What Causes Varicose Veins ?

What Causes Varicose Veins ?

Patients frequently ask “what causes varicose veins?”  The simple answer: Dysfunction of the tiny valves in the legs that are designed to allow blood to proceed upwards to the heart. The evolution of these valves in mammals prevented pooling of blood in the legs as primates began walking upright. Through centuries of natural selection, modern man is now born with hundreds of these “check” valves scattered throughout the deep and superficial veins of their legs.

Valves have two very thin, cup-like membranes that collapse when pushed open by blood moving upward, but balloon open shutting against each other when gravity tries to pull blood back down and away from the heart. Valves are most important when we stand or sit because when we walk or run, the leg muscles squeeze the veins propelling the blood rapidly through the valves to the heart. That is why people whose jobs require standing or prolonged sitting tend to have more stress on their valves and are likely to get varicosities.

Valves constantly exposed to the stressful efforts of gravity dilate, pull the fragile valve tissues apart, and allow blood to leak backward down the vein to the next effective check valve that eventually is overcome by the same forces (domino affect), until the entire length of vein to the ankle is incompetent. Since vein valves cannot be replaced or repaired when symptoms develop, the incompetent vein must be removed surgically or closed by minimally invasive procedures. Most varicose veins are superficial and can be closed without affecting the return blood to the heart from the legs.

Genetics play an important role in who gets varicose veins. Some are born with either fewer or weaker valves. For others, the collagen tissue that makes up the structure of venous valves appears to be stronger and more elastic. These individuals are better able to withstand the effects of gravity, pregnancy, and incidental trauma.

Tips to delay or prevent the onset of varicose veins:

Exercise and strengthen leg muscles

Keep weight down

Wear support stockings

Elevate legs when possible

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