Why Are Varicose Vein Cases Increasing Worldwide? The Data Behind the Trend

Varicose veins affect approximately 20 to 25% of adults worldwide — and the numbers are growing. In South Korea, Health Insurance Review and Assessment Service (HIRA) figures counting inpatients and outpatients show patient numbers increased by 57% between 2017 and 2021, reaching about 378,000 in 2021. What is driving this trend, and what does it mean for you?

1. Aging Populations

Varicose veins are strongly age-dependent. Venous valve leaflets accumulate mechanical wear over decades, and vein walls progressively lose elasticity as the extracellular matrix degrades with age. Prevalence rises with age. In Korea's national data, patients in their 50s and 60s account for about half of all varicose vein cases (26.9% and 23.8% in 2020). As populations across East Asia, Europe, North America, and the Middle East age rapidly, the baseline pool of people at risk expands every year.

2. Sedentary and Prolonged-Standing Work Environments

Two categories of workers face elevated risk: those who stand for hours daily (nurses, teachers, chefs, retail workers, hairdressers, flight attendants) and those who sit for extended periods (office workers, programmers, drivers). Both postures impair the calf muscle pump — the primary mechanism by which venous blood is propelled upward against gravity. The global shift toward service-sector and desk-based employment means a larger proportion of working-age adults spend their days in postures that place more load on the leg veins.

3. Rising Obesity Rates

Increased body weight raises hydrostatic pressure on leg veins directly (through increased gravitational load) and indirectly (through elevated intra-abdominal pressure that impedes venous return). Global obesity rates have roughly tripled since 1975 according to WHO data.

4. Female Hormonal Factors

Women develop varicose veins more often than men. Estrogen and progesterone relax vascular smooth muscle, reducing the structural resistance of vein walls to distension. Every pregnancy adds cumulative risk through increased blood volume, uterine compression of pelvic veins, and hormonal changes. As women increasingly delay childbearing to older ages — when baseline venous elasticity has already declined — the female-predominant burden of varicose vein disease continues to grow.

5. Improved Diagnosis and Awareness

Some portion of the apparent increase reflects improved detection rather than true disease increase. The wider availability of duplex ultrasound means that cases previously misattributed to "tired legs," "eczema," or "restless legs syndrome" are now being correctly identified as venous disease.

6. Genetic Predisposition in an Aging Cohort

Large genetic studies — including an 810,000-person genome-wide association study published in Nature Communications in 2022 — indicate that varicose vein susceptibility is substantially heritable. As the genetically predisposed segment of the population ages into the decade of highest incidence, caseloads may rise as well.

What This Means for You

Varicose veins are neither a niche condition nor a disease of the elderly alone. The symptoms — heavy legs, ankle swelling, skin changes, nocturnal cramps — are often attributed to other causes, so venous disease can go unrecognised for years. The same symptoms can also have non-venous causes, which is why an examination is needed to tell them apart.

If you have several of the risk factors described above — family history, older age, female sex, pregnancy history, occupational standing or sitting, or obesity — and leg symptoms that keep returning, it is reasonable to have them checked at a clinic visit, where duplex ultrasound can show whether the veins are involved.

Data sources: Korea HIRA | Korea National Health Insurance Corporation | WHO Global Health Observatory | Ahmed WU et al. Nature Communications, 2022