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Los Angeles Times
19-07-2025
- Health
- Los Angeles Times
What to know about chronic venous insufficiency — President Tump's health diagnosis
Earlier this week, President Trump was diagnosed with chronic venous insufficiency, or CVI, after he noted mild swelling in his lower legs. White House physician Dr. Sean P. Barbabella in a memo July 17 said the swelling prompted a full medical evaluation, including ultrasound tests and blood work. Those confirmed CVI, a condition the doctor described as 'benign and common — particularly in individuals over the age of 70.' Dr. Barbabella said he found no other signs of more serious cardiovascular issues like blood clots and declared the president to be in 'excellent health.' 'CVI is when the veins of the body do not work well,' said Dr. Mimmie Kwong, assistant professor of vascular surgery at UC Davis Health, when veins cannot transport blood effectively, causing it to pool, especially in the legs. CVI is one of the most common vein problems in the U.S. and worldwide, affecting 'about one in three adults in the United States,' Kwong said. That translates to more than 30 million people in the U.S., most often older adults, according to Dr. Ali Azizzadeh, a professor and director of Vascular Surgery at Cedars-Sinai and associate director of the Smidt Heart Institute. He noted the condition is more common in women. As people age, the veins, such as in their legs, may have a harder time returning blood to the heart, he said. The valves in the veins of the legs are supposed to keep blood moving in one direction: back toward the heart. But when those valves are damaged or weakened, they can stop working properly, leading blood to flow backward and collect in the lower legs. Individuals who stand or sit for extended periods, or those with a family history of vein issues, may be at a higher risk of developing the condition. 'When the calf muscles are active, they pump the veins that return blood from the legs to the heart,' Azizzadeh explained. 'With prolonged inactivity of those muscles, blood can pool in the legs.' While CVI isn't always painful, it can cause discomfort that worsens as the day goes on. The mornings may feel the best: 'The legs naturally drain while you are lying down and sleeping overnight,' said Azizzadeh, 'so they will typically feel lightest in the morning.' As the day progresses and blood starts to pool, people with CVI may experience swelling, heaviness, aching or a dull pain in their legs. The symptoms tend to worsen after prolonged periods of standing or sitting. If swelling worsens, thickening, inflammation or dry skin can result, with more severe cases developing wounds that do not heal and can even result in amputation, Kwong said. Ttreatment is more manageable when problematic veins are closer to the surface of the skin, Kwong said. It's more problematic when deep veins are affected. The first line of treatment is usually simple lifestyle changes. 'We suggest CEE: compression, elevation, and exercise,' Azizzadeh said. Wearing compression stockings can help push blood out of the legs; elevating the legs allows gravity to help drain blood from the legs toward the heart, and regular walking forces calf muscles to pump blood throughout the body. For people with more serious cases, doctors may recommend a minimally invasive procedure that uses heat to seal off the leaky veins. Common treatments include ablation techniques, surgical removal of veins (phlebectomy), or chemical (sclerosant) injections. 'All of these therapies aim to cause the veins to shut down, so they no longer cause the CVI,' Kwong said. In President Trump's case, the condition appears to be mild and manageable. His doctors emphasized there was no cause for concern and that he remains in good overall health. But for millions of Americans living with CVI, recognizing the symptoms and knowing how to manage them can make a big difference in day-to-day comfort and long-term well-being.
Time Magazine
17-07-2025
- Health
- Time Magazine
What Is Chronic Venous Insufficiency? Trump's Diagnosis, Explained
On July 17, the White House announced that President Donald Trump was diagnosed with a condition called chronic venous insufficiency after he noticed swelling in his legs. According to Press Secretary Karoline Leavitt, Trump, who is 79, was diagnosed following an ultrasound of his legs; he does not have complications of the condition, such as deep vein thrombosis, and an echocardiogram indicated that he has normal cardiac structure and function. We asked experts what to know about the condition, including what it feels like and how it's treated. What is chronic venous insufficiency? Chronic venous insufficiency (CVI) affects more than 25 million adults in the U.S. It's one of the most common diagnoses that Dr. Ali Azizzadeh, professor and director of vascular surgery at Cedars-Sinai Medical Center and associate director of the Smidt Heart Institute, sees in his patients every day. CVI occurs when the valves in the legs don't work correctly, which causes blood to pool, putting increased pressure on the veins. It tends to affect both legs, though it can occur in just one. Read More: 7 Myths About Cardiomyopathy—Debunked 'We have blood vessels that take the blood from the heart to the rest of the body—those are arteries,' Azizzadeh says. 'Veins are responsible for returning the blood from the rest of the body back to the heart. When somebody has chronic venous insufficiency, that means the veins are not working properly, and because of that, the blood—instead of going up towards the heart from the legs—can pool in the leg.' That often leads to visible swelling in the ankles and feet. What causes the condition? There are a variety of risk factors for chronic venous insufficiency. The condition is most common in people who are middle-aged or older, since veins naturally weaken over time, says Dr. John Higgins, professor of cardiology at UTHealth Houston. Women are at heightened risk compared to men: 'It's about 2 to 1 for women, and the reason for that is pregnancy, as well as the effects of hormones like estrogen and progesterone on the the valves,' he says. Read More: 9 Weird Symptoms Cardiologists Say You Should Never Ignore Other risk factors include a family history of CVI, being overweight or obese, and having a history of blood clots in the legs. Standing for long periods of time can also play a role. 'When you stand up, there's more pressure on your veins than when you're sitting or laying down,' Higgins says. As for the president—who is not a patient of Higgins—'he's someone who's on his feet a lot.' What kind of symptoms and complications does it cause? The majority of the time, chronic venous insufficiency is little more than a 'nuisance,' according to Dr. Sean Lyden, department chair of vascular surgery at Cleveland Clinic. 'For most people, it's nothing except for some leg swelling,' he says. 'As the day goes on, their leg swells more and more, so it feels tight, heavy, and bursting.' By the time patients with CVI go to bed, they might notice the 'big sock lines' that indent skin where socks hit, a common thing among older adults, he adds. Some people also experience discoloration in their feet and ankles. When people have CVI for a long time—10 or 15 years—they can develop hardening and thickening in the skin, which can eventually cut off the blood supply and lead to venous ulcers, Lyden adds. Generally, however, most people are able to successfully manage the condition, and it does not affect life expectancy. 'It's a very common diagnosis, and it's not dangerous,' says Azizzadeh. 'It's more that it bothers the patient, with regards to the swelling and the pain and the discomfort." Azizzadeh, who does not treat Trump, adds that CVI "doesn't impact [Trump's] prognosis in terms of life expectancy or anything like that.' How is chronic venous insufficiency treated? The most common treatment for chronic venous insufficiency is wearing 20-30 mmHg medical-grade compression socks, which push blood back up to the heart. 'You put them on in the morning and you keep them on all day,' Lyden says. 'It stops the veins from dilating until they drain better.' Most people with CVI need to wear these socks forever, though Lyden acknowledges that, in the summer heat, the extra layer can be unpleasant. People often don't put them on when they're going outside on hot days, which causes their legs to swell up again. People with CVI also benefit from elevating their legs above their heart during the day, which can be done by lying down and resting the legs on pillows or cushions, or on top of, for example, a coffee table or desk. Simple exercises can also make a positive difference. 'Pumping your calf muscles helps,' Higgins says. For those who are overweight, losing weight can improve symptoms. Read More: The 1 Heart-Health Habit You Should Start When You're Young In advanced cases, when conservative treatment doesn't sufficiently improve symptoms, some people undergo a minimally invasive outpatient procedure called venous ablation. 'It's a very simple operation,' Azizzadeh says. 'It closes the leak,' so blood no longer flows in the wrong direction. 'It's very straightforward and successful." Still, for the majority of people, CVI doesn't reach the point of requiring surgical intervention. 'The bottom line is, it's very manageable,' Higgins says. 'Most people will do just fine with the conservative therapy.'
Business Mayor
17-05-2025
- Health
- Business Mayor
Who needs more exercise: Women or men?
Exercising regularly is known to lower the risk of death, especially from heart problems. But scientists have discovered that that reduction in risk may differ between the sexes, with some people reaping greater benefits in less workout time. So, who has to exercise more to reduce their risk of death: Women or men? It turns out that women may reap these survival benefits more easily than men do. That's according to a large study published in 2024 in the Journal of the American College of Cardiology , which included data from more than 412,000 American adults ages 27 to 61, 55% of whom were female. You may like 'The beauty of this study is learning that women can get more out of each minute of moderate to vigorous activity than men do,' study co-lead author Dr. Martha Gulati , director of preventive cardiology in the Smidt Heart Institute at Cedars-Sinai, said in a statement . 'It's an incentivizing notion that we hope women will take to heart.' The researchers collected participants' physical activity data via the National Health Interview Survey (NHIS), the largest and longest-running health survey in the U.S. The study looked at data collected between 1997 and 2017. Related: 11 minutes of moderate exercise a day cuts early death risk by 20%, huge analysis suggests The survey itself included questions about the types of exercises people performed and at what frequencies, durations and intensities. It also included participants' socioeconomic and demographic characteristics and medical conditions. The study excluded people who had certain health conditions at the start of the study time frame, such as coronary heart disease or cancer. Read More Most melatonin gummies have higher doses than what's on the label Get the world's most fascinating discoveries delivered straight to your inbox. The researchers also looked through the National Death Index — a national database of death records — for deaths from any cause, as well as cardiovascular-related deaths. The data from survey participants is linked to this death-record data , so the researchers could then connect the data from their NHIS participants to the mortality data through the end of 2019. Overall, 39,935 participants died in the study timeframe, including 11,670 cardiovascular-related deaths, such as those from heart disease, heart attacks and strokes. About 32% of the women and 43% of the men surveyed said they engaged in regular aerobic exercise , exercising for at least 150 minutes per week. Compared to inactive individuals of the same sex, women who exercised regularly had up to a 24% lower risk of death from any cause. For men who exercised regularly, however, the reduction in mortality risk reached only 15%. Women also gained these survival benefits much more quickly than men did, the study found. In men, the highest reduction in death risk was seen at about 300 minutes of moderate-to-vigorous physical activity (MVPA) per week. That came with an 18% reduction in all-cause mortality. Women saw an equal benefit in less than half that time, at about 140 minutes of MVPA a week. Women who trained more than that each week saw a greater benefit until they also peaked at around 300 minutes of weekly MVPA. That trend held true across all durations of exercise, the researchers found, with women consistently seeing 'proportionately greater benefits' for any amount of exercise than men did. About 20% of women and 28% of men said they engaged in two or more sessions of strength training, such as lifting weights, each week. Overall, though, women reported an average of about 0.85 sessions per week, while men averaged 1.25 sessions per week. On average, the women who strength-trained at least twice a week had a 19% lower mortality risk than women who trained less often or not at all. Men, on average, saw a 11% lower risk compared with inactive men. These benefits were even greater when it came to cardiovascular health specifically. Related: Why is it harder for some people to build muscle than others? Compared with inactive individuals, women who performed aerobic physical activity had a 36% lower cardiovascular mortality risk, while for active men, this risk reduction was about 14%. Muscle strengthening produced similar outcomes, with a cardiovascular risk reduction of 30% for women and 11% for men, compared to baseline. 'What surprised us the most was the fact that women who do muscle strengthening had a reduction in their cardiovascular mortality by 30%,' Gulati told NPR . 'We don't have many things that reduce mortality in that way,' she added. The study did have some limitations, including that people's exercise data was self-reported, so it relied on the participants accurately reporting their activity study also tracked only leisure-time exercise, meaning it didn't count exercise completed during household tasks or as part of a job, which may have also contributed to the results. In addition, the study didn't account for potentially unassessed health issues in some participants, or changes in people's exercise trends over time. That said, the results echo similar findings from a 2011 meta-analysis published in the journal Circulation . This review of 33 studies concluded that there was a stronger link between exercise and lower death risk in women than men. The researchers behind the 2024 study hope their findings could help motivate more women to exercise, whether through traditional ' cardio ' or muscle strengthening regimes including bodyweight exercises or lifting weights. 'I am hopeful that this pioneering research will motivate women who are not currently engaged in regular physical activity to understand that they are in a position to gain tremendous benefit for each increment of regular exercise they are able to invest in their longer-term health,' Dr. Christine Albert , chair of the Department of Cardiology in the Smidt Heart Institute who was not involved in the study, said in the statement.
