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A GLOBAL APPROACH OF WORLD EMIDEMIOLOGY IN CHRONIC VENOUS DISORDERS

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

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  1. A GLOBAL APPROACH OF WORLD EMIDEMIOLOGY IN CHRONIC VENOUS DISORDERS Dr M. Cazaubon et Pr FA. Allaert

  2. Global Approach in CVD • 1/ Incidence • 2/ Prevalence • 3/ Risk factors

  3. 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

  4. 2/ PREVALENCE CVD MANY STUDIES

  5. 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

  6. Studies with similar methodology for varicose veins in female

  7. PREVALENCE VARICOSE VEINS In Western Countries 25 % à 33 %  10 % à 20 % 

  8. PREVALENCE OF VARICOSE VEINS IN DEVELOPING COUNTRIES

  9. 3. RISK FACTORS • FAVOURITES • Gender • Heredity • Pregnancies • OUTSIDERS • Standing at work • Obesity • Height • Constipation, fiber intake…… • Hormonal therapy • Ethnicity

  10. A/ GENDER and varicose veins

  11. B. HEREDITYand varicose veins

  12. 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

  13. CC.Number of pregnancies and CVD Jawien et al. Phlebology 2004

  14. 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 )

  15. 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)

  16. 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** **

  17. 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

  18. Visible disease and ethnicity in San Diego Study

  19. 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.

  20. Patients description

  21. Patients description

  22. Patients description

  23. Clinical description of CVD using the CEAP classification

  24. Risk factors

  25. Treatment modalities

  26. 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

  27. 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

  28. 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

  29. In all the world • That is the aim of our observatory of chronic venous diseases

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