10 Things to Know About Chronic Venous Insufficiency

The common condition in older adults can become serious if left untreated

Kristen Fischer,

AARP

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Published July 17, 2025

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After experiencing swelling in his lower legs, President Donald Trump was diagnosed with a condition known as chronic venous insufficiency (CVI), White House Press Secretary Karoline Leavitt announced July 17.

Research suggests about 150,000 new patients are diagnosed with the vein disease each year, and the majority of them are older than 50. Here’s what you need to know about CVI, including the warning signs to look out for.

1. It occurs when the veins in your legs become damaged

CVI occurs when malfunctions in your leg vein valves prevent blood from flowing back up to the heart, says Mikel Sadek, M.D., a vascular surgeon at NYU Langone Health. “So when they don’t work as well, and they’re no longer only functioning in the one direction, [blood] can sort of begin to fall back down the leg.”

As a result, blood builds up in the veins, increasing pressure on them and causing symptoms that range from pain to open wounds.

2. It differs from varicose veins, can be serious if untreated

CVI is different from varicose veins, veins just under the skin that swell from weakened walls and malfunctioning valves. CVI affects blood flow to the heart.

It can develop as a result of varicose veins, but not all people with varicose veins get CVI. About 1 in 50 adults with varicose veins progress to CVI, which can affect veins close to the skin and those deeper in the leg.

Symptoms of chronic venous insufficiency

Common symptoms can include:

Achy or tired legs
Burning or tingling sensation in your legs
Cramping in your legs at night
Discolored skin that looks reddish-brown
Swelling in your lower legs and ankles
Flaking or itching skin on your legs or feet
A heavy feeling in your legs
Leathery-looking skin
Open sores on the lower legs
Varicose veins

Source: Cleveland Clinic

Even if you have only varicose veins, you should look for symptoms that indicate they’re affecting blood flow to your heart, Sadek says. Spider veins, which don’t bulge as much as varicose veins and are closer to the surface of your skin, could be a cause for concern since they can indicate that the blood is not making it back up to the heart as well as it used to.

3. Signs, symptoms can vary

Symptoms of CVI can include achy, itchy or tingling legs. Some people develop reddish-brown looking skin, swelling or cramping at night.

Your legs may feel heavy, or the skin may look leathery. You may also notice open sores near your ankles or varicose veins in your legs.

While heaviness, aching, swelling, throbbing and itching are hallmark CVI symptoms, Sadek says the symptoms can present themselves in a variety of ways.

4. The causes are wide-ranging

You’re more likely to develop CVI if you’re overweight, pregnant, have high blood pressure, don’t exercise, smoke or have had swelling in a vein closer to your skin, according to Johns Hopkins Medicine. You may be more likely to develop it if a family member has had it.

The Cleveland Clinic says a common cause of vein damage that leads to CVI is deep vein thrombosis, a blood clot not near the surface of the skin. Blood clots can cause CVI, but Sadek notes that CVI can also cause blood clots though less often.

CVI seems to run hand in hand with peripheral artery disease, which occurs when fats and cholesterol accumulate in your limbs.

5. It can be serious, but it’s usually not

If CVI is left untreated, the pressure from blood buildup will cause capillaries to burst. This can cause inflammation and tissue damage and create open sores on the surface of the skin.

If those ulcers don’t heal, they can lead to infections. Other complications can include pulmonary embolism, a blood clot in the lungs, and deep vein thrombosis.

6. Your risk for CVI goes up with age

CVI typically affects people older than 50, and the risk increases as you age. About 1 in 20 adults has the condition, according to the Cleveland Clinic.

7. It happens in stages

CVI has seven stages, and doctors typically diagnose it at stage 3 or above, according to the Cleveland Clinic.

Stage 0. No noticeable symptoms other than your legs may feel tired or achy.
Stage 1. Visible blood vessels, including spider veins.
Stage 2. Varicose veins that are at least 3 millimeters wide.
Stage 3. Edema, which is swelling, but no other changes to your skin visually.
Stage 4. Changes in the skin’s color and texture.
Stage 5. Appearance of an ulcer.
Stage 6. An active, or open, ulcer.

8. It’s pretty simple to diagnose

Generally, a physical exam and ultrasound are all you’ll need to diagnose CVI. Your doctor may request a magnetic resonance imaging (MRI) scan to rule out other causes.

9. It’s treatable

Your treatment plan may include compression therapy using stockings or bandages and lifestyle changes such as losing weight, exercising or elevating your legs whenever possible. Your doctor may prescribe a blood-thinning medication. If you have other health conditions, they may affect your treatment course.

Surgical procedures can be an option if your case of CVI is more serious. These can involve removing or blocking off problem veins or using healthy veins to reroute veins for better blood flow.

Typically, Sadek gives newly diagnosed patients three months to see if lifestyle changes help then recommends other forms of treatment if necessary.

If you have CVI, you may see your doctor a few times a year to monitor the condition and treatment. Sadek says a patient’s symptoms usually drive the treatment.

You can’t reverse the damage to your veins from CVI, but treatment can improve your quality of life.

10. You may be able to prevent it

You can lower your risk for chronic venous insufficiency, but you may not be able to prevent it completely. To reduce your risk, experts at the Cleveland Clinic say:

Don’t smoke or use tobacco.
Move throughout the day, especially if you sit a lot.
Stick with a heart-healthy diet.
Exercise regularly.
Maintain a healthy weight.
Avoid clothing that’s too tight.

The takeaway

If you have a known vein issue and any symptoms of chronic venous insufficiency, talk to your doctor or see a vein specialist, Sadek says.

“It’s worthwhile getting checked out,” Sadek says. “People always think of varicose veins [and CVI] as a purely cosmetic or aesthetic issue, but it’s often far more than that.”

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Kristen Fischer is a contributing writer at AARP based at the Jersey Shore. She has also written for Health, WebMD, and McKnights and is the author of Zoo Zen: A Yoga Story for Kids.