Coagulation

Varicose veins may predispose to DVT


People with varicose veins appear to have an increased risk of DVT, pulmonary embolism and peripheral artery disease (PAD), according to new research.

A retrospective Taiwanese study of almost 213,000 adults with varicose veins and 213,000 without them found the incidence of DVT was more than five times higher in the group with varicose veins.

The association held for all age groups 20 to over 70 year-olds – but was highest in 20-34 year-olds and decreased with age.

“The overall HR of DVT decreased to 3.98 when the analysis was restricted to a follow-up duration of one year or more, indicating that the HR was higher within the first year after the diagnosis of varicose veins,” they said.

The incidence of pulmonary embolism and PAD were also higher among people with varicose veins (HR 1.73 and 1.72 respectively), however the researchers said potential confounders made the level of risk less clear.

Information on factors such as smoking and obesity was not available.

The study authors said there were several possible mechanisms to explain the DVT risk, including increased levels of inflammatory and prothrombotic markers in people with varicose veins.

Commenting on the study Professor Ross Baker, director of the WA Centre for Thrombosis and Haemostasis at Murdoch University, told the limbic the findings were a stimulus for further research.

“It’s interesting and the large number of cases and controls is a good thing. Some of the things we are not quite sure of in the study are what types of varicose veins they are and what is a varicose vein or not. There are a whole lot of different varieties of varicose veins.”

He said the association between varicose veins and DVT was biologically plausible.

“Certainly in people with significant varicose veins, it’s conceivable there is pooling in the leg that can predispose to thrombosis. But whether you can do anything different in practice, it is too early to know.”

He added that inflamed blood vessels or thrombophlebitis may well be a warning sign for DVT and worth seeing a doctor for assessment.

 

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