Prevalence of treated hypothyroidism in patients with chronic venous disorders: A cross-sectional analysis

Abstract

Background

Chronic venous insufficiency (CVI) Chronic venous disorders (CVD) represent highly prevalent conditions with significant impact on quality of life and healthcare systems. Thyroid hormones play a relevant role in vascular physiology and pathology but the epidemiological association between hypothyroidism and CVD has not been adequately explored. The aim of this study was to assess the prevalence of overt hypothyroidism requiring replacement therapy treated hypothyroidism in patients with CVD and to compare it with expected prevalence estimates derived from external population-based studies. That prevalence of the general population.

Methods

We conducted a retrospective, cross-sectional study cross-sectional analysis of retrospective records carried out at a tertiary referral vascular center in Italy. All patients evaluated for lower-limb varicose veins between January 2013 and December 2025 were considered. A total of 1804 patients with CVD (CEAP class ≥ C1) (CEAP class C1-C6) were included. Overt hypothyroidism Treated hypothyroidism was defined by chronic levothyroxine therapy documented in medical history. Prevalence was calculated overall and stratified by sex and age decades. Indirect age- and sex-standardization was performed using reference prevalence rates from population-based studies, and the Standardized Prevalence Ratio (SPR) with 95% confidence intervals was calculated.

Results

Among the 1804 patients (75.7% women), 129 were receiving levothyroxine, yielding an overall prevalence of overt hypothyroidism treated hypothyroidism of 7.15%. Prevalence was higher in women than in men (8.86% vs 1.83%, p < 0.001) and increased progressively with age in both sexes (p-trend <0.001). Based on indirect standardization, the expected number of cases was 79.5, resulting in an SPR of 1.62 (95% CI 1.35–1.90; p < 0.001), indicating a 62% higher prevalence compared with the general population of treated hypothyroidism in our cohort than expected based on external reference population estimates.

Conclusions

Overt hypothyroidism Treated hypothyroidism is significantly more prevalent in patients with CVI CVD than in the general population reference population, particularly among women and older individuals. These findings suggest that thyroid dysfunction represents a frequent comorbidity in CVI CVD and warrant further prospective studies to clarify its clinical and pathophysiological relevance.