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Approximately 25% of U.S. adults have varicose veins, which are thought to be relatively benign. In this retrospective cohort study, researchers in Taiwan explored associations of varicose veins with other vascular diseases, using linked national databases to identify about 212,000 adults (mean age, 55; 69% women) with varicose veins who were propensity matched to the same number of controls without varicose veins.
During follow-up of 7 to 8 years, the incidence of deep venous thrombosis in varicose vein patients was 6.55 per 1000 person-years compared with 1.23 per 1000 person-years in the control group — nearly a fivefold relative increase. The corresponding incidence rates were 0.48 vs. 0.28 for pulmonary embolism and 10.73 and 6.22 for peripheral artery disease.
Chang SL et al. Association of varicose veins with incident venous thromboembolism and peripheral artery disease. JAMA 2018 Feb 27; 319:807. (https://doi.org/10.1001/jama.2018.0246)
Comment
This retrospective study design cannot be controlled for all confounders, but the DVT association was least likely to reflect confounding, according to additional analysis by the authors. The associations of varicose veins with both arterial disease and thrombotic venous disease suggest that underlying inflammatory and prothrombotic mechanisms might explain these findings. Although the results have no immediate clinical implications, they raise the question of whether varicose veins should be considered a risk factor for deep venous thrombosis.