too low to be of clinical value, especially in men.
Conclusions: Even in the presence of trunk varices, most lower limb symptoms probably have a non-venous cause. Surgical extirpation of trunk varices is unlikely to ameliorate such symptoms in most patients.


Key messages

  • In this population survey women were more likely than men to report a wide range of lower limb symptoms

  • In men, only itching was significantly related to the presence of trunk varices

  • In women there was a significant relation between trunk varices and heaviness or tension, aching, and itching

  • The level of agreement between the presence of symptoms and trunk varices is probably too low to be clinically useful

  • A thorough clinical history and examination should be carried out before surgery




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