Vascular disease affects the whole body

with Andrew Feiring, M.D., Vascular Cardiologist, Advanced Healthcare

Posted: Sept. 1, 2005

Vascular disease, which can affect arteries throughout the body, is experienced by 8 to12 million Americans at any one time. If not treated, the effects of this disease can be devastating to a person’s quality of life and even result in loss of limb, stroke, renal failure, or death.

Andrew Feiring, M.D., a vascular cardiologist at Advanced Healthcare, says, “While most people think about coronary artery disease as a separate disease, it is actually a condition that comes under the umbrella of vascular disease.”

Andrew Feiring, M.D., Vascular Cardiologist, Advanced Healthcare "While most people think about coronary artery disease as a separate disease, it is actually a condition that comes under the umbrella of vascular disease."

Vascular disease involves the process of arteriosclerosis or the build-up of plaque in the walls of the artery. The result is a blocked or narrowed artery, which can rupture or lead to closure of the artery.

If blockages occur in the area around the heart, this is referred to as coronary artery disease. Peripheral vascular disease (PVD) involves blockages in the legs or arms. PVD can affect your ability to walk or move your arms, and may lead to ulceration, gangrene and, in extreme cases, amputation. If blockages in arteries affect the kidneys, the result can be hypertension or renal failure. If blockages appear in the carotid arteries of the neck, the result may be a stroke. Sometimes vascular disease affects the arteries going to the intestines and can produce problems with blood flow to the intestines.

Dr. Feiring points out that the risk factors for cardiac disease are the same as those for vascular disease in the rest of the body. It is important for everyone to try to control these risk factors in order to avoid vascular disease.

Risk factors include the following:

• Cigarette smoking
• Family history of vascular disease
• Hypertension (high blood pressure)
• High cholesterol levels
• Diabetes and tobacco use

Vascular disease is more common in people over 50 years old, unless they are diabetic, and men tend to show signs of vascular disease about a decade earlier than women. The incidence of vascular disease does increase as people age. Dr. Feiring observes that 30 to 40 percent of people over 80 years old will typically show some signs of vascular disease.

If you are diagnosed with vascular disease in one part of your body, you should be checked for signs of the disease in other parts of your body. For instance, if you have vascular disease in your lower extremities, where the arteries are larger than the arteries around the heart, there’s a good chance that you may also have build-up of plaque in the smaller arteries around your heart. Or if you have arteriosclerosis in your carotid arteries in the neck and also symptoms of PVD, you have at least a 50 percent chance of also having blockages in your coronary arteries.

Dr. Feiring points out that it’s important to look at heart disease in patients as just one part of the vascular system that may be affected. The heart needs to be evaluated in relationship to the vascular system throughout the body. Arteries in the neck, the kidneys, the legs, the intestines, and the heart should not be segmented for treatment since disease in one area of the vascular system affects another area. For instance, if you have plaque in your renal arteries, you will probably have hypertension, which will make coronary artery disease worse and increase your risk for stroke.

Dr. Feiring emphasizes that finding plaque or narrowing in one artery in the vascular system should definitely raise the suspicion that you have the same process taking place in other parts of the vascular system, even though you may not currently have symptoms.

Sometimes vascular disease does not produce symptoms. For instance, frequently the first symptom of carotid artery disease may actually be a stroke. The first symptom of PVD is usually pain that occurs during activity (called claudication) due to decreased blood flow in the legs. For some patients, a course of exercise therapy, lifestyle changes, and medications can halt the progression of the disease; however, once you have certain symptoms, such as an ulcer on your foot, the disease can move quickly toward amputation unless it is treated aggressively.

Dr. Feiring says he looks at where vascular disease is present throughout a patient’s body and then prescribes a multi-faceted treatment plan to address the risk factors. Controlling risk factors is an important step in the treatment of vascular disease. He says, “While quiting smoking may not reverse the effects of vascular disease, it may delay the rate of its progression.” He points out that there are some recent studies of people with carotid artery disease which indicate that if you attack your lipid profile very aggressively, stop smoking, and control your blood pressure, you may actually be able to cause some regression of plaque that has been building up.

Symptomatic vascular disease that interferes with life style can frequently be treated with angioplasty, a non-surgical procedure that increases blood flow through the arteries by using balloons, shaving devices, laser, or medicated stents (small metal tubes) to keep the arteries open. This procedure is performed frequently to treat blockages around the heart, but it can also be effective for other parts of the vascular system. For example, Dr. Feiring has successfully published data showing that treating some types of PVD with medicated stents can reduce amputation and the chance of dying.

Dr. Feiring says, “By treating the patients with vascular disease in a comprehensive and aggressive fashion we are capable of not only prolonging life, but we are able to maintain the quality of life by keeping people ambulatory and independent.”

Andrew Feiring, M.D. - Vascular Cardiology
Good Hope Clinic
3003 W. Good Hope Road
Milwaukee
414-352-3100

Columbia Cardiac Clinic
2015 E. Newport Avenue, Suite 208
Milwaukee
414-247-4500

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