So, you’ve decided to stick with Chicagoland Vein Blog on this journey to explore the strange and interesting world of vein disease. I thank you.
I’m blogging from Vein Blog Central, our modern, comfortable office space located in Northbrook…conveniently located…ironically for a “vein” clinic…between the two main North Shore “arteries” of the Edens Expressway and I-294. Dr. Dave is here to guide you through the tortuous, labyrinthine world of varicose veins.
Speaking of tortuous…why are varicose veins all tortuous, serpiginous, bulgy and twisty? Where do they come from? Who gets them? What can be done about them? All these questions can and will be answered but the road to the answer will be, appropriately, full of twists and turns. Today we will focus on the epidemiology of venous disease.
Who Gets Varicose Veins?
If you have them, you are certainly not alone. More than 80 million Americans suffer from some form of venous disorder. 25% of women and 15% of men suffer from symptomatic varicose veins. Up to 55% of American women may be affected by vein disease during their lifetime. The same can be said for about 25% of men.
Some of the most current data available stems from the San Diego Population Study which enrolled over 2,000 patients and was carried out between 1994-1998. Here is some data you may find interesting:
1. Age: Patients who are 70-79 have twice the prevalence of venous disease vs those aged 40-49 and 4 times the prevalence of significant skin changes associated with chronic disease. However, we often see patients in their 20’s and 30’s with significant superficial venous disease. So, clearly, other factors than age must be at work.
2. Family history: This can be a factor in over 80% of patients with varicose veins…so choose your parents wisely!
3. Long periods of standing/sitting…a higher number of hours correlates with a higher incidence of chronic venous disease. Obviously, certain careers require more standing then others…waitress, teacher,bank teller,barrista… to name a few…and these fields have a higher number of members who develop chronic venous disease.
3. Hormonal factors: during puberty,pregnancy,use of birth control pills, menopause
• The higher the number of pregnancies the worse venous disease; it can be worse with each successive pregnancy. Another thing to thank your thankless kids for.
• The longer the duration of Hormone Repalcement Therapy, the worse the associated venous disease
4. Decreased exercise is associated with worse venous disease. Unfortunately this sets up a “vicious circle” for many of our patients. Varicose veins often cause tired and painful legs. This leads people to want to give up exercising and become sedentary…which leads to worsening of the venous disease. Many patients find themselves able to resume exercise regimens once their veins have been treated.
5. Previous injuries to the lower extremities can ultimately lead to the development of diseased superficial veins.
6. Previous clots, either superficial or deep within the venous system of the lower extremities. Another “vicious circle”! If you’ve had a clot you can develop varicose veins, which can ultimately be a risk factor for developing clots. It’s time to break the circle and decrease your chances of developing deep and superficial clots. Clots are potentially “game-changing” medical problems. And when I say game-changing I really mean life-threatening. Clots=Bad.
Interestingly enough, patients with coronary artery disease risk factors (hypertension, history of angina or of having coronary angioplasty) had a decreased rate of venous disease! Experts are unsure of the reason why, but have guessed that venous vasoconstriction may lead to decreased venous pooling in the lower extremities. In fact, new medications on the horizon such as Daflon may exploit the property of venoconstriction to our patients’ advantage. More about treatments later!
So, the take-home points for today regarding the epidemiology of venous disease is that it’s mainly related to how well you chose your parents (genetic factors) along with hormonal factors (progesterone makes vein walls stretchy…so pregnancy, menstrual periods can make them worse), work environments (standing/sitting for hours at a time), exercise regimens (lack thereof) and previous trauma to veins.
Up next…Varicose Veins 102: Venous Anatomy and Physiology.