Many people assume that being in great physical shape will keep you from developing varicose veins, however, this is not the case. While an active, healthy lifestyle might ease the severity of varicose veins, or lessen their symptoms, physical condition alone cannot prevent the onset of varicose veins.
Hereditability Study of Varicose Veins
Kohno, Niihara, Li X, Hamano, Nabika, Shiwaku, Isomura, Morita, Sundquist, and Zöller queried into this topic utilizing data across several generations. Participants with a biological parent afflicted with varicose veins had a significantly greater risk of developing varicose veins, in contrast to participants whose parents did not have varicose veins (standard incidence ratio 2.2; 95% CI, 1.9-2.6).
Speculations as to the root cause of varicose veins typically included work related standing or sitting for prolonged durations, or sitting with legs crossed. However, the study by Kohno and his associates indicates a hereditary component to causation. 
Specifically, one gene known as Fork Head gene domain, or FOXC2 (located on chromosome 16), has been identified in connection with venous valve failure in the extremities. It is important to note that varicose veins are caused by failure of the one-way venous valves, which causes blood to pool and swell the veins.
While environmental and occupational factors also link to causation of varicose veins, these hereditary findings are significant in that they show promise for predictability of varicose veins, as well as the potential for gene therapies related to varicose veins.
The inherited FOX C2 gene mutation, located on the 16th chromosome, is indicated by a red line below after q24.1 
The Fox C2 gene mutation is located on the 16th chromosome in a location whose role is to relay instructions for transfer RN’ase to distribute a micro-filamentous protein called Actin. Filamentous Actin, a.k.a. F Actin, is necessary for the structural strength and integrity of venous walls and valves.
Those individuals with the Fox C2 mutation may begin showing signs of varicose veins as early as their adolescent years, whereas those whose varicose veins resulting from external factors tend to see symptoms later in life.
Non-hereditary factors linked to the onset of varicose veins include obesity, pregnancy, smoking, prolonged standing or sitting. Symptoms include throbbing, constant pain, swelling, and weakened skin at the site of varicose veins.
Regardless of whether your varicose veins stem from hereditary or non-hereditary factors, it is a known constant that once varicose veins become visible, they will continue to degrade and worsen with time
At the San Diego Vascular Center, our team of board certified vascular surgeons specializes in providing the best minimally invasive, nonsurgical treatment options to patients who wish to have their unsightly varicose and spider vein treated. These procedures are performed in our state-of-the-art outpatient facility and include VNUS closure (Venefit™), EVLA (VenaCure®), sclerotherapy, foam sclerotherapy, and laser spider vein treatment.
The procedures are fast and virtually painless, with minimal downtime. Most patients can return to work within a day.
- Linkage to the Fox C2 region of chromosome 16 for varicose veins in otherwise healthy, unselected sibling pairs.
Ng MY, Andrew T, Spector TD et al. Lymphedema Consortium. Twin research and Genetic epidemiology Unit St Thomas’ Hospital, London ,SE17EH. J Med Genet 2005 Mar: 42:235-9
- Familial Transmission of Hospital-Treated Varicose Veins in Adoptees: A Swedish Family Study. J Am Coll Surg. 2016; 223(3):452-60
- Kohno K; Niihara H; Li X; Hamano T; Nabika T; Shiwaku K; Isomura M; Morita E; Sundquist K; Zöller B