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Original Investigation
June 27, 2005

Relationships Between Symptoms and Venous Disease: The San Diego Population Study

Author Affiliations

Author Affiliations: Departments of Family and Preventive Medicine (Drs Langer, Allison, and Criqui and Ms Denenberg), Medicine (Drs Allison and Criqui), and Surgery and Bioengineering (Dr Fronek), University of California, San Diego, and Graduate School of Public Health, San Diego State University (Ms Ho), San Diego.

Arch Intern Med. 2005;165(12):1420-1424. doi:10.1001/archinte.165.12.1420

Background  The associations between symptoms and venous disease of the lower extremities are poorly characterized.

Methods  We conducted a cross-sectional study to evaluate relationships between symptoms associated with venous disease and prevalent disease in 2408 men and women aged 29 to 91 years who were employees, retirees, or spouses at a large state university. Index participants were randomly selected within strata by age, sex, and ethnicity. A structured interview assessed the prevalence of aching, itching, heaviness, tired legs, cramping, swelling, and nighttime restless legs. A comprehensive standardized examination determined the prevalence of visible disease (normal, telangiectasias, varicose veins, and trophic changes) and functional disease (normal, superficial, and deep disease). We related symptoms to disease with attention to modification by sex, ethnicity, and age.

Results  Aching, itching, heaviness, tired legs, cramping, and swelling were related to both superficial and deep functional disease. The same symptoms were related to varicose veins and trophic changes. Swelling and heaviness were related to telangiectatic disease. Except for restless legs and trophic changes, the prevalence of symptoms across each category was greater in women than men. Aching was the most common symptom but was relatively nonspecific. Swelling was the most specific marker for prevalent visible and functional disease. Heaviness and itching also helped to distinguish prevalent disease.

Conclusions  Venous symptoms were more prevalent in study participants with both visible and functional disease and in women. Swelling was the most specific predictor; heaviness, itching, and aching also helped to distinguish cases.