Venous Insufficiency and Varicose Veins: Overview and Risk Factors

Chronic venous insufficiency is a common medical problem, with symptoms ranging from mildly unsightly veins to recurrent skin infections and ulcers that require hospitalization. An estimated 25 percent of the U.S. adult population has some degree of varicose veins and up to 5 percent have advanced disease.

The venous system of the lower extremities is composed of deep veins that lie within the muscular compartments and superficial veins that lie closer to the skin.  Venous insufficiency is a disorder of the deep veins, whereas varicose veins are a disorder of the superficial veins.

Although the underlying cause is not yet fully understood, genetic, hormonal, and environmental factors have been assumed to play a role.

Most cases of varicose veins cause no symptoms. However, they can cause swelling, aching, tension, leg fatigue, burning, and itching, which are relieved upon lying down or elevating the legs. As the disease progresses, skin discoloration occurs. In severe cases, recurrent skin infections and ulcers can develop, which may be life–threatening.

Risk Factors

The following factors are associated with increased risk of venous disorders:

• Family history: There is as much as a 90 percent risk of developing varicose veins if both parents have varicose veins, but less than a 20 percent risk if neither parent is affected.
  
• Female gender: Varicose veins occur up to twice as often in women, compared with men.
  
• Increasing height
  
• Increasing age
• History of leg injury
• Lifestyle factors: Obesity, prolonged standing, sedentary lifestyle, and pregnancy are believed to contribute to varicose veins.