What causes varicose veins?

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 valvular dysfunction, often due to a loss of elasticity in the vein wall, plays a crucial role in the development of varicose veins 1. Several factors increase the risk of developing varicose veins, including:

• Genetics
• Age
• Gender (women are more prone due to hormonal factors)
• Pregnancy
• Obesity
• Prolonged standing or sitting The condition occurs most commonly in the legs because standing and walking increase pressure in the veins of the lower body 1.

Key Factors

The basic mechanism involves increased venous pressure that stretches the vein walls over time, damaging the valves and creating a cycle of increasing pressure and further valve damage. Shear stress on venous endothelial cells due to reversed or turbulent blood flow and inflammation are also important etiologic factors for venous disease 1.

Prevention and Management

While varicose veins are often cosmetic concerns, they can sometimes cause discomfort, aching, or more serious complications. Prevention strategies include regular exercise to improve circulation, maintaining a healthy weight, avoiding prolonged standing or sitting, elevating the legs when resting, and wearing compression stockings if at risk 1.

From the Research

Causes of Varicose Veins

• Varicose veins are caused by poorly functioning valves in the veins and decreased elasticity of the vein wall, allowing pooling of blood within the veins and their subsequent enlargement 2, 3.
• The exact pathophysiology is debated, but it involves a genetic predisposition, incompetent valves, weakened vascular walls, and increased intravenous pressure 4.
• Risk factors for varicose veins include:
  • Chronic cough
  • Constipation
  • Family history of venous disease
  • Female sex
  • Obesity
  • Older age
  • Pregnancy
  • Prolonged standing 4, 5
• Prolonged standing and obesity are considered major reasons for varicose vein disease 5.
• Varicose veins can be caused by inefficient or defective valves within the vein, leading to abnormally twisted, lengthened, or dilated superficial vessels 6.

Pathophysiology

• The mechanisms of varicose veins involve a combination of genetic predisposition, incompetent valves, weakened vascular walls, and increased intravenous pressure 4.
• The decreased elasticity of the vein wall and poorly functioning valves allow blood to pool within the veins, leading to their enlargement 2, 3.
• Varicose veins can lead to complications such as infection, leg ulcers, stasis changes, and thrombosis 4.