EXPLAINER: Chronic venous insufficiency, condition ailing Trump

President Trump’s left ankle, which appears swollen and could indicate chronic venous insufficiency/HANDOUT

U.S. President Donald Trump’s recent diagnosis of Chronic Venous Insufficiency (CVI) has thrust the little-discussed condition into the global spotlight.

His visible leg swelling has raised widespread concern, turning attention to a disease that quietly affects millions worldwide.

But what exactly is CVI, and why should more people be paying attention?

According to the Cleveland Clinic, CVI is a venous disease that occurs when leg veins are damaged and can no longer function properly.

Normally, valves in the veins ensure blood flows back to the heart, but in CVI, these valves fail, causing blood to pool in the legs.

This increased pressure leads to symptoms such as swelling, skin changes, and in severe cases, open sores or ulcers, particularly around the ankles.

“People often mistake these symptoms for fatigue or simple aging, but without treatment, the condition tends to worsen,” cardiologist Bernard Ashby told CNN.

The National Institutes of Health (NIH) lists common symptoms of CVI as achy or tired legs, burning or tingling sensations, nighttime leg cramps, reddish-brown skin discoloration, and swelling in the lower legs and ankles, especially after standing for long periods.

Other signs include flaking or itchy skin, a feeling of heaviness in the legs, leathery-looking skin, and persistent ulcers near the ankles.

“Severe oedema in the lower leg can cause scar tissue to develop,” the Cleveland Clinic notes.

“This scar tissue traps fluid in the tissues, making the calf feel hard and increasing vulnerability to ulcers.”

Cardiologist Ashby highlighted several risk factors for CVI, including age, obesity, smoking, pregnancy, lack of physical activity, and a family history of vein problems.

Occupations that involve long periods of standing or sitting, such as security guards, drivers, and office workers, also increase risk.

“CVI is not life-threatening on its own, but if left untreated, it can lead to serious complications like skin infections or deep vein thrombosis (DVT),” Ashby warned.

Treatment depends on severity. Mild cases often respond to lifestyle changes such as regular exercise, weight loss, and leg elevation.

Doctors may also recommend compression stockings to aid blood flow. Advanced cases might require medical or surgical intervention to repair or remove damaged veins.

“While CVI is manageable, it is a long-term condition that requires ongoing care,” Ashby added. “Patients must adopt lifestyle changes, such as avoiding prolonged sitting or standing and incorporating regular walking or leg exercises.”

In Kenya, where specialised vein care is limited outside major urban centres, early detection and public awareness are critical.

Global data shows chronic venous disease, including CVI, affects 25–40 per cent of women and 10–20 per cent of men.

Though local statistics are scarce, urban hospitals report rising cases, especially among older adults and people with sedentary lifestyles.

President Trump’s diagnosis followed public observations of swelling in his ankles and bruising on his hands, prompting a medical evaluation.

The White House confirmed he underwent diagnostic tests, including vascular ultrasounds, which ruled out more serious conditions like DVT. Additional tests found no evidence of heart failure or kidney problems, and his overall cardiovascular health was deemed stable.

“This is a fairly common condition in individuals over 70 and not surprising given his age and body profile,” CNN’s Chief Medical Correspondent Sanjay Gupta said.

At 79, Trump’s risk factors, age, overweight status, frequent long flights, and limited cardiovascular exercise align with the typical CVI profile. While he plays golf regularly, experts note this may not provide sufficient cardiovascular benefit.

Emergency physician Jeremy Fauci emphasised the importance of ruling out DVT, which involves clots in deep veins and can lead to life-threatening complications like pulmonary embolism. In Trump’s case, no such clots were found.

As President Trump begins treatment, his diagnosis underscores the need for greater awareness of CVI, a condition many live with unknowingly until complications arise.