Regarding “High endogenous estradiol is associated with increased venous distensibility and clinical evidence of varicose veins in menopausal women”

Abstract

In a recently published paper (J Vasc Surg 2000;32:544-9) are the results of a clinical and instrumental investigation on the association between estrogen and varicose veins. In fact, the authors give—for the first time—elegant proof that high endogenous estradiol is associated with clinical evidence of varicose veins. Based on plethysmographic (SPG) calf volume measurements, the authors go further and state that high endogenous estradiol is associated also with increased venous distensibility. But this second statement is not justified in the light of the type of measurements performed. The plethysmographic test performed by the authors measures the change (increase) in calf volume during standard occlusion of the thigh. This change is called venous capacitance or maximal venous incremental volume (MVIV) , but does not represent “a measure of venous distensibility.” What MVIV represents is merely the amount (volume) of blood needed to fill the calf veins, and this volume is certainly greater if there are also varicose veins to fill. In other words, in this study higher MVIV and varicose veins are the same thing, and if one of these is associated with high dose endogenous estradiol, the other will be, too. Unfortunately, the inappropriate statement that “high endogenous estradiol is associated with increased venous distensibility” is the very title of the article and is repeated in the abstract. Readers are thus misled to believe in “scientific fact” that has been neither tested nor proved by the authors. 24/41/114807