What’s Chronic Venous Insufficiency — and Do I Have It?

More than 190 million people in the United States live with some form of chronic venous disease (CVD), making the condition 1.5 times more common than heart disease and five times more common than diabetes. 

At Woodlands Heart and Vascular Institute, our Vein Clinic was voted Houston’s top varicose vein treatment center in 2025. In addition to providing minimally invasive vein removal solutions, our expert team goes beyond aesthetics to address underlying venous disease.

In this month’s blog, Dr. Laura Fernandes takes a closer look at an exceptionally common — and frequently underdiagnosed — condition called chronic venous insufficiency (CVI), including risk factors and warning signs that you may have it.

Venous disease is a spectrum

Venous disease is an umbrella medical term for the various conditions that can damage and impair your veins, or the thin-walled vessels that transport deoxygenated blood from your organs, tissues, and extremities back to your heart.

CVD is a disease spectrum, with spider veins and varicose veins on the milder end, and chronic venous insufficiency (CVI) and its various effects — including leg swelling, skin changes, and ulcers — on the severe end.

Over 50 million Americans have CVI, but because the condition is vastly underdiagnosed, many are unaware of the problem. 

A continuous circulatory cycle

Understanding CVI begins with knowing a bit about vein function and circulation. 

Your heart pumps oxygenated blood through thick-walled vessels called arteries to your brain, internal organs, and extremities. Your veins then carry the deoxygenated blood back to your heart, which transfers it to your lungs for fresh oxygen, and the circulatory cycle continues. 

Veins are low-pressure, low-velocity vessels that expand easily (they hold much of your blood supply at any given time). Unlike arteries, which have the heart muscle pumping blood through them, veins transport blood with the aid of valves, respiration, and muscle contractions. 

Damaged veins and circulation 

CVI occurs when damaged leg veins lead to sluggish lower extremity circulation. Because they work under greater stress to keep blood flowing efficiently against gravity, the valves inside your leg veins are more susceptible to damage. 

Blood pools behind impaired vein valves, flowing backward when your leg muscles relax. That creates areas of high-pressure buildup in the veins that can:

• Exert substantial pressure on the surrounding vessel walls
• Cause the vessels to swell and distort (become varicose)
• Damage nearby capillaries, prompting them to leak fluids 

Over time, the cascade of circulatory effects that begins with basic vein valve dysfunction slows the entire circulatory process, hindering adequate drainage in the lower extremities and leading to uncomfortable symptoms. 

CVI risk factors and symptoms

Gravity may be the main reason leg veins are more likely to suffer damage, but it’s certain accelerating factors that make CVI more likely. Vein damage risk increases with:

• Older age, being female, and family history
• Being overweight or pregnant
• Frequent sitting
• Smoking cigarettes
• A job that requires frequent standing (i.e., teaching, nursing)

The more risk factor boxes you can check, the greater your likelihood of developing vein damage and CVI. With early CVI, you may notice: 

• Mild but persistent swelling (edema) in your lower legs
• A feeling of heaviness, achiness, or fatigue in your legs
• Tingling or burning sensations in your legs while resting
• Visible vein distortions (i.e., spider veins, varicose veins)

The longer CVI goes untreated, the more it progresses and the more problems it can cause. 

Without intervention, what begins as persistent leg swelling can lead to worsening varicose veins, spreading spider veins, worrisome skin changes (venous stasis dermatitis), and the formation of slow-healing wounds (venous ulcers). 

Concerned you may have CVI? 

Luckily, we can do a lot to treat CVI, slow or halt its progress, and support improved venous health and lower extremity circulation.

Varicose vein treatment, compression therapy (wearing compression socks), daily exercise, weight loss, and smoking cessation can treat early CVI — or help prevent it before it starts. 

Have you noticed signs of venous disease or CVI? Don’t take a wait-and-see approach with your leg health; contact Woodlands Heart and Vascular Institute in The Woodlands, Texas, by phone or online today to book an appointment with Dr. Fernandes.