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Obesity and lower limb venous disease - The epidemic of phlebesity.

Davies, Huw Ob and Popplewell, Matthew and Singhal, Rishi and Smith, Neil and Bradbury, Andrew W (2016) Obesity and lower limb venous disease - The epidemic of phlebesity. Phlebology. ISSN 1758-1125.

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Official URL: http://journals.sagepub.com/doi/full/10.1177/02683...

Abstract

INTRODUCTION

Lower limb venous disease affects up to one half, and obesity up to one quarter, of the adult population. Many people are therefore affected by, and present to health services for the treatment of both conditions. This article reviews the available evidence of pathophysiological and clinical relationship between obesity and varicose veins, chronic venous insufficiency and ulceration and deep vein thrombosis.

METHODS

A literature search of PubMed and Cochrane libraries was performed in accordance with PRISMA statement from 1946 to 2015, with further article identification from following cited references for articles examining the relationship between obesity and venous disease. Search terms included obesity, overweight, thrombosis, varicose veins, CEAP, chronic venous insufficiency, treatment, endovenous, endothermal, sclerotherapy, bariatric surgery and deep vein thrombosis.

RESULTS

The proportion of the population suffering from lower limb venous disease and obesity is increasing. Obesity is an important risk factor for all types of lower limb venous disease, and obese patients with lower limb venous disease are more likely to be symptomatic as a result of their lower limb venous disease. The clinical diagnosis, investigation, imaging and treatment of lower limb venous disease in obese people present a number of challenges. The evidence base underpinning medical, surgical and endovenous management of lower limb venous disease in obese people is limited and such treatment may be associated with worse outcomes and increased risks when compared to patients with a normal body mass index.

CONCLUSION

Lower limb venous disease and obesity are both increasingly common. As such, phlebologists will be treating ever greater numbers of obese patients with lower limb venous disease, and clinicians in many other specialties are going to be treating a wide range of obesity-related health problems in people with or at risk of lower limb venous disease. Unfortunately, obese people have been specifically excluded from many, if not most, of the pivotal studies. As such, many basic questions remain unanswered and there is an urgent need for research in this challenging and increasingly prevalent patient group.

Item Type: Article
Subjects: WG Cardiovascular system. Cardiology
Divisions: Planned IP Care > Vascular
Related URLs:
Depositing User: Mr Philip O'Reilly
Date Deposited: 30 Mar 2017 10:56
Last Modified: 30 Mar 2017 10:56
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/1306

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