What you need to know about vascular disease

Cardiovascular disease, often referred to as heart disease (sometimes called coronary artery disease or coronary heart disease), is the leading cause of death in the United States, with more than 800,000 deaths a year. Early detection, treatment advances, knowledge of the warning signs and changes in lifestyle can reduce risk and improve quality of life for people with this disease.

Vascular disease happens when plaque builds up in the arteries throughout the body. It’s the same disease that causes heart attacks when the arteries in the heart become blocked. Because arteries are all connected to the same “plumbing” system throughout the body, you can get vascular disease anywhere in the body.

What is the vascular system?

Think of the heart as the central pump that feeds the vascular system (also called the circulatory system, which is made up of the arteries and veins throughout your body). The heart pumps out blood, and the arteries carry this blood throughout the body, supplying billions of cells with the nutrients and oxygen they need to live and reproduce. The veins return the blood to the heart, where it is replenished and then pumped out again in this ongoing cycle.

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What is vascular disease?

Cardiovascular disease is the big umbrella term when there’s a buildup of cholesterol and calcium, which in turn causes a partial or complete blockage of an artery located anywhere in the body. The term includes coronary heart disease and several types of vascular disease:

• Peripheral artery disease (PAD): the most common form of vascular disease. PAD is a narrowing of the arteries, most commonly experienced in the lower legs. More than 10 million people in the United States have PAD. Most people with PAD experience discomfort and worsening pain in the lower legs during activity, called claudication. They may also experience tightness, heaviness and stiffness in the legs.
• Renal artery disease: sometimes called renal artery stenosis, a narrowing of the blood vessels in the kidneys. Over time, this disease can lead to uncontrolled high blood pressure and even kidney failure.
• Carotid artery disease: sometimes called carotid stenosis, occurs when plaque builds up in the carotid arteries of the neck. There are two carotid arteries in your neck, each supplying one side of your brain. If a piece of plaque breaks off, it can block blood flow to the brain, which is a common cause of stroke.

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What are the causes and risk factors of vascular disease?

High blood pressure, high cholesterol, diabetes and obesity are well known causes of vascular disease. However, smoking is less well recognized by the community and is, by far, the most important risk factor that we can modify.

Genetics also play a role in vascular disease. For example, if your mother and father both had a heart attack or a stroke in their 40s, you have an increased risk of cardiovascular disease and should make your primary care physician aware of your family’s history.

What are the warning signs of vascular disease?

The location of blockages can cause different symptoms. The most common warning sign of peripheral artery disease is pain and discomfort in the legs while walking. The calf muscle might not be getting enough oxygen, creating a pain that usually stops once the physical activity ends.

Blockages in the arteries that carry blood to the kidneys results in uncontrolled high blood pressure, as the kidneys control this important function. Blockages of the carotid arteries, which are located in the neck and carry blood to the brain, are a common vascular disease. Warnings sings include a mini-stroke, loss of vision, garbled speech and the inability to move your arm or leg.

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How is vascular disease treated?

The first and best option is risk-factor modification: smoking cessation, exercise, a healthy diet and weight loss. If you have underlying medical conditions, controlling your high blood pressure, diabetes and cholesterol are equally important. Most of the time, when the diagnosis is made early enough, risk-factor modification, combined with medications, enables us to avoid or delay surgery.

There are two primary types of drugs that are effective in the treatment of vascular disease and are also the mainstay of coronary artery disease: antiplatelets (such as aspirin) and statins.

If the disease reaches an advanced stage, surgery may be required. The major types of surgery are an angioplasty, in which a balloon is inserted into the effected artery, inflated and then removed; or the insertion of a stent that remains in place. In severe cases, bypass surgery is required to divert the blood flow around the blockage.

Is there a cure for vascular disease?

We can slow the progression of vascular disease, but unfortunately there is no cure. The most effective steps anyone can take right now are to control your risk factors for vascular disease. If you smoke, it is never too late to stop. If you suspect you are experiencing symptoms of vascular disease, please contact your physician right away.

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