Clinical Manifestations and Etiological Factors of Chronic Venous Disease: A Multicenter Cross-Sectional Study in Bangladesh

Abstract

Background: Chronic venous disease (CVD) is a progressive condition with a wide range of presentations, from asymptomatic telangiectasias to active venous ulcers. Despite its significant burden, limited multicenter data exist on the clinical manifestations and risk factors of this condition in Bangladesh. The study aims to evaluate the clinical profiles, etiological factors, and complication patterns of CVD using the CEAP classification system among Bangladeshi patients. Methods: A multicenter cross-sectional study was conducted at the National Institute of Cardiovascular Diseases and selected private vascular clinics. A total of 470 participants aged ≥18 years with suspected CVD were consecutively recruited. Data on demographics, occupational factors, symptoms, and risk factors were collected using structured questionnaires and physical examinations. Duplex ultrasonography confirmed diagnoses. Disease severity was categorized using the CEAP classification, and logistic regression identified predictors of advanced disease (C3–C6). Results: The mean age was 45.2 ± 12.7 years; 53.6% were male. The most common CEAP stage was C2 (varicose veins, 35.1%), followed by C3 (edema, 16.8%) and C6 (active venous ulcer, 9.6%). Early stages (C0–C1) accounted for 18.1%. Leg pain (62.8%) and heaviness (59.8%) were predominant symptoms, while edema (34.0%) and venous ulcers (16.6%) reflected advanced disease. Key risk factors included prolonged standing (39.4%), age ≥50 years (42.1%), female sex (46.4%), obesity (23.8%), family history (25.7%), and low socioeconomic status (30.4%). Complication rates increased progressively from 3.6% in C0 to 77.8% in C6 (p < 0.001). Obesity and prolonged standing were significantly associated with severe disease. Conclusion: CVD in Bangladesh most frequently presents with varicose veins, with many patients progressing to ulcerative stages. Occupational and lifestyle risk factors strongly influence disease progression, highlighting the need for early screening, preventive strategies, and targeted interventions for high-risk groups.