A Common Condition With an Uneven Impact

Chronic venous insufficiency (CVI) is a circulatory condition that affects millions of Americans, yet not everyone is equally at risk. In CVI, the one-way valves in the leg veins weaken or become damaged, allowing blood to pool in the lower legs. This leads to symptoms like swelling, aching, heaviness, varicose veins, and—if left untreated—skin changes or ulcers.

At Sheen Vein (Aesthetics and Functional Medicine) in St. Louis, we see patients every week who wonder: Why me? They may know friends, coworkers, or family members who stand all day but never develop CVI, while they struggle with discomfort and visible veins. The truth is, CVI is the result of multiple overlapping factors, and some of them you can control—while others you can’t.

1. Genetics – The Inherited Factor

Your family history plays one of the biggest roles in determining your risk. If your parents or grandparents had varicose veins or CVI, your chance of developing it is much higher. Genetics influence:

• The strength and elasticity of your vein walls
• How well your vein valves form and function
• Your body’s natural collagen content, which supports vein integrity

Some people are simply born with veins that are more prone to stretching and valve weakness over time.

2. Age – Wear and Tear on the Valves

Vein valves are tiny flaps of tissue that keep blood moving toward the heart. With age, these valves can become less flexible or sustain damage from years of pressure and strain. That’s why CVI is more common after age 50, although we do see it in younger patients—especially those with strong genetic risk or occupational strain.

3. Gender and Hormonal Influences

Women are more likely to develop CVI, in part because estrogen and progesterone affect vein wall elasticity. Hormonal changes during pregnancy, menopause, or from birth control pills can weaken vein walls and valves. Pregnancy also increases blood volume and puts more pressure on the leg veins, making valve failure more likely.

4. Occupational and Lifestyle Factors

Jobs and daily habits play a big role in CVI risk. Standing or sitting for long hours without movement allows blood to pool in the legs, increasing venous pressure. This is common in:

• Teachers
• Nurses
• Retail workers
• Office workers
• Hair stylists

Regular movement helps the calf muscles act as a pump to push blood back toward the heart. Without it, valves face more stress over time.

5. Weight and Physical Activity

Excess weight adds pressure to the veins in the legs and pelvis, making it harder for valves to keep blood moving upward. On the other hand, regular physical activity—especially walking, cycling, or swimming—helps strengthen the calf muscle pump and reduces venous pressure. People who maintain a healthy weight and stay active generally have a lower risk, even if they have other risk factors.

6. History of Leg Injury or Blood Clots

Trauma to the leg—whether from an accident, surgery, or sports injury—can damage vein valves or reduce vein elasticity. Similarly, a history of deep vein thrombosis (DVT) can scar and weaken valves, making CVI more likely in the years that follow.

7. Other Medical Conditions

Conditions that increase abdominal or pelvic pressure, such as chronic constipation or certain lung diseases, can also strain the leg veins. Inflammatory conditions, autoimmune disorders, and connective tissue diseases can weaken vein structure as well.

Why Some People Avoid CVI Despite Risk Factors

You may know someone who stands all day yet never develops vein problems. In many cases, they have a combination of protective factors:

• Strong genetic vein structure
• A naturally active lifestyle that keeps calf muscles engaged
• Lower body weight, reducing venous pressure
• No history of vein injury or clots
• Good hydration and overall cardiovascular health

It’s also possible for early vein damage to go unnoticed—some people may have mild CVI that hasn’t yet caused symptoms.

Can You Prevent CVI?

While you can’t change your genetics or age, you can reduce your risk and slow the progression if early signs appear:

• Move frequently throughout the day—avoid sitting or standing for more than 30 minutes at a time without walking
• Wear medical-grade compression stockings if you’re in a high-risk job
• Maintain a healthy weight to reduce leg vein pressure
• Elevate your legs for 10–15 minutes a few times a day
• Stay hydrated and follow a balanced diet for vascular health

The Bottom Line

CVI isn’t random—it’s the result of an interplay between genetic predisposition, hormonal and age-related changes, lifestyle factors, and overall health. Understanding your personal risk factors can help you take steps now to protect your veins and avoid long-term complications.

If you’re experiencing leg swelling, aching, heaviness, or visible varicose veins, early evaluation is key. At Sheen Vein (Aesthetics and Functional Medicine) in St. Louis, we use advanced diagnostic tools and minimally invasive treatments to keep your circulation healthy and your legs comfortable.

Schedule your vein consultation today to find out your risk and learn how to protect your vein health for years to come.

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