I take hypertensives. i notice that my hand veins at home are dilated but that they are not at all at md's office. this a fight-or flight response?

No: There are variations in the visibility of veins depending on hydration, posture, time of day, salt intake and the like.

Swollen hand veins.: Hand veins can swell for many reasons but the most common is certainly hereditary . Other factors would be level of hydration, aging, sun exposure and loss of elasticity and volume. Actually, I am amazed at the amount of patients that i see with bulging hand veins. Your vein reaction may be due to a combination of temperature changes and anxiety reactions.