Varicose Veins – Are Varicose Veins Genetic?

Nebula Genomics DNA Report for Varicose Veins

Are varicose veins genetic? We created a DNA report based on a study that attempted to answer this question. Below you can see a SAMPLE DNA report. To get your personalized DNA report, purchase our Whole Genome Sequencing!

What are Varicose Veins?

Varicose veins are swollen, enlarged, and twisted veins. They are part of a spectrum of chronic venous diseases. Although any vein close to the skin can become varicosed, they typically occur in the legs that incur more pressure than other parts of the body from standing and walking and can appear blue or purple. 

Varicose veins have one way valves. This causes blood to pool, leading to swelling, discomfort, and aching in the legs. The condition can also cause skin changes such as itching, discoloration, and ulcers.

Spider veins are a mild form of the condition. Varicose veins and spider veins are  typically not a severe medical condition. However, they can be unsightly and sometimes cause discomfort. 

Doctors often treat them with lifestyle changes such as exercise and weight loss. However, in some cases, they can lead to more severe complications of varicose veins, such as venous ulcers or deep vein thrombosis.

Those at higher risk for varicose veins can help prevent them through some mild lifestyle changes such as keeping a healthy weight, exercising regularly, and putting their feet up while sitting.

Are Varicose Veins Genetic?

Varicose veins can have a genetic component, but lifestyle and medical conditions also play a role. It is well established that the condition is hereditary. That is, experts note that if a parent has varicose veins, there is a higher likelihood that their children will develop them as well. 

Lifestyle factors such as standing or sitting for long periods of time, obesity, and lack of exercise can lead to a higher risk of developing the condition. Other medical conditions, such as deep vein thrombosis and pregnancy, can also contribute to its development. 

Research on the genetic components of varicose veins is ongoing, and the genes associated with the condition still need to be fully understood. However, some studies have identified a few genetic variations that may play a role in varicose vein development.

FOXC2: The FOXC2 gene is important for the normal development and maintenance of venous and lymphatic valves.

COL3A1: This gene produces collagen, a vital component of the walls of the veins. A genetic alteration in this gene causes vascular Ehlers Danlos syndrome (EDS). Patients with this condition often have early onset forms that can be severe.

HIF1A: This gene encodes a transcription factor that regulates the response to hypoxia, or low oxygen levels. Hypoxia has been suggested to play a role in developing varicose veins. Studies have shown that patients have increased expression of this and related genes.

MMP gene family: Matrix metalloproteinases (MMPs) are enzymes involved in the breakdown of extracellular matrix proteins, essential for blood vessels’ structural integrity. Studies show that specific MMP genes may be involved in developing varicose veins.

Epidemiology

An older study suggested that about half of the worldwide adult population may have some form of vein disease, but fewer than half will have visible forms of the condition. The study states that it is more common in women than men, indicating that women are up to three times more likely to develop varicose veins than men.

A more recent publication in the journal Circulation states that approximately 23% of adults in the United States have the condition. Once again, it was found to be more common in women and older adults.

Symptoms

Experts typically characterize varicose veins as enlarged, twisted veins visible beneath the skin’s surface. They often appear as dark purple or blue cords on the legs. The condition is usually not painful. Symptoms can include sensations of an aching or throbbing pain in the legs or their legs may feel heavy or tired, especially after sitting or standing for long periods.

Other patients may experience less common symptoms of varicose veins including itching, burning, or changes in skin color around the affected area.

If serious, the affected leg may become swollen, especially around the ankle and foot.

Serious cases can lead to long-term complications that include painful ulcers near the affected site, blood clots (observed through leg pain and swelling), and bleeding. People who suspect any of these symptoms should see a health professional immediately.

A similar condition is chronic venous insufficiency (CVI). This occurs when blood pools in the superficial and deep leg veins. CVI can occur with or without the presence of varicose veins.

Causes

Varicose veins occur when weak or damaged vein walls near the skin’s surface cause blood to pool and flow in the wrong direction. This leads to increased blood pressure which encourages the veins to enlarge and twist. 

Having a family history of the condition is the greatest risk factor for developing varicose veins. Some people inherit venous problems they are unaware of, such as having too few valves or valves that do not function as they should. Another example is having abnormalities in the vein wall. The resulting weakness may predispose the valves to misfunction, raising the risk of varicose veins.

Other risk factors that encourage added pressure to the veins are older age, being female, changes in hormone levels, and being overweight.

Standing or sitting for long periods can also restrict blood flow and put pressure on the veins. A case control study of risk factors published in 2018 found that reflux in deep veins, history of leg injury, history of post thrombotic syndrome, and physical inactivity were significant risk factors for venous ulceration in patients with varicose veins.

Pregnant women may also experience the condition when the body produces more blood to support the growing fetus. This can put extra pressure on the veins in the legs. Hormonal changes during pregnancy may also contribute to its development.

In addition to those that occur during pregnancy, hormonal changes that occur during menopause or when taking birth control pills may increase the risk.

Additionally, the risk of developing varicose veins increases in those that smoke or have a history of deep vein thrombosis (DVT).

Diagnosis

Doctors diagnose varicose veins with a physical examination. During the examination, the healthcare professional will examine the affected area and may ask the patient to describe symptoms.

In some cases, imaging may be necessary to confirm the diagnosis. A primary care doctor may refer the patient to a vein center or vein specialist.

In this case, healthcare professionals use a special type of ultrasound called a venous Doppler ultrasound. This non-invasive test uses sound waves to create images of the veins in the legs, allowing healthcare professionals to identify abnormalities in blood flow.

Treatment

Treating varicose veins depends on the severity of the condition and the symptoms experienced. Doctors often recommned conservative measures such as lifestyle changes to start. They may also recommend that patients wear compression stockings to prevent blood pooling.

However, if the symptoms are severe or there are complications such as skin changes or ulcers, more invasive treatment options may be necessary.

Lifestyle changes

Lifestyle changes in daily activity such as maintaining a healthy weight, exercising regularly, and avoiding prolonged periods of sitting or standing can help improve symptoms of varicose veins. Doctors may also recommend compression stockings to help improve blood flow in the legs and reduce swelling and discomfort.

Procedures

Sclerotherapy is a common and minimally invasive treatment for varicose veins. It involves injecting a salt solution into the affected veins, causing them to collapse and eventually fade away. It is the most commonly recommended route after lifestyle changes. 

A doctor may use laser treatments, which may or may not be invasive. The least invasive type is endovenous laser treatment (EVLT), which involves using a laser to close off the affected veins, redirecting blood flow to healthy ones. On the other hand, thermal ablation involves inserting a tiny fiber through a catheter into the affected vein and using laser energy to destroy it. 

In the most serious cases, a surgeon may perform vein ligation or stripping, which involves removing the affected vein through a small incision, redirecting blood flow to healthy ones. These surgerys are usually outpatient procedures in which the patients go home the same day.

In some cases, combining these treatments may provide optimal relief of symptoms. The choice of treatment will depend on the severity and location of the affected veins and the individual’s overall health.

If you liked this article, you should check out our other posts in the Nebula Research Library!

November 24, 2023