Chronic venous insufficiency (CVI) is one of the most common vascular conditions in the world. A systematic review pooling data from 32 studies across six continents found that some form of chronic venous disease affects a substantial share of the general population, with visible varicose veins alone present in roughly 19% of people and more advanced stages involving skin changes or ulcers affecting 4% to 5%. The numbers climb steeply with age, and certain jobs, body types, and medical histories push the risk even higher.
Overall Prevalence by Stage
Chronic venous disease exists on a spectrum, and how common it is depends on where you draw the line. Clinicians classify it using a staging system (C0 through C6) that ranges from invisible symptoms like leg heaviness and aching all the way to open leg ulcers. A global pooled analysis published in 2020 broke down prevalence by stage: about 9% of people have symptoms with no visible signs, 26% have small spider veins, 19% have raised varicose veins, 8% have leg swelling, 4% have skin changes like darkening or thickening, and roughly 1% to 1.4% have healed or active leg ulcers.
Put together, these numbers mean the majority of adults will experience at least some degree of venous disease in their lifetime. The earlier stages are so widespread that many people consider them a normal part of aging rather than a medical condition. But the later stages, particularly venous leg ulcers, carry real consequences. A meta-analysis of 13 studies estimated the overall prevalence of venous leg ulcers at 0.32% of the general population. That sounds small until you consider it translates to millions of people globally living with chronic, slow-healing wounds.
Varicose Veins: The Most Visible Sign
Varicose veins are the most recognizable marker of venous disease and one of the most studied. Estimates of how many adults have them vary wildly depending on the population surveyed. In Western countries, roughly 10% to 15% of men and 20% to 25% of women have visible varicose veins. One broad estimate puts the global figure at about 33% of adults aged 18 to 64. In the United States alone, an epidemiological study found that 11 million men and 22 million women between ages 40 and 80 had varicose veins.
Regional variation is significant. Studies from Iran and Saudi Arabia have reported prevalence rates above 60%, while data from parts of Asia show rates closer to 8% to 18%. The United Kingdom sits around 33%. Some of this variation reflects genuine differences in genetics, diet, and lifestyle. Some of it reflects differences in how studies define and count varicose veins. Regardless, the condition is common enough that it ranks among the most frequent reasons people visit vascular specialists.
Who Gets It: Age, Sex, and Body Weight
Age is the single strongest predictor. Venous insufficiency can appear as early as the 20s, with one Italian study finding a 15% prevalence of functional venous insufficiency in the 20-to-30 age group. But rates increase sharply after 50, and symptoms that were intermittent earlier in life tend to become constant by the sixth decade. In some populations, varicose vein prevalence reaches 71% in people over 60.
The relationship between sex and venous disease is more nuanced than most people assume. The traditional view is that women are affected more often, and that holds true for varicose veins in many studies. But the Edinburgh Vein Study, which examined over 1,500 people in the general population, found that the age-adjusted prevalence of CVI was actually 9% in men compared to 7% in women, and trunk varicose veins were present in 40% of men versus 32% of women. This suggests men may be underdiagnosed, possibly because they’re less likely to seek treatment for leg symptoms.
Higher body weight consistently correlates with worse venous disease. Research shows that BMI is positively correlated with clinical severity scores, meaning heavier individuals tend to present with more advanced stages. People with a BMI above 40 are more likely to have primary venous reflux, the underlying valve failure that drives CVI, and are at greater risk of progressing from varicose veins to skin changes and ulcers. Elderly men with high BMI and existing venous reflux appear to face the highest risk of clinical progression.
Occupational Risk: Standing and Sitting
Your job matters. A study using both questionnaires and Doppler ultrasound found a statistically significant link between work posture and venous insufficiency symptoms. Standing for more than four hours per day during a shift correlated with varicose veins on medical examination, while sitting for more than four hours correlated with self-reported varicose veins as well. Both prolonged standing and prolonged sitting appear to be risk factors, though through slightly different mechanisms: standing increases the pressure your leg veins must work against, while sitting for long periods reduces the calf muscle pumping that helps push blood back toward the heart.
Among the 100 subjects who received full medical examinations in that study, 73 showed features of chronic venous insufficiency. The condition was far more common in women (88.7% of those examined) than men (48.6%), and both age and total years of work experience were positively correlated with disease severity. Professions commonly flagged in the research include nursing, teaching, retail, factory work, and food service.
After a Blood Clot: Post-Thrombotic Syndrome
One specific pathway to venous insufficiency is through deep vein thrombosis (DVT), the formation of a blood clot in a deep leg vein. When a clot damages the vein walls and valves, it can leave behind lasting insufficiency known as post-thrombotic syndrome (PTS). This affects an estimated 20% to 40% of people who have had a DVT, with 5% to 10% developing severe symptoms like chronic pain, heavy swelling, and skin ulceration.
Some research suggests the true rate may be even higher. A retrospective study at a referral hospital found that 53.8% of DVT patients developed PTS within three months, though 69% of those cases were classified as mild. The takeaway is that a significant share of people who survive a DVT will deal with some degree of chronic venous insufficiency afterward, making DVT prevention and proper treatment an important factor in the broader prevalence picture.
The Economic Scale of the Problem
The sheer number of people affected translates into enormous healthcare costs. An analysis of venous leg ulcers associated with deep venous disease across seven countries (the US, UK, Germany, France, Italy, Spain, and Australia) estimated total annual direct medical costs at $10.73 billion, averaging $5,527 per patient per year. The US alone accounted for $4.94 billion of that total, with an average cost of $7,679 per patient annually. In the UK, per-patient costs were even higher at $10,169 per year, driven largely by nursing care for chronic wounds.
These figures cover only the most advanced cases requiring active wound management. They don’t capture the much larger population spending money on compression stockings, clinic visits for varicose veins, or the lost productivity from leg pain and swelling. When you factor in the full spectrum of venous disease, it ranks as one of the most expensive chronic conditions in developed healthcare systems.