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Int J Angiol
DOI: 10.1055/a-2760-0702
Review Article

Chronic Venous Insufficiency in Men: A Systematic Review of Gender Patterns

Authors

  • Vito Anggarino Damay

    1   Department of Cardiovascular Medicine, Universitas Pelita Harapan, Banten, Indonesia

  • Kho Jesselyne Aurelia Santoso

    2   Faculty of Medicine, Universitas Pelita Harapan, Banten, Indonesia

  • Ignatius Ivan

    3   Jakarta Varices Clinic, Jakarta, Indonesia

  • Stella Tania Lim

    2   Faculty of Medicine, Universitas Pelita Harapan, Banten, Indonesia

  • Mohammad Zuhriansyah Sabran

    2   Faculty of Medicine, Universitas Pelita Harapan, Banten, Indonesia
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Abstract

Males with chronic venous insufficiency (CVI) often present later and with more advanced disease than females. Quantifying male-specific presentation patterns could inform earlier detection and tailored management. To synthesize male-specific epidemiological and clinical presentation data in CVI, with emphasis on Clinical, Etiological, Anatomical, and Pathophysiological (CEAP) class distribution and associated risk factors. We conducted a PRISMA-conform systematic review, searching PubMed, ScienceDirect, and Google Scholar. Eligible studies were observational or interventional designs reporting male-specific data for adults. Outcomes were CEAP class and clinical presentation. Study selection, data extraction, and risk-of-bias assessment were performed independently by two reviewers. A total of 10 studies involving 12,344 males were included. Across studies, males more frequently presented with advanced CEAP classes (C3–C6), whereas females more often had C1–C2 disease. Population cohorts reported a higher prevalence of saphenous reflux and trophic changes (C4–C6) in males, especially with increasing age. Factors associated with advanced disease in males included obesity, prolonged-standing occupations, smoking, and delayed consultation. Despite more females being affected overall, males comprised the majority of severe presentations in clinic-based series. Males with CVI present later and at more advanced stages, with risks amplified by age, adiposity, and occupational loading. These findings support sex-sensitive strategies, and future research should address the lack of male-focused interventional data. Clinically, this mandates proactive screening and targeted education for at-risk men to mitigate delays in diagnosis and prevent complications like venous ulcers.

Keywords

chronic venous insufficiency - male - CEAP classification - epidemiology - occupational risk - sex differences


Publication History

Received: 25 October 2025

Accepted: 10 November 2025

Article published online:
23 December 2025

© 2025. International College of Angiology. This article is published by Thieme.

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