By Kym McNicholas, CEO of the Global PAD Association

The recent news about former President Donald Trump’s diagnosis with chronic venous insufficiency (CVI) presents an important opportunity to shed light on a condition that affects millions of Americans yet remains largely under-discussed in public health conversations. Let me be absolutely clear: whether you agree with his politics or not, this is NOT about what side you are on. This plays no part in our advocacy and reason for this article. Our views and standpoints at the Global PAD Association are completely apolitical. This is purely an opportunity to raise awareness of a serious, under-talked-about condition that affects millions of Americans across all political spectrums.

When I heard about President Trump’s diagnosis, my first thought wasn’t about politics, but about the millions of Americans who struggle with similar vascular issues without knowing their options. As both the CEO of the Global PAD Association and someone whose own father has navigated these challenging waters, I see this high-profile case as a chance to start a much-needed conversation.

Chronic venous insufficiency occurs when the valves in leg veins don’t work properly, causing blood to pool in the legs and leading to swelling, pain, and skin changes. The textbook symptoms that President Trump reportedly experienced—swollen legs—are classic indicators of this condition. CVI alone affects approximately 40% of the U.S. population to some degree, yet it’s rarely discussed in mainstream health conversations.

What particularly concerns me about Trump’s diagnosis, however, isn’t just the CVI itself, but what might be left unchecked. At 78 years old, the former president falls into an age group where I would wonder if his doctors also screened him for peripheral artery disease (PAD). While having CVI certainly doesn’t mean you automatically have PAD, the statistical likelihood of developing both conditions increases significantly with age. In fact, the combination of venous and arterial issues is so common in older adults that there’s a broader term encompassing both: peripheral vascular disease (PVD).

Approximately 1 in 5 Americans over age 60 have PAD, but this percentage increases dramatically with age. For those in their late 70s and 80s, the prevalence is approximately 20%, making it a significant health concern for older adults. What makes this particularly troubling is that both conditions represent major public health challenges that remain severely underdiagnosed and undertreated. Studies suggest that only about 25% of PAD patients receive guideline-recommended therapies, despite the condition’s association with increased risk of heart attack, stroke, and limb loss.

This diagnostic gap isn’t just a statistic—it’s a reality I’ve witnessed countless times through our work at the Global PAD Association. When a patient presents with leg swelling, as in Trump’s case, healthcare providers might diagnose CVI but stop there, never investigating whether arterial disease might also be present. This incomplete approach can lead to missed opportunities for intervention that could prevent serious complications down the road.

The treatment approach to CVI should always begin with conservative measures. Exercise, particularly walking, helps activate the calf muscle pump to improve venous return. Leg elevation, especially above the level of the heart, uses gravity to assist blood flow back toward the heart. Graduated compression stockings provide external pressure that helps veins push blood upward. Weight management can reduce pressure on the venous system. These first-line approaches are often effective and always worth trying before considering more invasive options.

My own father’s journey through the vascular healthcare maze illustrates why both comprehensive evaluation and second opinions are absolutely critical. When he developed significant leg swelling, his doctor appropriately started with compression therapy. However, when compression socks—even those extending to the groin—failed to reduce his swelling, his physician immediately jumped to recommending an invasive VenaSeal procedure on both the front and back of both legs.

What’s troubling is that his doctor never mentioned other conservative options that should have been tried first. There was a missing step in the treatment progression: oral supplements specifically designed for venous insufficiency, such as Venixxa or Vasculera. These over-the-counter tablets contain diosmin and other flavonoids that have been shown to improve venous tone and reduce inflammation.

It wasn’t until we sought a second opinion from vascular surgeon Dr. Miguel Montero Baker at Hope Vascular that these options were presented to us. Dr. Baker recommended trying Venixxa before considering any invasive procedures. The results were remarkable—my father’s swelling and pain resolved completely with this simple, non-invasive approach.

This experience taught me a crucial lesson that applies to President Trump’s situation as well: when facing any vascular diagnosis, always seek multiple opinions. Just because a physician has impressive credentials—whether they’re on the White House medical team, have numerous publications, or speak at conferences—doesn’t mean their approach is the only or best option for your unique situation. I say this not knowing the specifics of Trump’s medical team or their recommended treatment plan, but as a general principle that applies to all patients.

The vascular treatment landscape is surprisingly varied. Some physicians underdiagnose and undertreat, while others may recommend unnecessarily aggressive interventions, skipping effective conservative options that should be tried first. Finding the right balance requires patients to be informed advocates for their own care, something that can be challenging when facing complex medical terminology and treatment options.

For venous issues like CVI, the progression of treatment should follow a logical path: lifestyle modifications first (exercise, leg elevation), then external compression (graduated stockings), followed by oral supplements like Venixxa or Vasculera, and only then, if these approaches fail, should more invasive procedures be considered. For arterial problems like PAD, a similar progression applies: supervised exercise therapy, smoking cessation, antiplatelet medications, cholesterol management, and blood pressure control should be optimized before considering interventional approaches.

At the Global PAD Association, our patient advocacy team works tirelessly to ensure that individuals with vascular conditions receive comprehensive care that addresses their complete vascular health. We believe that informed patients make better decisions, and that’s why education is at the core of our mission.

Regardless of who you are—whether a former president or anyone concerned about vascular health—you deserve access to complete information about your condition and all available treatment options. That’s why we’ve established the Leg Saver Hotline at 1-833-PAD-LEGS, where anyone can speak with our team about vascular health concerns, treatment options, and important questions to discuss with healthcare providers.

As our population ages, the prevalence of both CVI and PAD will continue to rise, making education and proper diagnosis more important than ever. My hope is that President Trump’s diagnosis brings needed attention to vascular health issues that affect millions of Americans. These symptoms should never be dismissed as simply “signs of aging” or “poor circulation.”

By using this moment to spark broader conversations about vascular health, we can help ensure that everyone—regardless of political affiliation, socioeconomic status, or access to care—receives the comprehensive, evidence-based treatment they deserve for these challenging but manageable conditions. After all, vascular disease doesn’t care about politics, and neither should our approach to treating it.

References:

1. Salim S, Machin M, Patterson BO, et al. Global epidemiology of chronic venous disease: a systematic review with pooled prevalence analysis. Ann Surg. 2021;274(6):971-976.
2. Criqui MH, Jamosmos M, Fronek A, et al. Chronic venous disease in an ethnically diverse population - The San Diego population study. Am J Epidemiol. 2003;158(5):448-456.
3. Global Burden of Disease Study 2021. Age-standardized prevalence rates of peripheral artery disease in older adults from 1990 to 2021.
4. Peripheral artery disease (PAD) is clinically defined by an ankle-brachial index (ABI) of <0.90, affecting over 200 million people worldwide and an estimated 8.5 million individuals in the United States.
5. Cires-Drouet RS, Fangyang L, Rosenberger S, et al. High prevalence of chronic venous disease among health care workers in the United States. J Vascular Surgery: Venous Lymphatic Disorders. 2020;8(2):224-230.
6. Davies AH. The seriousness of chronic venous disease: A review of Real-World evidence. Adv Therapy. 2019;36:5-12.
7. Peripheral artery disease (PAD) is a common condition caused by atherosclerosis, which leads to reduced blood flow to the limbs and is associated with major adverse cardiovascular events.
8. Korn P, Patel ST, Heller JA, et al. Why insurers should reimburse for compression stockings in patients with chronic venous stasis. J Vasc Surg. 2002;35:950-957.
9. Kym McNicholas is the CEO of the Global PAD Association, a patient advocate, and an Emmy award-winning journalist. The Global PAD Association can be reached at 1-833-PAD-LEGS (1-833-723-5347) for information and support regarding peripheral artery disease and chronic venous insufficiency.