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Varicose veins associated with raised risk of developing DVT

But association may be down to common set of risk factors, rather than causal link

Louise Prime

Thursday, 01 March 2018

People diagnosed with varicose veins have a significantly increased risk of incident deep venous thrombosis (DVT), although it is not clear whether or not the association is causal or just results from the two conditions having a common set of risk factors, researchers have reported* in JAMA. They also found a possible link between DVT and the risk of pulmonary embolism (PE), and peripheral artery disease (PAD), but said this might be explained by possible confounding factors.

Researchers in Taiwan conducted a retrospective cohort study using claims data from Taiwan’s National Health Insurance programme. They enrolled 212,984 patients who were aged 20 years and older with varicose veins between 1 January 2001 and 31 December 2013, and matched them with a control group of 212,984 patients without varicose veins; patients previously diagnosed with DVT, PE, and PAD were excluded. They then compared incidence rates of DVT, PE, and PAD in people with and without varicose veins, and estimated relative hazards.

They reported that people with varicose veins group had higher incidence rates than the control group for DVT (6.55 vs 1.23 per 1000 person-years); for PE (0.48 vs 0.28 per 1000 person-years); and for PAD (10.73 vs 6.22 per 1000 person-years). They calculated that hazard ratios for the varicose veins group compared with the control group were 5.30 for DVT, 1.73 for PE, and 1.72 for PAD. They noted that their findings regarding potential associations between varicose veins and risk of PE and PAD were less clear, because of possible confounding factors.

The study authors concluded: “Among adults diagnosed with varicose veins, there was a significantly increased risk of incident DVT... Whether the association between varicose veins and DVT is causal or represents a common set of risk factors requires further research.”

*Chang S, Huang Y, Lee M, et al. Association of varicose veins with incident venous thromboembolism and peripheral artery disease. JAMA 2018; 319(8): 807–817. doi:10.1001/jama.2018.0246

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