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Eur J Vasc Endovasc Surg. 2015 Sep;50(3):360-7. doi: 10.1016/j.ejvs.2015.05.013. Epub 2015 Jun 30.

Association of Venous Disorders with Leg Symptoms: Results from the Bonn Vein Study 1.

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Department of Dermatology, University of Bonn, Germany.
Institute of Medical Informatics, Biometry und Epidemiology, University of Essen, Germany.
Department of Dermatology, University of Cologne, & Private Practice, Bonn, Germany.
Medical Faculty, Deanery of the Medical School, Heinrich-Heine University of Düsseldorf, Germany; IUF Leibniz Research Institute for Environmental Medicine, Heinrich-Heine University of Düsseldorf, Germany.
Department of Dermatology, University of Bonn, Germany. Electronic address:



The aim was to study the association between venous disorders and leg symptoms in the population based cross sectional Bonn Vein Study 1 (BVS1).


A total of 1,350 men and 1,722 women aged 18-79 years were enrolled into BVS1. Chronic venous insufficiency (CVI), varicose veins (VVs), and clinical classes (C-classes/CEAP [Clinical, Etiological, Anatomical, and Pathophysiological]) were determined by clinical and duplex investigation. Leg symptoms (heaviness, tightness, swelling, pain after standing or sitting, pain while walking, muscle cramps, itching, and restless legs) were assessed in a standardized interview. For 2,624 subjects (48.7% male) with complete information on venous disorders, relevant characteristics and information on at least one leg symptom, multivariate logistic regression analysis was performed.


More women (929/63.0%) reported at least one leg symptom within the last 4 weeks than men (560/48.7%). Prevalence of reported symptoms increased with age (45.4% of the 18-29 year olds, 73.9% of the 70-79 year olds). Leg symptoms were more frequent in obese and underweight subjects. As confirmed by clinical and duplex examination 22.6% had VV and 15.8% had CVI. VV (OR: 1.4; CI: 1.1-1.7) and CVI (OR: 1.8; CI: 1.3-2.3) were significantly associated with reporting at least one leg symptom. In particular, there was a positive association of VV and CVI with itching, feeling of heaviness, tightness, swelling, and pain after standing or sitting. C2-C6 showed a statistically significant association with feeling of heaviness, tightness, swelling, and itching, while for pain on walking and muscle cramps this was shifted towards C classes C3-C6 and C3-C4, respectively.


Venous disorders show significant associations with several leg symptoms. Itching, feeling of heaviness, or tightness seem to be more closely related than other symptoms. The associations between C classes and symptoms seem to be restricted to classes C2 or higher.


CEAP; Chronic venous insufficiency; Symptoms; Varicose veins; Venous disorders

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