Varicose Vein Risk Test

How does this test work?

The test looks at nine factors whose link with varicose veins and chronic venous insufficiency is described in clinical guidance: age, sex, varicose veins in the family, number of pregnancies, daily routine (long periods of standing or sitting), body mass index, regular activity, hormone-containing medication and a previous deep vein thrombosis. The ESVS 2022 guideline on chronic venous disease lists older age, female sex, family history, pregnancy and obesity among the main risk factors for varicose veins.

Each answer scores 0–4 points; the points are added up and matched to one of three levels. The scoring is transparent and shown in the table below. A previous deep vein thrombosis adds an “assessment advised” note regardless of the score, because valve damage after a clot is assessed separately in clinic.

How are the results interpreted?

The maximum total is 19 points. The level follows the score; two people at the same level may have different factors, which is why the result card highlights factors rather than the number.

The levels summarise how predisposed you are; they do not say whether varicose veins are present. If you already have visible veins or leg symptoms, the right tool is the Vein Symptom Checker.

How is varicose vein risk calculated?

Varicose vein risk is not estimated from a single measurement but from predisposition and living conditions taken together. Heredity is one of the strongest influences: people whose parents both have varicose veins are markedly more predisposed than those with no family history. Vein walls and valves lose elasticity with age; in pregnancy, higher blood volume and hormone levels strain the leg veins. NICE guideline CG168 also notes that varicose veins are more common in women, with increasing age, in pregnancy, with obesity and in occupations that involve prolonged standing.

This test gives each factor a weight and summarises predisposition in three levels. The weights follow the ranking of risk factors in the guidelines; the result is not a precise probability and varies from person to person.

Which factors can be changed?

Age, sex, family history and past pregnancies cannot be changed, but weight, activity, long periods of standing or sitting and the habit of taking breaks can. Walking for 30 minutes on at least 3 days a week works the calf muscles and helps blood return to the heart. In jobs that involve long periods of standing, a short walk and ankle movements every 30–60 minutes keep the calf pump working. If you take hormone-containing medication, stopping it is a decision for your doctor, not for you; the test simply notes that the factor is present.

How is body mass index linked with varicose veins?

Body mass index (BMI) is weight divided by height squared; in the WHO classification, 25–29.9 is overweight and 30 or above is obesity. Excess weight raises the pressure in the leg veins and strains the valves, which is why the test gives BMI 0–2 points. NICE’s 2025 weight management guideline (NG246) recommends keeping your waist measurement to less than half your height, that is a waist-to-height ratio below 0.5; if you enter your waist, the result card shows this ratio too.

One caution: in lipoedema, fat tissue in the legs can push BMI up misleadingly. If the hips and legs are disproportionately wide compared with the trunk and the feet are spared, BMI alone is not a useful measure; the Lipoedema or Lymphoedema? Test is more appropriate.

Why does pregnancy raise the risk of varicose veins?

In pregnancy, blood volume increases, progesterone relaxes the vein wall and the growing womb presses on the large vein in the abdomen; all three raise the pressure in the leg veins. Each pregnancy renews that load, which is why the test gives 0–2 points for the number of pregnancies. Some varicose veins that appear in pregnancy recede in the months after birth; those that remain are assessed afterwards. Compression stockings and leg elevation during pregnancy can be discussed with your doctor.

Does standing at work increase the risk of varicose veins?

Standing for more than 4 hours a day with little movement switches off the calf muscle pump and lets blood pool in the leg veins, which is why the test gives this routine 2 points. Long periods of sitting have a similar but milder effect (1 point). What matters is not the hours so much as the lack of movement: even while standing, shifting your weight, pumping the ankles and short walking breaks reduce the load. There is more on this in Does Standing for Long Hours at Work Increase the Risk of Varicose Veins?

When should you see a doctor?

Whatever your risk level, a planned vascular surgery consultation is sensible if you have visible twisted veins on the legs; heaviness, swelling or aching that worsens in the evening; night cramps; discolouration or hardening of the skin around the ankle; or a wound that does not heal. With a high risk profile, a one-off assessment and, if needed, a Doppler ultrasound scan are recommended even without symptoms.

Do not wait if any of these apply: sudden painful, red or warm swelling in one leg; sudden shortness of breath or chest pain; bleeding from a varicose vein that does not stop. Call emergency services – 999 in the UK, 112 in Türkiye – or go to an emergency department.