Haemostatic factors and risk of varicose veins and chronic venous insufficiency: Edinburgh Vein Study

Despite much research, the aetiology of venous disease is still poorly unde rstood. Since haemostatic factors are involved in the processes of fibrinol ysis and platelet aggregation, it is conceivable that such processes may be implicated in the pathology of varicose veins and chronic venous insuffici ency (CVI). The Edinburgh Vein Study examined 1566 men and women aged 18-64 years that were randomly selected from the lists of 12 general practitione rs. Each subject completed a questionnaire, underwent a comprehensive clini cal examination and had a blood sample taken for the analysis of plasma fib rinogen, tissue plasminogen activator (t-PA) and von Willebrand factor (vWF ) antigens. Subjects with trunk varicose veins and those with CVI had highe r levels of each haemostatic factor compared with those with no trunk varic es and no CVI. Although unit increases in t-PA and vWF were initially assoc iated with a significantly increased risk of CVI in men, and both factors w ith an elevated risk of trunk varices in women, multiple adjustment for age , smoking status and body mass index reduced the odds ratios to non-signifi cance. However, this does not entirely rule out the possibility of a pathog enic role for haemostatic factors in venous disease, but rather indicates t he need for further experimental and epidemiological studies. Blood Coagul Fibrinolysis 11:775-781 (C) 2000 Lippincott Williams & Wilkins.