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Aim: Obesity is of importance among the risk factors predisposing for chronic venous disorders (CVD). Little is known how obesity affects the management of CVD. As the data concerning the treatments of CVD in the obese are incomplete, we performed an analysis of the different CVD therapies managements with respect to body mass index and the obesity., Methods: We analyzed 9797 CVD patients from of a previous large national CVD survey, in regard to their Body Mass Index (BMI), CVD class and CVD therapies. Among them 2213 patients presented class I, 516 class II or morbid obesity., Results: BMI was significantly associated with the method of CVD therapy. Logistic regression showed that venoactive drugs are preferentially used except in class I obesity patients but also when therapy is managed by general practitioner. Logistic regression analysis showed that class II and morbid obesity is associated with more frequent prevalence of previous surgical procedures related to CVD (OR=2.62 with 95% confidence interval of [2.16-3.17]) and topical agent use, (OR=1.77, [1.38-2.25]) but with a significant decreased compliance with compression therapy (OR=0.74, [0.61 - 0.89]), regardless of the clinical course of the disease, and socio-demographic factors. While class I obesity increased the adherence with VADs., Conclusion: The therapy of CVD is affected by body mass index. Class II and morbid obese CVD patients are less frequently compliant with compression therapy but are willing to accept surgical procedures and the use of topical agents.

Aim: The aim of this study was to evaluate the factors that limit the use of venoactive drugs (VADs), especially in patient with chronic venous disorders (CVD) noncompliant with compression therapy in a nationwide survey., Methods: Analysis included 5134 CVD patients compliant with compression therapy and 4663 of those not accepting such method of therapy, participating in a large survey., Results: Venoactive drugs (VADs) and topical agents were used significantly less frequently by patients noncompliant with compression therapy compared to the compliant population (95.2% vs. 97.7%, P<0.001 and 70.1% vs. 79.9%, P<0.001, respectively). There were also less patients on two VADs concurrently in these subgroups (14.6% vs. 24.6%, P<0.001 respectively). Logistic regression analysis confirmed that noncompliant also have decreased adherence to Ruscus aculeatus extracts (OR=0.870), micronized purified flavonoid fraction (MPFF) preparations (OR=0.886), and topical agents (OR=0.877), but not horse chestnuts seed extracts. Coexisting obesity and other chronic illnesses were among the factors that decreased the use of Ruscus aculeatus extracts and micronized purified flavonoid fraction (MPFF) preparations. The use of topical agents was reduced with age, male sex, patients with coexisting chronic illnesses, obesity and adverse to accepting compression therapy. Additionally diuretics, antiplatelet agents and low-molecular weight heparins were less frequently used in the noncompliant population., Conclusions: Patients who are not compliant with compression therapy are more frequently not adherent to pharmacological therapy. Coexisting obesity and other chronic illnesses demonstrate decrease in adherence to CVD pharmacotherapy.