Understanding Chronic Venous Insufficiency: Signs, Risks, and Prevention Tips

President Trump’s recent diagnosis has drawn attention to chronic venous insufficiency (CVI)—a condition that’s surprisingly common, especially as we age. But what is CVI, and why does it matter?

CVI occurs when the valves in your leg veins weaken or become damaged. These valves usually help push blood back up to your heart, but when they stop working properly, blood pools in your legs. This leads to venous hypertension (increased pressure inside your veins), which can cause uncomfortable and sometimes serious symptoms.

What Are the Symptoms of Chronic Venous Insufficiency?

Common signs and symptoms of CVI include:

• Swelling (edema) in the lower legs and ankles

• A feeling of heaviness, aching, or cramping in the legs

• Varicose veins

• Skin changes like darkening, itching, or thickening

• Slow-healing wounds called venous ulcers in more advanced cases

CVI is more serious than minor vein issues like spider veins. Without treatment, it can worsen over time and impact your daily comfort and quality of life.

Who’s at Risk for Chronic Venous Insufficiency?

Certain factors increase your risk of developing CVI, including:

• Age over 50

• Female sex (though men are affected too)

• Obesity

• Pregnancy (especially multiple pregnancies)

• Family history of vein problems

• History of deep vein thrombosis (DVT) – blood clots in the legs can damage vein valves and increase your risk of developing CVI later on

• Jobs requiring prolonged standing or sitting

Other contributors include weak calf muscles, genetic factors, and chronic health conditions like heart failure that increase pressure in your veins.

How to Prevent Chronic Venous Insufficiency

While CVI can’t always be prevented, these steps can help lower your risk and slow its progression:

• Maintain a healthy weight to reduce pressure on your veins

• Avoid standing still for long periods when possible

• Stay active—walking helps your calf muscles push blood out of your legs

• Elevate your legs when resting

• Wear compression stockings if you're at higher risk

• Moderate compression (20–30 mm Hg) is typically recommended

• Compression can help prevent progression in people with early signs of vein disease

According to vascular experts, compression therapy and lifestyle changes like weight management and regular activity are key to protecting your leg health.

How Is Chronic Venous Insufficiency Diagnosed?

CVI is typically diagnosed using:

• A physical exam and discussion of your symptoms

• Duplex ultrasound, a special imaging test that checks for backward blood flow or blocked veins

Clinicians may also use a classification system (called CEAP) to describe the severity of your vein disease and help guide treatment.

Why Chronic Venous Insufficiency Matters

CVI is more than just tired legs. If left untreated, it can lead to:

• Skin damage and discoloration

• Painful, slow-healing wounds (venous ulcers)

• Ongoing discomfort that affects daily life

• Increased risk of future blood clots, especially in people with a history of deep vein thrombosis (DVT)

Recognizing the signs and seeking early care can help you manage symptoms, protect your skin, and lower your risk of complications like blood clots.

If you’re noticing leg swelling, discomfort, or changes in your skin, talk to your clinician about whether CVI might be the cause—and what steps you can take to protect your vein health.

Reference

Fukaya E, Kolluri R. Nonsurgical management of chronic venous insufficiency. N Engl J Med. 2024;391(24):2350-2359. doi:10.1056/NEJMcp2310224