Vascular Diseases Can Be Serious But Are Preventable

James Mathew, M.D., Cardiologist, Columbia St. Mary’s

Posted: Feb. 1, 2007

Vascular disease is disease of the blood vessels. Left untreated, it can lead to serious complications. Diseases of the heart and blood vessels are the number one cause of death in both men and women in the United States. The good news is that there are a number of effective ways to prevent and treat them.

Vascular disease is typically a result of arteriosclerosis – a hardening of the arteries caused by a build up of plaque over time. Vascular disease affects the arteries that carry blood to many different regions of the body and can come in many forms. People who develop any form of vascular disease have a high chance of developing disease in the blood vessels of the heart leading to heart attack, and disease of the blood vessels supplying blood to the brain leading to stroke.

An early symptom of blocked blood vessels in the heart is chest pain or shortness of breath on exertion. This usually goes away with rest. It is important to tell your doctor about this. If such symptoms get worse or if they come at rest, it is a medical emergency because it may be a warning sign or even the beginning of a heart attack.

One of the most common forms of vascular disease is known as peripheral vascular disease (PVD) and involves the arteries that carry blood to the legs and less often to the arms. Often a person with PVD will first notice pain or weakness in the legs while walking. As it progresses, PVD leads to resting leg pain, leg swelling and skin ulcers that will not heal. An ankle brachial test – a simple blood pressure test on a person’s ankles and arms – is a very useful screening test for PVD.

Another common form of vascular disease is carotid artery disease. Similar to PVD, carotid artery disease occurs due to a buildup of plaque in the arteries in the neck. These arteries carry blood from the heart to the brain and this buildup can lead to stroke. Any changes in vision, slurred speech, loss of balance, or numbness or weakness on one side of the body should be evaluated immediately by your doctor as these are common symptoms of carotid artery disease.

Abdominal aortic aneurysm (AAA) is a very serious form of vascular disease that accounts for nearly 15,000 deaths each year in the United States. This disease occurs when the aorta – the body’s largest blood vessel, located in the abdomen – weakens and enlarges. A sudden onset of back or abdominal pain can be a warning sign. Often AAA goes undetected due to lack of symptoms, but an abdominal ultrasound or CT scan can locate the aneurysm if your doctor suspects you are at risk.

Venous disease, another common form of vascular disease, occurs when a person’s veins become blocked and swollen, especially in the legs. Varicose veins, leg pain, leg swelling, skin discoloration and ulcers are all typical symptoms of venous disease.

Risk factors
Although the symptoms of various vascular diseases differ depending upon the affected area, the risk factors for developing any of these diseases are fairly consistent.

Smoking is by far the No. 1 preventable risk factor for developing any type of vascular disease. Smoking promotes the narrowing of the blood vessels and increases the chance of developing a blood clot resulting in acute problems like heart attack. Smoking also reduces a body’s good cholesterol, or HDL cholesterol, thus facilitating arteriosclerosis.

High blood pressure, high cholesterol and diabetes are the other major treatable risk factors for vascular disease. In fact, the prevalence of these problems is so high in the United States that treating them and avoiding smoking would have a very significant favorable impact on vascular disease mortality. Obesity, advancing age, lack of exercise and stress also are risk factors for a person developing vascular disease, particularly heart attack.

Preventing vascular disease by addressing these risk factors is important. However, even if a person already has vascular disease, there are actions he or she can take to treat the disease and reduce its consequences.

A good diet, plenty of exercise, and weight maintenance are important keys to treating vascular disease as well as for preventing them. Smoking cessation negates the ill effects of smoking. An annual physical examination to screen for common risk factors and to identify any disease will allow early treatment and the best possible outcome. Proper treatment of high blood pressure, diabetes and high cholesterol will retard the progression of disease and reduce their bad outcomes. There are also medicines effective in preventing as well as treating vascular disease.

A variety of scanning and angiographic techniques are available to assess the full severity and extent of vascular diseases. These tests will provide the information necessary to formulate individualized treatment plans. Advances in treatment techniques using balloon catheters and stents (commonly known as angioplasty) now make them effective in a majority of patients with blocked blood vessels in the heart and elsewhere. Careful evaluation will also identify patients who may benefit from operations for blocked vessels in the heart, the neck or the limbs.

Thus, heightened awareness, lifestyle modifications, evaluation by a team of experts, proper medications and selective use of angioplasty and surgery can prevent heart attack, stroke and limb loss. This will improve your chances of a healthier and longer life.
James Mathew, M.D.
Cardiologist
Columbia St. Mary’s
414-961-VASC

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