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Obesity and impaired venous function.
MedLine Citation:
PMID:  18313335     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: The clinical severity of venous disease is often worse in obese patients. The objectives of this study were to compare lower limb venous physiology assessed by air plethysmography in a large group of obese and normal-weight patients; to consider the effect of posture on these measures and on foot vein pressure in a smaller cohort. METHODS: Venous function was assessed using air plethysmography and duplex scanning in 934 consecutive patients presenting for assessment of venous disease. These were grouped into obese or non-obese categories. A smaller group of twenty patients with a range of body weights were randomly selected from a database of patients with varicose veins. Foot vein pressures and femoral vein diameter were measured standing, sitting, lying and ambulating. RESULTS: Venous disease was more clinically severe in the obese limbs (CEAP C5&6 non-obese group 20.5%, obese group 35.4%, p<0.001 chi(2)). Venous reflux was worse in the obese but measures of muscle pump function were better. Residual volumes and fractions were better in the obese (mean residual volume, non-obese 60 SD 36, obese 50 SD 42, p<0.001 t test). In the smaller study group weight correlated with the diameter of the superficial femoral vein (r=0.50), ambulatory venous pressure (r=0.45), venous filling index (r=0.49) and the ejection volume (r=0.38, p<0.05). The foot venous pressure was significantly greater in the obese in all positions. CONCLUSION: The CEAP clinical stage of venous disease is more advanced in obese patients than non-obese patients with comparable anatomical patterns of venous incompetence. This may be the result of raised intra-abdominal pressure reported in previous studies, leading to greater reflux, increased vein diameter and venous pressures.
A M van Rij; C S De Alwis; P Jiang; R A Christie; G B Hill; S J Dutton; I A Thomson
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Publication Detail:
Type:  Journal Article     Date:  2008-03-03
Journal Detail:
Title:  European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery     Volume:  35     ISSN:  1532-2165     ISO Abbreviation:  Eur J Vasc Endovasc Surg     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-05-19     Completed Date:  2008-06-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9512728     Medline TA:  Eur J Vasc Endovasc Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  739-44     Citation Subset:  IM    
Department of Surgery, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
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MeSH Terms
Body Mass Index
Case-Control Studies
Femoral Vein / physiopathology
Foot / blood supply
Lower Extremity / blood supply*
Middle Aged
Muscle Contraction
Muscle, Skeletal / physiopathology
Obesity / complications,  physiopathology*,  ultrasonography
Popliteal Vein / physiopathology
Saphenous Vein / physiopathology
Severity of Illness Index
Ultrasonography, Doppler, Duplex
Varicose Veins / etiology*,  physiopathology,  ultrasonography
Venous Pressure*

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