Dear Dr. Roach: I am in my early 90s and was diagnosed with “venous insufficiency” in both legs about 20 years ago. Over the years, I have attempted to deal with chronic edema in both ankles and feet by using elevation and compression devices. Of course, these are only temporary measures and only provided a brief period of some relief.

I have been tested in the past for deep vein thrombosis and had a thorough heart exam one month ago.

My question to you is, are there any other concerns I should be alert for in my advanced stage, and what testing should I get done? My blood pressure is always close to normal, and my cardiovascular blood work is rated very good.

The only medicine I take regularly is for prostate issues. — M.B.

Answer: Venous insufficiency is a common diagnosis whose name sounds like it might be very serious. However, it just means that the valves in the veins don’t work as well as they used to, leading to varicose veins (which may or may not be visible) and veins that could leak.

Leakage of fluid outside the blood vessels (the blood cells are too big to leak out) causes localized swelling, called edema. Edema fluid is pulled by gravity down to the lowest part of the body, so the feet are the main places where edema is found.

Just being older is enough of a reason to have venous insufficiency. The valves in the veins are delicate structures and often don’t last an entire lifetime.

However, some medications are notorious for causing edema. Calcium channel blockers like amlodipine (Norvasc) often do, and a class of prostate medicines, the alpha blockers (such as terazosin), can cause edema, although newer ones are less likely to cause it.

Many of my patients know that liver failure, kidney failure and heart failure can all cause swelling in the feet, but a careful exam and some laboratory testing can usually eliminate these as possibilities. You may not need any more testing.