In the news: What you need to know about chronic venous insufficiency

This week, we learned that the president of the United States is among the many people who suffer from chronic venous insufficiency. The Society for Vascular Surgery says the condition may affect as many as 40% of all Americans. 

To learn more about chronic venous insufficiency, we turned to two experts at the Medical University of South Carolina. Jean Marie Ruddy, M.D., is with the Division of Vascular Surgery and is the medical director of the Vascular Laboratory at MUSC. Teresa Kelechi, R.N., Ph.D., is a nurse researcher specializing in helping people manage chronic venous disease. 

Q: What is chronic venous insufficiency?

Kelechi: It’s a disorder of the veins. It basically means there’s high blood pressure that causes the walls of the veins to stretch and kind of open up. Because they're porous, there are little holes that allow blood particles to leak into what we call the interstitial space. It can cause the legs to look swollen and the skin to be inflamed.

Ruddy: When the veins are functioning correctly, every movement of the leg – especially calf muscles – helps pump blood back up to the heart, with intermittent valves to prevent backflow when standing. 

But with prolonged standing or sitting, the valves get full and overflow to let blood move backward into the lower leg. If this happens frequently, the valves become damaged, leading to chronic venous insufficiency. 

Q: What are the symptoms?

Kelechi: The disorder itself generally is diagnosed when people complain of having achiness in their calves or legs. Their legs feel heavy. They will complain that they have swelling. They might notice bulging veins in their legs, or they might notice little blood vessels that look like they're broken. Generally, it affects down around the ankle area. 

Over time, the skin, as it goes through various inflammation processes, turns red and gets itchy and scaly. 

Q: What causes chronic venous insufficiency?

Kelechi: Age is one factor – you see it more in older people. It can also be hereditary and can appear in people who stand a lot or sit a lot. People who have other conditions like obesity and diabetes are at risk, too.

Ruddy: Sitting or standing a lot is a risk factor as well. It makes the veins work harder to pump blood to the heart.

Q: How is it treated?

Kelechi: You elevate your legs. You walk, do your exercises, keep your skin moisturized. And the big thing is wearing compression stockings or wraps that will help with the vein circulation.

Ruddy: Some people may benefit from minimally invasive vein procedures to further improve how their legs feel on a daily basis. These interventions do not require a hospital admission and are often accomplished in the clinic setting. They are focused on minimizing pain, and typically there is no restriction on activities.  We aim to improve the patient's quality of life and ability to reach daily activity goals.

Q: How can people try to keep from getting chronic venous insufficiency?

Kelechi: Make sure you drink plenty of water. Walking is critical. If you're sitting a lot, you want to make sure you raise your legs. Prevention is really physical activity. And if, unfortunately, you were born with a tendency to have it, make sure that you keep on your compression stockings. Try to manage your weight.

If nothing else, we should get up from our desk and do toe lifts to pump the calf muscles. Anything that pumps the calf muscle is beneficial.

Q: What do you hope people take away from this?

Ruddy: It is important that patients understand that venous insufficiency is common and is not a risk to their global health. It does not place them at higher risk for heart attack, stroke or clot but can be a discomfort that compromises their quality of life, and that is still very important.

Kelechi: Chronic venous insufficiency is not a disorder that singles out certain people. There was a time when men had it more because they were in standing professions. Worldwide, millions of people have this disorder. Be careful with your weight because obesity is one of the main risk factors.