The research team, led by investigators from Gulf Medical University in Ajman, conducted a cross-sectional survey between June 2025 and April 2026, recruiting 1,043 eligible participants through online platforms, community health groups, and public venues such as shopping malls and cafes. The sample was designed to span the entire country, with residents from Abu Dhabi, Dubai, Sharjah, Ajman, Umm Al Quwain, Ras Al Khaimah, and Fujairah all represented. Participants completed a self-administered questionnaire covering sociodemographic characteristics, lifestyle habits, and medical history, and were shown standardized clinical images to assess whether they could visually recognize varicose veins. The survey instrument was reviewed by experts in vascular surgery and community medicine for content validity and piloted among ten individuals before full deployment.

The headline finding was that 15.05 percent of surveyed adults reported having received a prior clinical diagnosis of varicose veins. This figure sits within the lower range of internationally reported prevalence estimates, which generally fall between 10 and 30 percent of adults globally, and aligns with several regional studies from the Middle East. However, the researchers are careful to emphasize that because participants were recruited through non-probability convenience sampling rather than a randomized population-based approach, the estimate reflects the study sample only and cannot be generalized to the broader UAE population. The sample also skewed toward South-East Asian nationals, who comprised 68.5 percent of respondents, exceeding government-reported estimates of their share of the UAE population.

What makes the study particularly compelling is the strength of the genetic signal. Participants who reported a positive family history of varicose veins had roughly sixteen times higher odds of having been diagnosed with the condition themselves after adjustment for other variables, making familial predisposition the single most robust independent predictor in the analysis. This finding is consistent with recent genome-wide association studies that have identified multiple susceptibility loci involved in extracellular matrix regeneration, immune signaling, vascular development, and smooth muscle function. Even participants who were unsure of their family history showed elevated odds compared to those without known familial risk, suggesting that genetic factors may be operating more broadly than many patients and clinicians realize.

Beyond genetics, the study identified several modifiable risk factors with striking effect sizes. Participants who reported standing for more than six hours daily had nearly seven times higher adjusted odds of varicose veins compared to those standing less than two hours. The biological mechanism is well understood: prolonged standing elevates venous hydrostatic pressure in the lower limbs, placing sustained stress on the one-way valves that normally prevent blood from pooling. Over time, this pressure can cause valvular incompetence, venous reflux, and progressive structural changes in the vein wall. The finding is particularly relevant in the UAE context, where a large expatriate workforce is concentrated in physically demanding occupations such as retail, hospitality, construction, and healthcare that involve extended periods of standing.

Obesity also emerged as a significant independent predictor, with obese participants showing more than three times higher adjusted odds of diagnosis compared to those with normal body mass index. The pathophysiology involves increased intra-abdominal pressure and elevated venous pressure in the lower limbs, both of which impede normal venous return. This is especially pertinent given that nearly 58 percent of adults in the UAE are estimated to be overweight or obese, representing a substantial at-risk population. Advancing age was another strong predictor, with participants over 45 years showing nearly six times higher adjusted odds than those under 30, reflecting age-dependent vascular changes including progressive loss of endothelial cells, inflammation, scarring of the venous wall, and thickening and stiffening of venous valves.

Several other associations provided intriguing, if preliminary, insights. Participants who reported drinking less than two liters of water per day had nearly twice the adjusted odds of varicose veins, a finding consistent with a regional case-control study in Egypt and potentially relevant given the UAE’s extreme heat and elevated dehydration risk. Self-reported low magnesium levels were also independently associated with the condition, echoing a clinical study that linked low serum magnesium to chronic venous insufficiency, possibly through mechanisms involving inflammation and destabilization of the extracellular matrix. Moderate-to-high caffeine consumption and diabetes also retained statistical significance in the multivariate model, while hypertension, high cholesterol, arthritis, hormonal diseases, and constipation lost their significance after adjustment, suggesting those associations were driven by confounding from other variables.

The study also assessed public awareness of the condition using standardized clinical images, finding that 72.5 percent of participants correctly identified varicose veins. While this suggests reasonable visual recognition among the surveyed population, the researchers note a critical gap between awareness and action. Many people perceive varicose veins as merely cosmetic and normalize early symptoms such as leg pain, heaviness, skin discoloration, itching, and muscle cramps. This awareness-to-action gap may be particularly pronounced among the UAE’s expatriate majority, who may face healthcare costs, occupational time constraints, and other structural barriers that delay seeking medical evaluation. Left untreated, varicose veins can progress to serious complications including venous ulcers, deep vein thrombosis, and chronic venous insufficiency.

The researchers acknowledge several important limitations. The cross-sectional design cannot establish causal relationships, the non-probability sampling introduces potential selection bias, and the reliance on self-reported diagnosis rather than clinical examination or Doppler ultrasound confirmation may introduce misclassification. The questionnaire, while reviewed for content validity by three experts, did not undergo formal psychometric validation. Additionally, older adults have had longer exposure time to receive a diagnosis, which may partly inflate the observed age association, and self-reported family history may reflect greater awareness and diagnostic vigilance within affected families rather than pure genetic risk.

Despite these caveats, the study represents a meaningful first step in understanding venous health in a population that has been largely invisible to epidemiological research. The UAE’s unique combination of a predominantly expatriate demographic, extreme environmental temperatures, rising obesity rates, and a workforce concentrated in both physically demanding and sedentary occupations creates a distinctive context for chronic venous disease. The authors call for clinically validated, probability-based population studies to confirm these preliminary findings and for targeted early diagnosis among high-risk individuals. In the meantime, the message for residents is clear: varicose veins are not just a cosmetic issue but a treatable medical condition, and those with a family history, obesity, or jobs requiring prolonged standing should be particularly vigilant about their venous health.

Subject of Research: Epidemiology of self-reported clinically diagnosed varicose veins and their associated risk factors among adults in the United Arab Emirates

Article Title: A survey of self-reported varicose veins with prior clinical diagnosis among adults residing in the United Arab Emirates: a cross-sectional study examining associated factors

Article References: Sevhani, R. I., Vasudevan, V., Vanjani, D. H., AP, P., Mewada, A. A., Shah, D. A., Devnani, K. D. M., Wazil, S. M., & Sreejith, A. (2026). A survey of self-reported varicose veins with prior clinical diagnosis among adults residing in the United Arab Emirates: a cross-sectional study examining associated factors. Frontiers in Epidemiology, 6, Article 1916966. https://doi.org/10.3389/fepid.2026.1916966

Image Credits: AI Generated

DOI: 10.3389/fepid.2026.1916966

Keywords: varicose veins, United Arab Emirates, chronic venous disease, cross-sectional study, family history, obesity, prolonged standing, prevalence, risk factors, public health, expatriate health, venous insufficiency