Following recent White House disclosures about President Donald J. Trump’s diagnosis of Chronic Venous Insufficiency (CVI), the American Heart Association has stepped forward to provide essential details on this condition and its notable connections to cardiovascular risk elements, diseases, and elevated mortality rates.
The Association, recognized globally as the premier nonprofit dedicated to promoting heart and brain health across all populations, highlights that chronic venous insufficiency—a specific type of chronic venous disease—is remarkably common, particularly among elderly individuals. Despite its prevalence, this ailment frequently goes unnoticed and inadequately managed. Importantly, there exists a robust link between CVI and heightened risks of cardiac problems, including cardiovascular disease (CVD) and death, even when accounting for variables like age, gender, pre-existing cardiovascular risks, and other health conditions. Individuals with CVI often exhibit established cardiovascular risk factors and diseases, such as advancing age, excess body weight, tobacco use, lack of physical activity, and diagnosed cardiovascular disorders.
Growing older represents a key risk element for developing CVI in general. With advancing years, the valves within the leg veins—crucial for directing blood upward toward the heart—tend to lose strength or sustain damage. This impairment hinders the smooth return of blood, permitting reverse flow within the veins, which causes blood to accumulate in the lower extremities and ultimately triggers the onset of CVI.
‘Chronic Venous Insufficiency can profoundly affect daily living and overall well-being, yet catching it early and pursuing appropriate treatments can lead to meaningful improvements,’ noted Joshua A. Beckman, M.D., FAHA, who previously served as volunteer chair of the American Heart Association’s Vascular Health Advisory Committee and Scientific Council on Peripheral Vascular Disease. ‘This underscores the critical need for people to recognize the indicators and manifestations of CVI, enabling them to pursue prompt medical assessments and interventions.’ Dr. Beckman holds the position of Executive Clinical Director of Cardiovascular Services and Chief of the Division of Vascular Medicine, while also acting as a professor in the Department of Internal Medicine at UT Southwestern Medical Center in Dallas. He occupies the Gayle and Paul Stoffel Distinguished Chair in Cardiology there. Additionally, he functions as an associate editor for Circulation, the foremost journal in cardiovascular medicine, and has contributed to the American Heart Association as a volunteer since 2004.
Recognizing Symptoms of Chronic Venous Disease
Manifestations of chronic venous disease encompass swelling known as edema, prominent varicose veins, and alterations in the skin often referred to as ‘venous eczema’ or ‘stasis dermatitis.’ These skin changes typically present as reddish, pruritic, or scaly areas on the lower legs due to impaired circulation. In more severe cases, ulcerations may develop. Affected individuals might experience discomfort such as pain, itching, or bleeding in the involved regions, alongside sensations of aching, cramping, pulsating, tiredness in the legs, a sense of heaviness, or restless leg syndrome.
White House Press Secretary Karoline Leavitt lately confirmed that President Donald Trump received a diagnosis of chronic venous insufficiency following observations of slight swelling in his lower leg. Officials from the White House further clarified that tests revealed no signs of deep vein thrombosis or arterial issues, with all lab findings falling within acceptable ranges.
Distinguishing Deep Vein Thrombosis from CVI
While deep vein thrombosis (DVT) and chronic venous insufficiency (CVI) both impact the veins—most commonly those in the legs—they remain separate entities. Deep vein thrombosis constitutes a grave medical issue characterized by the formation of a blood clot, or thrombus, within a deep vein, usually located in the legs or pelvic area. A dangerous potential outcome of DVT is pulmonary embolism (PE), in which fragments of the clot dislodge, travel through the bloodstream, and obstruct pulmonary arteries, severely impeding lung perfusion.
Treatment Approaches for CVI
Management strategies for CVI primarily involve compression therapy, which may include multilayer bandaging, short-stretch wraps, elastic clothing, graduated compression stockings, and pneumatic compression devices. Physicians might also recommend topical anti-inflammatory corticosteroids, antibiotics, or diuretics as supportive measures. For certain cases, patients could gain advantages from endovascular interventions—procedures that are minimally invasive. These often entail threading a slender catheter via a tiny cut, commonly in the groin region, and navigating it to the clot site using guidance from imaging modalities such as X-rays or ultrasound to clear blockages.
Diagnostic Methods for CVI
Healthcare providers diagnose CVI using advanced imaging techniques like duplex ultrasound, magnetic resonance venography (MRV), or computed tomography venography (CTV). These methods help identify reverse blood flow, venous blockages, or external compressions affecting the veins.
Key Statistics on CVI in the United States
Drawing from the American Heart Association’s 2025 Heart Disease and Stroke Statistics report for the U.S.:
- In 2022—the latest year with complete data—CVI served as the primary diagnosis for 5,805 hospital discharges and appeared among all recorded diagnoses in 234,655 discharges.
- Chronic Venous Insufficiency directly contributed to 62 deaths in the U.S. during 2022.
- CVI featured in ‘any mention mortality’ statistics for 977 fatalities that year.
- The predominant symptom reported is pain, affecting 29% of cases, followed by swelling, sensations of heaviness, fatigue, and cramping.
- Spider veins occur in 7% of patients, while varicosities and skin alterations each affect 4%. Stasis ulcers are noted in 1% of those diagnosed with CVI.
These figures emphasize the widespread nature of CVI and the urgent need for greater awareness, proactive screening, and effective interventions to mitigate its impact on public health, particularly as populations continue to age and lifestyle-related risks persist.
