The greatest pressure of venous hypertension in secondary varicose veins occurs:

The greatest pressure of venous hypertension in secondary varicose veins occurs during muscle contraction due to the action of the muscle pump. When muscles, particularly those of the legs, contract during activities such as walking or exercising, they compress the veins located nearby. This compression helps to push blood upward through the veins towards the heart and reduces the pressure within the venous system. However, in patients with varicose veins, this mechanism can be compromised.

Furthermore, when the muscles contract, they create a considerable increase in intramuscular pressure, which can exacerbate the pressure in the affected veins, especially if there is already venous valve incompetence. This contraction does not just support venous return but also contributes to the elevated pressures experienced in varicose veins, leading to the characteristic symptoms associated with venous hypertension, such as swelling and discomfort.

In contrast, during muscle relaxation or when at rest, venous pressures tend to decrease as there is less mechanical compression on the veins. Similarly, while standing quietly, some pressure may remain due to gravitational effects, but it does not exert the same level of force as muscle contraction. Thus, muscle contractions play a critical role in the dynamics of venous blood flow and the pressures experienced in varic