Peripheral Vascular Disease
What is Peripheral Vascular Disease?
Peripheral vascular disease is a condition
in which blood flow to the arms, legs or other parts of the body becomes
restricted. This can lead to pain in the affected limbs, and in the most severe
cases, gangrene. It is also referred to as peripheral arterial disease as it mainly
just affects the arteries.
Most importantly, peripheral vascular disease
is strongly associated with coronary artery disease – a condition in which the
blood supply to the heart becomes restricted, increasing the risk of heart attack.
What causes peripheral vascular disease?
Peripheral vascular disease is usually
caused by narrowing of the arteries, through a process called atherosclerosis. In
atherosclerosis, there is a gradual build-up of plaque (fatty deposits) in the
lining of the arteries. This results in the arteries becoming narrowed, leading
to a restriction in the blood flow. This process also increases the risk of a
blood clot forming.
The rate at which the plaques develop
depends on a number of factors, such as a person’s genes, your cholesterol
level, and whether or not you smoke.
What are the risk factors?
The risk factors for developing peripheral
vascular disease are the same as those for atherosclerosis in general, i.e.:
- Family history of disease
- High blood pressure
- High Cholesterol
- Being overweight
What are the symptoms?
Peripheral vascular disease most commonly affects
the legs – the main symptom is cramping pains in the muscles of the legs on any
exertion (this is called intermittent claudication). This can also happen in
If the blockage in the arteries becomes
more severe, you may experience pain even when at rest. This normally occurs in
the feet and at night-time, when you are lying down. This can lead to foot ulcers
and even gangrene. In extreme cases, amputation may be necessary.
Peripheral vascular disease can also
affect the kidneys, leading to the development of high blood pressure and renal
Many people with peripheral vascular disease
do not even realise they have it, as many elderly people attribute their
symptoms to ageing. It is therefore important to be on the look-out for
symptoms, especially if you think you may be at risk.
Why does peripheral vascular disease increase
risk of heart attack?
Peripheral vascular disease can be a sign that
you may also have developed, or be at risk of developing, atherosclerosis in your
coronary arteries - those arteries that supply blood to the heart. This is called
coronary artery disease (also known as coronary heart disease). There is also a
greater chance that you could have developed atherosclerosis in the arteries of
your brain – which can lead to stroke. In addition, a clot formed in one of
your peripheral arteries may travel to the brain, causing a stroke.
Because of this, people with peripheral
vascular disease have a six to sevenfold increased risk of heart attack or
What should I do if I have symptoms?
If you suspect you have symptoms
associated with peripheral vascular disease, or you think you may be at risk,
visit your family doctor (GP). Early treatment can prevent the disease from
Your doctor will conduct a physical
examination to look for signs of the disease, and will be able to decide if you
need further assessment. The doctor may carry out a special type of blood
pressure test called an ankle-brachial index. This tests the difference in
blood pressure between your arm and your ankle, so that the doctor can see if
there is a problem in blood flow to your legs.
In some cases, the doctor may decide to
refer you to the hospital to have more specialist imaging tests carried out, to
find out the extent of the damage in your arteries.
What is the treatment?
If you are diagnosed with peripheral
vascular disease, the first and most important step is normally to make some
changes to your lifestyle. These could include stopping smoking, making sure
any other conditions you have – such as diabetes and blood pressure are under
control, and making changes to your diet to reduce cholesterol level. Regular exercise
is very important as this can help to improve the circulation in your legs.
Your doctor may prescribe you with various
types of medications. These may include medication to prevent blood clots and reduce
your risk of stroke and heart attack (e.g., aspirin), a type of drug known as a
statin to lower your cholesterol and drugs to control your blood pressure. You may
also be given a drug specifically to improve the blood flow to your legs, and
reduce the pain when walking.
Sometimes, if your artery is severely blocked
or if medication isn’t helping, you may need a procedure called an angioplasty.
This involves inserting a catheter into the artery to open it up. In some
cases, surgery may also be necessary to bypass the artery that has been blocked.
This is done by inserting a new blood vessel (a ‘graft’) to create a detour
around the affected artery.