Varicose vein is associated with an increased risk of ischemic stroke: a population-based matched cohort study.

IF 3.6 4区医学 Q1 MEDICINE, GENERAL & INTERNAL

Postgraduate Medical Journal Pub Date : 2025-04-30 DOI:10.1093/postmj/qgaf063

Feng-Renn Hsieh, Wei-Kai Lee, Sunny Ssu-Yu Chen, Cheuk-Kwan Sun, Wen-Bin Yeh, Yao-Min Hung, Fuu-Jen Tsai, Renin Chang, Li-Fei Pan

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引用次数: 0

Abstract

Importance: The association between varicose veins (VVs) and stroke, and the influence of VV management on the risk of stroke remained unclear.

Objective: To evaluate whether VVs are associated with an elevated risk of stroke and assess if interventions for VVs alter this risk.

Design: From 1 January 2000 to 31 December 2015, adults with VVs were matched by propensity score with those without VVs. Patients with prior strokes were excluded. Follow-up continued until 31 December 2018.

Outcomes: Relative hazards through comparing incidence rates of ischemic stroke (IS) and hemorrhagic stroke (HS) between the two groups using Cox proportional hazards models.

Results: Comparison of the VV group (n = 23 238, mean [SD] age = 54.3 [15.6] years; 70% female) with the non-VV group (n = 92 952, mean [SD] age = 54.1 [15.7] years; 71% female) revealed a higher incidence rate of IS in the former than the latter (13.15 vs. 11.16 per 1000 person-years; 2555 vs. 8799 cases, respectively). The adjusted hazard ratio (aHR) for overall stroke in the VV group was 1.16 (95% CI = 1.11-1.21). Both females (aHR = 1.18 [95% CI = 1.11-1.25]) and males (aHR = 1.15 [95% CI = 1.07-1.24]) with VVs showed an increased IS risk. In patients aged ≥50, VVs were associated with a higher IS risk (aHR = 1.17 [95% CI = 1.12-1.23]). No significant correlation was found between VVs and HS. The association of VV management with a reduced risk of stroke (aHR = 0.82 [95% CI = 0.70-0.96]) was supported by sensitivity analyses.

Conclusions: Adults with VVs showed an increased risk of IS but not HS. Key message What is already known on this topic. Varicose veins (VVs) are linked to cardiovascular conditions, but their association with stroke risk and the impact of VV interventions remain unclear. What this study adds. This study demonstrated that adults with VVs, especially those aged ≥50, have a higher ischemic stroke (IS) risk. VV interventions may reduce this risk. How this study might affect research, practice, or policy. Stroke risk assessment and VV management should be considered in older patients to improve preventive care.

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静脉曲张与缺血性卒中风险增加相关：一项基于人群的匹配队列研究

重要性：静脉曲张（VVs）与卒中之间的关系，以及静脉曲张管理对卒中风险的影响尚不清楚。目的：评估房颤是否与卒中风险升高有关，并评估房颤干预是否能改变这种风险。设计：从2000年1月1日至2015年12月31日，通过倾向评分将有vv的成年人与没有vv的成年人进行匹配。既往有中风病史的患者被排除在外。后续工作一直持续到2018年12月31日。结果：采用Cox比例风险模型比较两组缺血性卒中（IS）和出血性卒中（HS）的发生率。结果：VV组比较(n = 23 238，平均[SD]年龄= 54.3[15.6]岁；女性占70%)，非vv组(n = 92 952，平均[SD]年龄= 54.1[15.7]岁；71%的女性)显示前者的IS发病率高于后者(13.15 vs 11.16 / 1000人年；2555例对8799例)。VV组总卒中的校正危险比（aHR）为1.16 （95% CI = 1.11-1.21）。患有VVs的女性（aHR = 1.18 [95% CI = 1.11-1.25]）和男性（aHR = 1.15 [95% CI = 1.07-1.24]）均显示IS风险增加。在年龄≥50岁的患者中，VVs与较高的IS风险相关（aHR = 1.17 [95% CI = 1.12-1.23]）。VVs与HS无显著相关性。VV管理与卒中风险降低的关联（aHR = 0.82 [95% CI = 0.70-0.96]）得到敏感性分析的支持。结论：患有VVs的成年人患IS的风险增加，但HS的风险没有增加。关于这个话题的已知信息。静脉曲张（VVs）与心血管疾病有关，但其与中风风险的关系以及静脉曲张干预的影响尚不清楚。这项研究补充了什么？该研究表明，患有VVs的成年人，特别是年龄≥50岁的成年人，有更高的缺血性卒中（IS）风险。VV干预可以降低这种风险。这项研究如何影响研究、实践或政策。应考虑老年患者卒中风险评估和VV管理，以改善预防性护理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Postgraduate Medical Journal 医学-医学：内科

CiteScore

8.50

自引率

2.00%

发文量

131

审稿时长

2.5 months

期刊介绍： Postgraduate Medical Journal is a peer reviewed journal published on behalf of the Fellowship of Postgraduate Medicine. The journal aims to support junior doctors and their teachers and contribute to the continuing professional development of all doctors by publishing papers on a wide range of topics relevant to the practicing clinician and teacher. Papers published in PMJ include those that focus on core competencies; that describe current practice and new developments in all branches of medicine; that describe relevance and impact of translational research on clinical practice; that provide background relevant to examinations; and papers on medical education and medical education research. PMJ supports CPD by providing the opportunity for doctors to publish many types of articles including original clinical research; reviews; quality improvement reports; editorials, and correspondence on clinical matters.