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(Circulation. 2005;111:2398-2409.)
© 2005 American Heart Association, Inc.

Contemporary Reviews in Cardiovascular Medicine

Chronic Venous Insufficiency

Robert T. Eberhardt, MD; Joseph D. Raffetto, MD

From Cardiovascular Medicine, Boston Medical Center (R.T.E.), Vascular Surgery, Boston VA Health System (J.D.R.), and Boston University School of Medicine (R.T.E., J.D.R.), Boston, Mass.

Correspondence to Robert T. Eberhardt, MD, Boston Medical Center, 88 E Newton St, C818, Boston, MA 02118. E-mail robert.eberhardt@bmc.org

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
Chronic venous disease is often overlooked by primary and cardiovascular care providers because of an underappreciation of the magnitude and impact of the problem. The importance of chronic venous disease is related to the number of people with the disease and the socioeconomic impact of its more severe manifestations. Unfortunately, the literature concerning the prevalence and incidence of chronic venous disease has varied greatly because of differences in the methods of evaluation, criteria for definition, and the geographic regions analyzed. The most common manifestations of chronic venous disease are dilated cutaneous veins, such as telangiectases and reticular veins, and varicose veins. The term chronic venous insufficiency (CVI) describes a condition that affects the venous system of the lower extremities with venous hypertension causing various pathologies including pain, swelling, edema, skin changes, and ulcerations. Although the term CVI is often used to exclude uncomplicated varicose veins, varicose veins have incompetent valves with increased venous pressure leading to progressive dilation and tortuosity. We will use the term CVI to represent the full spectrum of manifestations of chronic venous disease.

Varicose veins have an estimated prevalence between 5% to 30% in the adult population, with a female to male predominance of 3 to 1, although a more recent study supports a higher male prevalence.¹ The Edinburgh Vein Study screened 1566 subjects with duplex ultrasound for reflux finding CVI in 9.4% of men and 6.6% of women, after age adjustment, which rose significantly with age (21.2% in men >50 years old, and 12.0% in . . . [Full Text of this Article]

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