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PERIPHERAL VASCULAR DISEASE (PVD)

Men's Health, Women's Health / By

PERIPHERAL VASCULAR DISEASE (PVD)

Peripheral vascular disease is a blood circulation disorder that causes restricted blood flow to parts of the body other than the brain and the heart.

  • This disorder causes the blood vessels (arteries or veins) located outside of the heart and brain to narrow, block, or spasm.
  • This means that when you develop peripheral vascular disease, parts of your body outside the heart and the brain do not receive enough blood flow to keep up with demand.
  • When narrowing occurs in the heart, it is called coronary artery disease, while, in the brain, it is called cerebrovascular disease.
  • Peripheral vascular disease most commonly affects the legs, but it can also affect the blood vessels that supply blood and oxygen to the arms, stomach, and the kidneys.
  • About 155 million people had the condition in 2015 resulting in about 52,500 deaths.
  • Peripheral vascular disease has a potential to cause loss of limb or even loss of life
  • People over the age of 50 are believed to suffer more from peripheral vascular disease.
  • It is slightly more common in men than in women.
  • The two main types of peripheral vascular disease are functional and organic.
  • While organic PVD results from structural changes in the blood vessels caused by inflammation, plaque buildup, or tissue damage, functional PVD occurs as a result of a decreased blood flow in response to something that triggers the blood vessel to either narrow or widens, such as brain signals or changes in body temperature

CAUSES

Organic PVD is usually caused by atherosclerosis – a condition in which plaque buildup in the blood vessels. Common risk factor for atherosclerosis include:

  • Smoking
  • High blood pressure
  • Diabetes
  • High cholesterol
  • Inflammation from arthritis, lupus, or other conditions
  • Insulin resistance

Other conditions that may cause structural changes in the blood vessels are:

  • Deep vein thrombosis (DVT)
  • Chronic venous insufficiency
  • Varicose veins
  • Raynaud’s syndrome

Functional PVD is caused by:

  • Cold temperature
  • Drug use
  • Stress
  • Operating vibrating machinery or tools

Certain risk factors that may increase your chance of getting PVD to include:

  • Obesity
  • Being over the age of 50
  • A family history of stroke, or PVD
  • High levels of homocysteine

SYMPTOMS

  • Claudication- pain, aches, or cramps when walking or climbing the staircase. Pain might occur in the buttock, calf, thigh, and hip. The pain usually goes away after rest.
  • Leg cramps, numbness, or weakness.
  • Hair loss or slower hair growth on the feet and legs.
  • A change in the color of the legs such as pale or reddish-blue color
  • Slow-healing wounds and ulcers
  • Slower growth of the toenails
  • Weak or no pulse in the legs or feet
  • Numb or heavy sensation in the muscles
  • A thin or shiny skin on the legs and feet
  • Coldness in the lower leg or foot, especially when compared with the other side.
  • Erectile dysfunction in men

DIAGNOSIS AND TREATMENT

The doctor will carry out the following during diagnosis:

  • Review your family and medical history, which includes details of lifestyle, diet, and medication use.
  • Perform a physical examination which includes checking the skin temperature, appearance, and the presence of pulses in the legs and feet.
  • Blood tests to check for the presence of a condition such as diabetes and high cholesterol that can increase a person’s risk of developing PVD.
  • Ankle-brachial index (ABI) that measures the blood pressure in the ankles. The doctor then compares the reading to blood pressure in the arms. Lower blood pressure in the legs suggests a blockage.
  • Angiography where a dye is injected into the arteries to identify a blocked artery.
  • Imaging tests such as ultrasound, and MRI scan

TREATMENT

The aim of treatment is to slow or stop the progression of the disease, manage symptoms, and reduce the risk of serious complication such as heart attack and stroke.

The first line of treatment involves lifestyle modifications, including engaging in regular exercise, eating a balanced diet, losing weight, smoking cessation.

If these are not enough, medication may be recommended

  • Cilostazol and pentoxifylline to increase blood flow and relieve symptoms of claudication.
  • Daily aspirin or clopidogrel to reduce or stop blood clotting
  • Statins such as atorvastatin, simvastatin o reduce high cholesterol
  • Angiotensin-converting enzyme (ACE) inhibitors for hypertension
  • Diabetes medication to control blood sugar, if you have diabetes