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A GLOBAL APPROACH OF WORLD EMIDEMIOLOGY IN CHRONIC VENOUS DISORDERS Dr M. Cazaubon et Pr FA. Allaert. Global Approach in CVD. 1/ Incidence 2/ Prevalence 3/ Risk factors. 1/ INCIDENCE CVD. The only follow-up study 2-year incidence rate of varicose veins = 39 per 1000 men-years
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A GLOBAL APPROACH OF WORLD EMIDEMIOLOGY IN CHRONIC VENOUS DISORDERS Dr M. Cazaubon et Pr FA. Allaert
Global Approach in CVD • 1/ Incidence • 2/ Prevalence • 3/ Risk factors
1/ INCIDENCE CVD • The only follow-up study • 2-year incidence rate of varicose veins = • 39 per 1000 men-years • 52 per 1000 women years • (40-89 years of age) • FRAMINGHAM STUDY • BRAND et al. Am J Prev Med 1988
2/ PREVALENCE CVD MANY STUDIES
Variations in prevalence of varicose veins • Prevalence of varicose veins worlwide = 0,1% in women from villages in rural New Guinea = 60,5% in women working in a department store in Czechoslovakia • Necessity to compare similar studies with the same methodology
Studies with similar methodology for varicose veins in female
PREVALENCE VARICOSE VEINS In Western Countries 25 % à 33 % 10 % à 20 %
3. RISK FACTORS • FAVOURITES • Gender • Heredity • Pregnancies • OUTSIDERS • Standing at work • Obesity • Height • Constipation, fiber intake…… • Hormonal therapy • Ethnicity
B . HEREDITYand CVD • 4294 women with CVD • 49% of their children have venous disorders • % of children with CVD and mothers’class of CEAP • C4 or > C4: 69% • C3: 60% • C2 : 56% • C1: 43 % FA ALLAERT AVF 2003
CC.Number of pregnancies and CVD Jawien et al. Phlebology 2004
C.Number of pregnancies ( P) and CVD • 1 P OR= 1,3 • 2 P OR = 1,4 • 3 P OR = 1,6 • 4 P OR = 1,9 • >5 P OR = 2,2 Bonn study Bromen and Rabe 2004 (Population study )
Others Risk factors Standing at work Obesity Height Constipation, fiber intake…… Hormonal therapy Ethnicity Epidemiology of CVD. M Cazaubon FA ALLAERT in Sclérotherapy of varicose veins ( ESKA 2005 in press)
VARICOSE VEINS IN TROPICAL AFRICA • Prevalence of varicose veins in Tanzania • 6,1% in men • 5,0 % in women • Prevalence of telangiectasia and varicose veins : • 0,12% Ouganda* • 11% women in Mali** Burkitt 1972* Rougement Lancet 1974** **
Prevalence of venous disorders and ethnicity Non-Hispanic Whites have more venous disorders than : • Hispanics, • African Americans • Asians San Diego Study Criqui Am J Epidemiol 2003
Chronic Venous Disorders in patients from emerging countries, living in France Survey conducted by 70 angiologist F-A. ALLAERT M CAZAUBON and SFA Professeur adjoint Dpt. d’Epidémiologie et de Santé Publique, Université MacGill, Montréal, Canada. CENBIOTECH, CHRU Dijon.
Conclusion of the study • CVD are present in all people living in France , and coming from emerging country • Role of « environnemental » factors in immigrant people and ???genetic • They are consulting late, and we find the most severe class of CVD
CONCLUSION • It is necessary to develop a very sharp « chronic venous disorders consciousness » • To prevent it ( risk factors) • To diagnose it early and • For the appropriate treatment
2: CEAP CLASSIFICATION = COMPASS A - asymptomatic S - symptomatic C C - congenital P - primary S - secondary E S - superficial D - deep P - perforators A R - reflux O - obliteration R,O - reflux and obliteration P Ad Hoc Committee, American Venous Forum, Hawai 1994
In all the world • That is the aim of our observatory of chronic venous diseases