Chronic venous insufficiency in Italy: The 24-cities cohort study

Objective. To assess the relationship between sex, age, geographical region, lower limb symptoms and the presence of trunk varicose veins and venons incompetence. Design. Cross-sectional population study in 24 cities in the North, centre and South of Italy. Participants. Five thousand two hundred and forty-seven people were selected during spring and summer 2003 by advertising on telezision, in newspapers, and by leaflets lit 24 Italian cities, In all 5187 (4457[85.9 degrees] women and 730 men [14.1%]) volunteers were assessed. The median age was 54 (range: 18-90) years for the women and 61 (range: 18-49) years for the men. Methods. Self-administered questionnaire oil subjective,e symptoms of chronic venous insufficiency (CVI) ill the lower limbs,, and clinical examination, including colour duplex ultrasonography to assess tilt, presence and severity of varicose veins. Results. Overall only 22.7% of the subjects examined of venous disease with approximately 53% the population over 50 years of age showing some venous reflux. People living in Southern Italy were more severely affected than those living in the North. Varicosities and telangiectases were the most frequent objective signs in both sexes. Trunk varicosities (27%) and saphenous reflux (41%) increased with age and were more common in men; in contrast, minor objective symptoms such as telangiectases (70%), as well as subjective symptoms such as heavy (79 degrees) and tired legs (78%) were more common in women and were not age-related. Conclusions. Venous disease is very common in Italy, in particular in people living in the South. A correlation between varicose veins and venous incompetence is more marked in men, while minor objective and subjectine symptoms prevail in women. The findings from this non-random sample closely match results from previous studies, in which random sampling was used.