SAN DIEGO — Obesity does not appear to be associated with venous disease and varicose veins generally, Dr. Jean-Patrick Benigni said at the annual meeting of the American Venous Forum.
“In an obese population, evidence of an association between obesity and venous reflux is not so high,” said Dr. Benigni of the unit of cardiovascular pathology at Begin Hospital, Saint-Mandé, France.
Dr. Benigni did a clinical examination and duplex ultrasound in 757 obese patients, of whom 90% were female.
The evaluation found that 22% had varicose veins, slightly less than the estimated prevalence in the general female population of 25%. The percentage with varicose veins was the same whether body mass index was above 40 mg/kg
About 5% of the subjects had lower-extremity edema. But in subjects who were CEAP (clinical, etiologic, anatomic, and pathophysiologic) classes 3 or 4, defined as the presence of edema or skin changes without ulceration, only 33% were found to have venous reflux on duplex ultrasound.
Another report also found no evidence of increased venous disease in the morbidly obese (J. Vasc. Surg. 2003;37:79–85), Dr. Benigni said.
He conjectured that venous disease is related to circulatory system problems, not directly to obesity itself.
However, Dr. Frank Padberg Jr., a professor of surgery at the New Jersey Medical School, Newark, and author of the report cited by Dr. Benigni, cautioned that “varicose veins can be hidden under the layers of adipose.”