Magnitude of the Problem
Chronic venous disease has a considerable socio-economic impact with resulting work absenteeism and disability.
General Vein Information
Magnitude of the Problem
Studies have shown that chronic venous disease has a considerable socio-economic impact in western countries due to high prevalence, cost of investigations and treatment, and loss of working days. Varicose veins are present in 25-33% of female and 10-40 % of male adults.
The prevalence of leg swelling (edema) and skin changes, such as hyperpigmentation and eczema due to chronic venous disease varies from 3% to 11% of the population.
Venous ulcers occur in about 0.3% of the adult population in western countries. The prevalence of active and healed ulcers is about 1%. Healing of venous ulcers may be delayed in patients of low social class and those who are single. More than 20% of venous ulcers require therapy for more than one year.
Chronic venous disease is the 14th most frequent quoted disease for temporary work absenteeism and the 32nd most frequent disability and public financial assistance
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Varicose and Spider Veins
Possible Complications if Not Treated
With large varicose veins, spontaneous blood clots may develop in the superficial veins and, more rarely, in the deep veins. Clots in the deep veins (deep vein thrombosis or DVT) can dislodge and travel to the lungs, which can cause pulmonary embolism – a life threatening condition.
Skin changes, including increased or decreased pigmentation, hardening of the skin, underlying fat (lipodermatosclerosis), and ulcers, may develop in the lower legs. Ulcers may become weepy, infected and painful, and take longer to heal.
Spider veins may indicate an underlying vein disease, but otherwise are mainly a cosmetic concern.
The Causes
Some predisposing factors include ageing, standing occupations, and leg injury or trauma. Heredity is the No 1 contributing factor that causes varicose and spider veins. Up to 55% of South African women may be affected in their lifetime. Hormonal factors seen during puberty, pregnancy, menopause, and the use of birth control pills, affect the disease. It is common for varicose veins to become more prominent during pregnancy, and worsen with successive pregnancies.
Chronic Venous Insufficiency (CVI) is caused by long-term blood pressure, in the leg veins, that is higher than normal. Phlebitis (inflammation of a vein) and Deep Vein Thrombosis (DVT) might lead to CVI.
Factors that can increase the risk of CVI include :
- Family history of varicose veins
- Being overweight
- Being pregnant
- Not enough exercise
- Smoking
- Standing or sitting for long periods of time
- Increased age
- Change in hormone levels
- Use of certain medications
Women over 50 years have a higher risk of developing CVI.
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