{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T16:56:17Z","timestamp":1755795377842,"version":"3.44.0"},"reference-count":25,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2025,4,15]],"date-time":"2025-04-15T00:00:00Z","timestamp":1744675200000},"content-version":"unspecified","delay-in-days":104,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2024,12,12]]},"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>This study aimed to investigate the frequently overlooked symptoms of cold hypersensitivity and heavy legs related to varicose veins in a large sample of patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Data on 8782 adults aged 30\u201370 years without a history of cancer were sourced from the Taiwan Biobank between 2008 and 2020. Varicose veins, cold hypersensitivity and heavy leg sensations were assessed using questionnaires and analysed using logistic regression models with various covariates. Statistical analyses were performed, with analysis of variance for continuous variables and \u03c7<jats:sup>2<\/jats:sup> tests for categorical variables at a significance level of 0.05.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Our analysis showed significant associations between varicose veins, cold hypersensitivity, and heavy legs (p&lt;0.0001). Logistic regression models showed that moderate and severe cold hypersensitivity increased the risk of varicose veins with ORs of 1.490 (95% CI 1.205 to 1.842) and 1.894 (95% CI 1.546 to 2.320), respectively. Similarly, heavy legs were strongly associated with varicose veins (OR 4.239, 95%\u2009CI 3.381 to 5.315), and the interaction between cold hypersensitivity and heavy legs was significant (p=0.0009). Notably, the greatest risk for varicose veins was observed in individuals with heavy legs and severe cold hypersensitivity (OR 7.135, 95% CI 4.980 to 10.221).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The results of this study highlight the clinical significance of considering cold hypersensitivity and heavy legs as vital symptoms for diagnosing varicose veins, particularly in the absence of arterial disorders, which can improve diagnostic accuracy and patient outcomes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/openhrt-2024-002909","type":"journal-article","created":{"date-parts":[[2025,4,15]],"date-time":"2025-04-15T20:50:23Z","timestamp":1744750223000},"page":"e002909","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Cold hypersensitivity in the lower extremities: an underappreciated symptom in patients with varicose veins"],"prefix":"10.1136","volume":"12","author":[{"given":"Cheng-Ken","family":"Tsai","sequence":"first","affiliation":[{"name":"Department of Public Health, Institute of Public Health, Chung Shan Medical University, Taichung, Taiwan"},{"name":"Department of Surgery, I-Shou University, Kaohsiung City, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hsuan-Yin","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Surgery, I-Shou University, Kaohsiung City, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oswald Ndi","family":"Nfor","sequence":"additional","affiliation":[{"name":"Department of Public Health, Institute of Public Health, Chung Shan Medical University, Taichung, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Disline Manli","family":"Tantoh","sequence":"additional","affiliation":[{"name":"Department of Public Health, Institute of Public Health, Chung Shan Medical University, Taichung, Taiwan"},{"name":"Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wen-Yu","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Public Health, Institute of Public Health, Chung Shan Medical University, Taichung, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2046-4964","authenticated-orcid":false,"given":"Yung-Po","family":"Liaw","sequence":"additional","affiliation":[{"name":"Department of Public Health, Institute of Public Health, Chung Shan Medical University, Taichung, Taiwan"},{"name":"Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung, Taiwan"},{"name":"Institute of Medicine, Chung Shan Medical University, Taichung, 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