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Preventing varicose veins: No vein attempt | Philstar.com
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Health And Family

Preventing varicose veins: No vein attempt

UNDER YOUR SKIN - Grace Carole Beltran, MD - The Philippine Star

Varicose veins are definitely a cosmetic nuisance that prevents people from showing their legs because they’re afraid of being ridiculed.  But it is not just a cosmetic concern, it definitely goes beyond the aesthetic aspect that I often wonder why people overlook its presence.

Varicose veins (tortuous, twisted, or lengthened veins) are present in 15 percent of males over 18 and 30 percent of women over 18.  This common disease has been neglected because most patients have mild complaints including cosmetic embarrassment, leg aching, pruritus, skin rashes.  Most of those with varicose veins are unaware of their consequences, which is why they tend to ignore the problem.

How does a varicose vein develop?

Normal veins have one-way valves that allow blood to flow against the force of gravity back to the lungs for oxygenation.  In normal veins, flaps or “cusps” serve as one- way valves that act as gates.  This structure opens to allow the flow of blood towards the heart, they then close to prevent backflow or reflux of blood. If backflow occurs (blood falls down due to gravity), this causes a pile-up or accumulation of blood in that vein and leads to an increase in pressure, leading to vein engorgement, resulting in high pressure (venous hypertension due to accumulation of blood in the said vein, causing altered shear stress, endothelial damage, microcirculatory and tissue damage), thinned vein walls (due to stretching), and decreased muscular support (also due to stretching).  There is loss of elasticity in the vein wall and failure of the valve leaflets or cusps to fit together (failure to close properly).  Veins then can enlarge up to diameters above 10mm, leading to complications such as superficial thrombophlebitis, pigmentation, lipodermatosclerosis, ulceration, deep vein thrombosis and, worst, hemorrhage from minor trauma and death. 

What are the signs and symptoms of varicose veins?

• Aching, heavy legs (often worse at night and after exercise).

•  Appearance of spider veins in the affected leg.

•  Ankle swelling, especially at night.

• A brownish-blue shiny skin discoloration near the affected veins.

•  Redness, dryness, and itchiness of areas of skin, termed as stasis dermatitis because of waste products building up in the leg.

• Cramps especially when making a sudden move like standing up.

• Minor injuries to the area may bleed more than normal or take a long time to heal.

• In some people, the skin above the ankle may shrink (lipodermatosclerosis) because the fat underneath the skin becomes hard.

•  Restless legs syndrome appears to be a common overlapping clinical syndrome in patients with varicose veins.

•  Whitened, irregular scar-like patches can appear at the ankles, known as atrophie blanche.

What are the possible factors that can lead to the development or worsening of varicose veins? 

• Genetics.

• Age — the older an individual, the more tendency to develop varicose. Development of  venous hypertension in the elderly leads to release of chemical inflammatory mediators by various skin elements such as macrophages, fibroblasts, inflammatory reactants as TGF beta, MMP 1,2,9 overtime changes in fibroblasts morphology aged and dysfunctional cells in affected tissue contribute to inability to heal ulcers

• Gender — it is greater in women.

• Occupation (a job that requires lifting, prolonged standing, and sitting without moving).

• Weight — more common in obese patients.

• Height — the taller the person, the more difficult it is to force back blood towards the top.

• Several pregnancies, presence of tumor (increased intra-abdominal pressure).

• Lifestyle — prolonged sun exposure, smoking, intake of contracptive pills, low-fiber diet which induces constipation and increases intra-abdominal pressure

• Hormonal — puberty, menopause, pregnancy, taking birth control pills.

• White people are more prone to varicosities than blacks and Asians.

• Additional risk factors include: those with diabetes, hypertension, congestive heart failure.

• Occurrence of thrombosis and phlebitis (clot formation in the vein, causing obstruction

• Inflammation and very severe pain (of the involved vein)

• Wearing high-heeled shoes as this shortens the gastrocnemius muscle, compromising its strength in contracting and forcing blood upwards. 

Some of these factors listed are modifiable while others cannot be changed at all.  As for the thrombosis and phlebitis, there is a solution which can also modify other factors that are thought to be unalterable.

Prevention is always better than cure, so the saying goes. Treatment has been tackled several times on television and radio and in print media as well.  The latest development in varicose vein prevention involves  the use of a drug with the following characteristics:

a) Endothelial (blood vessel inner lining) protective, decreases endothelial inflammation.

b) Antithrombotic (acts on hemostasis, fibrinolysis, platelet aggregation).

c) Possesses fibrinolytic activity; reduces blood viscosity (thickness), prevents thrombus growth.

d) Decreases fibrinogen, triglyceride, very low density lipoprotein levels).

e) Improves cardiovascular disease signs and symptoms.

f) Decreases stasis (edema or manas),

g) Induces faster ulcer healing.

h) Reduces recurrent thrombotic events. 

This drug will not only prevent superficial and deep vein thrombosis but also other health problems, which include the following: vascular pathologies with thrombotic risk, transient ischaemic attacks (cerebrovascular stroke), CVA, peripheral vascular insufficiency, diabetic retinopathy (causing blindness), myocardial infarction (heart attack), retinal vassal thrombosis (causing blindness).  This drug is orally taken without any complication.

* * *

For questions or suggestions call 09174976261, 09282302825 or 4847821; e-mail gc_beltran@yahoo.com.

 

ANTITHROMBOTIC

BLOOD

HREF

LIPODERMATOSCLEROSIS

VARICOSE

VEIN

VEINS

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