Can Prominent Veins be caused by PMR or PRED ?

Doc reckoned "normal" in a "don't worry about it" sort of voice. Too many other (more important) things in the conversation for me to persue whether it was normal for normal people or normal for me and my condition. But since I hadn't noticed it previously it was worth asking and apparently it can sometimes mean something important - pmr seems to help my imagination!

I also noticed the opposite before a recent medical procedure. Unfortunate prep nurse having trouble finding a suitable vein reckoned "dehydration" as no fluids for many hours.

In general (there is one exception), arteries are the blood vessels that carry oxygenated blood around the body to supply the tissues with oxygen and other nutrients that are required for your body to function. The blood picks up the oxygen in the lungs, the heart provides the pump mechanism to make it flow around the system. Almost the same applies for veins - except they all carry blood that gathers up the waste products from the muscles and other tissues and take them to the liver, lungs and kidneys to be got rid of. The arteries leave the heart and so have a high blood pressure to cope with. They have thick, strong walls and often an elastic layer to them. They subdivide again and again like the branches of a tree until they get to the muscles and organs where they form tiny vessels called capillaries. Unlike a tree, these tiny vessels join together again and again, getting bigger each time until the blood gets back to the lungs to pick up oxygen again and then the vessels become arteries again. It is more complex than that of course but that is the basic outline.

Arteries tend to lie deeper in the body - and it is in arteries that you can feel your pulse because every time the heart beats it pushes the blood harder as it contracts and less as it relaxes ready for the next beat. Pulses can easily be felt at your wrist, in the crook of the arm (which they use for taking your BP), at the side of your neck and in your groin. These are all places the artery is fairly close to the surface. One artery you have all heard of is very close to the surface - the temporal artery. Like the others you can feel a pulse there and it is sometimes visible, beating away, especially if someone is angry and their BP rises. 

GCA is really only to be found in arteries that have an elastic part to their wall and it so happens that the temporal artery is one. It runs along your hairline and part of your forehead so isn't always easy to see - except maybe in bald gentlemen. However, if the artery becomes inflamed then it can become even more prominent - but at the same time the blood is less able to flow through it and that makes feeling the pulse in it more difficult. Because this artery is close to the skin, small and not esential to the circulation, it can be biopsied to look and see if there are any of the giant cells that give the disease its name to be found. Sometimes they are, sometimes they aren't. But the temporal artery isn't the only artery that GCA can affect - it just happened to be the easiest to take a bit out of to have a look.

So, if that artery were to be very visible and sore - you should go and ask your doctor about it.

Veins, on the other hand, are often quite visible near the skin surface - sorry about the pun, but especially on the back of your hands. When you are young they are not usually so noticeable and are surrounded by a thin layer of subcutaneous fat with lovely smooth skin on top. As we age, our skin becomes thinner and less elastic and that subcutaneous fat tends to disappear, especially if we are reasonably slim, or lose a lot of weight and then they become more obvious. You rarely see veins in the back of an obese person's hands - and even the ones in arms and legs are less easy to find. Taking a blood sample from an obese person is difficult, it is very difficult to feel the vessel as it has no pulse and you are even less likely to see it. And, by the way, blood samples for tests are always taken from a vein except when they need to measure how much oxygen is in your blood and then, only then, is it from an artery and it will be done by a doctor, usually in hospital.

Veins also become more obvious if you get hot and then your blood vessels widen to allow more blood through to cool you down. The veins have thin walls so when they widen you see it clearly on the back of your hands especially. That is how varicose veins form, the blood isn't being pumped back up to the heart efficiently, usually because the valves that stop the blood following gravity and falling back down towards your ankles are not working as well as they did and the walls of the veins become distended and thinner,  When your hands are cold the veins there become smaller - as the blood goes into the lower levels of the tissues to prevent loss of heat and keep your core warm - where all the vital organs are positioned because they need to be at 37C to work properly. Cool them down and they start to go into hibernation and work less efficiently, eventually even the heart is too cool to work and stops beating. You would die of hypothermia.

Another cause can be raised BP:

"Bulging veins are unusually large veins that appear at the surface of the skin. When veins are visible and have a swollen appearance, they are referred to as varicose veins. While they commonly appear in a person’s legs, they can also be found in other parts of the body as well, such as in the arms, chest, and face. Bulging veins may be due to a rise in blood pressure in the veins. This rise in venous blood pressure forces plasma out of the walls of the blood vessels, causing the surrounding tissues to become swollen and hard. In turn, the act pushes subcutaneous veins to the surface of the skin where they become more visible and in those individuals with low body fat, the effect becomes even more noticeable. When the legs are involved, symptoms that include pain that may worsen following sitting or standing for extended periods, skin darkening, cramping, swelling and rash may occur. Increased weight of an individual and inactivity can exacerbate symptoms."

So if the vessels on the back of your hand are more noticeable there are several reasons for it - but none of them are due to GCA. Your doctor should be checking your blood pressure regularly anyway and if it is raised significantly, either providing you with lifestyle advice (weight loss, more exercise) or medication. If you simply don't like what they look like there probably are ways of reducing the knobbly appearance. Otherwise, unless they are damaged through injury there is no real need to worry.

If you are still with me - sorry for the lecture! But I think I've answered all questions?