Veins return blood from the rest of your body to your heart, so the blood can be recirculated. To return blood to your heart, the veins in your legs have to work against gravity. If it doesn’t it leads to a condition called Varicose Veins. This is caused by weakened valves (incompetent valves) within the veins that allow blood to pool in your veins instead of moving to your heart.
Studies indicate that nearly 31 percent of the Middle East population is susceptible to varicose veins. Globally the prevalence is found to be between 10 to 30 percent with higher prevalence in developed countries.
“While varicose veins are twisted, enlarged veins, any superficial vein may become varicosed, but the veins most commonly affected are those in the legs. That's because standing and walking upright gives more pressure in the veins of your lower body,” stated Dr. Nihar Ranjan Pradhan, Senior Consultant, Vascular & Endovascular Surgeon, Apollo Hospitals, Hyderabad.
The incidence and prevalence of varicose veins is higher in patients with prior history of venous disease and/or family history of venous disease. Women tend to be more affected than men. Multiple pregnancies, OCP use, hormonal changes brought about by pregnancy, and menopause are additional risk factors in the female population. The incidence of the condition also increases with getting old. People over 45 years of age are seen to suffer most from this condition.
Most patients with varicose veins are existing in the 4th or 5th decade although the genesis of the disease begins from childhood. Varicosities remain to worsen and recruit new areas of involvement all through life and thus normally present in advanced stages by the time symptoms develop.
“Lifestyle choices as standing or sitting for long time, inactivity, leg injury, repeated strain in the abdominal region from heavy lifting or constipation etc. are the major elements that cause varicose veins.Obesity can also cause varicose veins to develop. Lifting more pounds gives pressure on your veins. Obese people may not realize they have varicose veins if the veins are not visible due to excess fat. If unseen, varicose veins go untreated, can lead to more serious health problems, such as leg ulcers. Some of the common symptoms to look out for inclusive of leg heaviness, exercise intolerance, pain or tenderness along a vein, pruritis or itching, burning sensations, restless legs, edema or swelling of the ankle and leg, skin changes and paresthesias or abnormal sensations,” stated Dr Pradhan.
As with any medical condition, varicose veins are simpler to protect than to treat. Therefore retaining a healthy lifestyle and regular exercise is a major step to prevention. Maintaining a low threshold to get evaluated for suspicious visibly dilated veins helps to treat as soon and prevent irreversible changes to the micro-circulation, skin and subcutaneous tissue.
Mortality related with varicose veins is almost completely due to the condition being related with Venous Thromboembolism, which has nearly 5 times greater risk. Patients with varicose veins and important venous reflux are at high risk to progression to chronic venous leg ulcers which can be challenging to treat successfully. Treatment in the early stages with medical therapy along with compression therapy or Endovascular treatment (EVLT, RFA) or (rarely) Open Surgery is most suggested for better results.
With well-timed and appropriate treatment, broad majority of patients have a good outcome and can go on to live a normal life.