Abstract MP077: Longitudinal Associations Between Venous Disease Progression and Change in Quality of Life: San Diego Population Study

Abstract

Background: Chronic venous disease, one of the most common chronic diseases in the United States, is associated with lower quality of life (QOL). Although earlier studies have identified a significant association between the cross-sectional prevalence of venous disease and QOL, few studies have investigated the association between venous disease progression and change in QOL. Therefore, the aim of this study was to investigate the relationship between progression of venous disease and change in QOL in a longitudinal cohort. Methods: A population-based cohort of 1103 participants were examined at baseline and 11 years later. At both visits, QOL and risk factors were assessed by questionnaire, anthropometric measures obtained by clinical examination, and venous disease assessed by visual inspection and duplex ultrasound. QOL was measured with the Medical Outcomes Study 36-Item Short Form (SF-36) with the resulting physical component (PCS) and mental component scores (MCS) being used in the analysis. Using ANCOVA methods to control for age, gender, and ethnicity, changes in venous disease were compared against QOL stratified into tertiles. Then, linear regression models were used to examine the longitudinal association of venous disease at baseline and change in QOL score at follow-up after controlling for covariates. Results: In the study population of 1103 individuals, 78 had regression, 340 had progression, and 685 were stable. The average age was 58.7 years (SD 10.4); 33% were male, 61% were non-Hispanic White, 15% were Hispanic, 12% were African American, and 12% were Asian. Mean BMI was 27.1 (SD 5.3), 45.4% had hypertension, 9.9% were diabetic, 3.6% were current smokers, and 34.8% were on medication for hyperlipidemia. Progression of venous disease was significantly associated with change in PCS after controlling for age, gender, and ethnicity ( β =-0.075; p =.04). The association was only slightly attenuated ( β =-.065, p=.08) after adjustment for BMI, high blood pressure, injury to either leg, smoking history, previous vein procedure, previous hernia surgery, flat feet, marital status, education level, occupation, cardiovascular-related morbidity, diabetes, and heaviness in either leg. No association was found with MCS before or after multiple covariate adjustment. Conclusions: This study confirms that individuals with progression of chronic venous disease have a greater decrease in QOL as identified by the physical component score of SF-36. Prevention of chronic venous disease progression may help retain QOL.