Varicose veins are usually a cosmetic issue, but they can cause pain and leg fatigue in some people. It’s estimated that about 20% of women and 10% of men have varicose veins, although some studies indicate the prevalence can be even higher. Here’s what we know about how common varicose veins really are.
Bonn Vein Study
One of the largest studies on venous disease was the Bonn vein study, which was conducted by the German Society of Phlebology between 2000 and 2002. This study analysed more than 3,000 participants who filled out a questionnaire and underwent an exam that included an ultrasound scan. Participants were divided into one of seven classes ranging from C0 (no vein abnormality) to C6 (open leg ulcers).
This study found that less than 10% of study participants had normal legs with no varicose veins, spider veins, or abnormalities through the ultrasound scan. About 1 out of every 5 people had varicose eczema, ulceration, or swelling. About 1 out of every 3 had superficial venous insufficiency affecting blood circulation in the legs. 14% of people fell into the C2 category with varicose veins without any skin changes or edema, including 12% of men and 16% of women.
Edinburgh Vein Study
The Edinburgh vein study was another major study on venous disease. This study began in 1999 with invitations sent to almost 1,500 women and men to participate in the study with a 13-year follow-up exam. The Edinburgh vein study asked participants to complete a questionnaire about their medical and lifestyle history with an exam that classified venous disease.
After 13 years, participants underwent a follow-up exam and reclassification to see if they had new or progressing varicose veins or complications. Almost 50% of study participants with venous disease deteriorated by the follow-up study. Nearly one-third of people with varicose veins had some type of complication.
This study found an incidence of varicose veins of 18%. After 13 years, the incidence was about 10% of people between 18 and 34 and almost 26% of people between 55 and 64.
Age Is an Important Risk Factor
As the Edinburgh study shows, the incidence of varicose veins increases with age. While about 10% of younger adults have varicose veins, the risk increases after the age of 50 with nearly half of all seniors experiencing varicose veins. This happens because, as you get older, your veins slowly lose elasticity. This makes your veins stretch and the valves in the veins weaken. When this happens, blood that should move toward the heart flows back into the vein and blood pools in the vein.
Obesity Increases the Risk of Varicose Veins
The United Kingdom is Western Europe’s most overweight nation with an obesity rate growing faster than the United States. About 27% of people are obese and another 36% are overweight for a combined rate of 63%. Being overweight or obese is considered a major risk factor for varicose veins.
Being overweight increases pressure on the veins in the legs which causes the valves in the veins to weaken and fail. Many people who are overweight do not even realise they have varicose veins as the swollen veins are hidden from view and may be up to 5 cm below the surface. Losing weight can reduce the risk of new varicose veins but it can’t reduce the size or eliminate existing varicose veins.
Women Are More Likely to Develop Varicose Veins
Several studies, including the Edinburgh and Bonn vein studies, have found that women are at a higher risk of varicose and spider veins than women. While the cause isn’t very well understood, it may be due to the progesterone hormone. Women have much higher levels of this hormone, which helps regulate menstrual cycles, thicken the uterine lining during pregnancy, and maintain organs.
In a 2009 study, researchers found that women with varicose veins tend to have higher progesterone levels than women who do not have varicose veins. This may be because progesterone helps relax the walls of blood vessels. It’s believed that women vessel walls relax, the valves within the vessels also relax and weaken due to the pressure of blood pushing on the sides of the vessels.
Along with putting women at a higher risk of varicose veins, progesterone may also partially explain why pregnant women are at a high risk of varicose veins. In addition to higher progesterone levels relaxing blood vessels, pregnancy also causes a decrease in the rate at which your blood moves from your legs to your pelvis. Pregnant women also have a higher volume of blood which increases pressure on the vessels.
Spider veins and varicose veins are so common that they are considered a normal part of pregnancy, affecting up to half of all pregnant women. Women who are overweight or have a family history of varicose veins are most likely to develop them during pregnancy.