From the Guidelines
Varicose veins are primarily caused by a combination of genetic predisposition, incompetent valves, weakened vascular walls, and increased intravenous pressure. The exact pathophysiology is debated, but it is known that several factors increase the risk of developing varicose veins, including:
- Family history of venous disease
- Female sex
- Older age
- Chronically increased intra-abdominal pressure due to obesity, pregnancy, chronic constipation, or a tumor
- Prolonged standing
- Deep venous thrombosis causing damage to valves and secondary revascularization
- Arteriovenous shunting 1. The condition occurs most commonly in the legs because standing and walking increase pressure in the veins of the lower body. The fundamental issue is increased venous pressure that stretches the vein walls over time, damaging the valves and creating a cycle of increasing pressure and further valve damage. While varicose veins often run in families, suggesting a genetic component, lifestyle factors like maintaining a healthy weight, regular exercise, avoiding prolonged standing or sitting, and elevating the legs can help prevent their development or worsening 1. It is essential to address the underlying causes and risk factors to prevent the progression of varicose veins and reduce the risk of complications.
From the Research
Causes of Varicose Veins
Varicose veins are caused by a combination of factors, including:
- Poorly functioning valves in the veins, which allow blood to pool and cause the veins to enlarge 2
- Decreased elasticity of the vein wall, which can lead to the formation of varicose veins 2
- Genetic predisposition, which can increase the risk of developing varicose veins 3, 4, 5
- Hyperestrogenemic states, such as those that occur during pregnancy, which can increase the risk of varicose veins 3
- Standing vocations, which can increase the risk of varicose veins due to increased pressure on the veins 3
- Obesity, which can increase the risk of varicose veins due to increased pressure on the veins 2, 6, 5
- Height, which has been identified as a new candidate risk factor for varicose veins, with taller individuals being at increased risk 6, 5
- Family history, which can increase the risk of varicose veins due to genetic factors 6
Risk Factors
The following are some of the risk factors that have been identified for varicose veins:
- Age, with older individuals being at increased risk 5
- Sex, with women being at increased risk due to hormonal factors 2, 5
- Pregnancy, which can increase the risk of varicose veins due to increased pressure on the veins 2, 5
- History of deep vein thrombosis, which can increase the risk of varicose veins 5
- Lifestyle factors, such as diet and exercise, which can affect the risk of varicose veins, although the evidence is not consistent 6