Peripheral Vascular Disease

Peripheral vascular disease (PVD) is a blood circulation disorder that causes the blood vessels outside of your heart and brain to narrow, block, or spasm. This can happen in your arteries or veins. PVD typically causes pain and fatigue, often in your legs, and especially during exercise. The pain usually improves with rest.

Complications

It can also affect the vessels that supply blood and oxygen to your

  • arms
  • stomach and intestines
  • kidneys
In PVD, blood vessels become narrowed and blood flow decreases. This can be due to arteriosclerosis, or “hardening of the arteries,” or it can be caused by blood vessel spasms. In arteriosclerosis, plaques build up in a vessel and limit the flow of blood and oxygen to your organs and limbs.

As plaque growth progresses, clots may develop and completely block the artery. This can lead to organ damage and loss of fingers, toes, or limbs, if left untreated.

Causes

What causes PVD?

Functional PVD

Your vessels naturally widen and narrow in response to your environment. But in functional PVD, your vessels exaggerate their response. Raynaud’s disease, when stress and temperatures affect your blood flow, is an example of functional PVD.

The most common causes of functional PVD are:

  • emotional stress
  • cold temperatures
  • operating vibrating machinery or tools
  • drugs

Organic PVD

Organic PVD means there’s change in the structure of your blood vessels. For example, the plaque buildup from arteriosclerosis can cause your blood vessels to narrow. The primary causes of organic PVD are:

  • smoking
  • high blood pressure
  • diabetes
  • high cholesterol

Additional causes of organic PVD include extreme injuries, muscles or ligaments with abnormal structures, blood vessel inflammation, and infection.

Part 4 of 10: Risk factors

What are the risk factors for PVD?

There are numerous risk factors for PVD.

You’re at higher risk for PVD if you:

  • are over age 50
  • are overweight
  • have abnormal cholesterol
  • have a history of cerebrovascular disease or stroke
  • have heart disease
  • have diabetes
  • have a family history of high cholesterol, high blood pressure, or PVD
  • have high blood pressure
  • have kidney disease on hemodialysis

Lifestyle choices that can increase your risk of developing PVD include:

  • not engaging in physical exercise
  • poor eating habits
  • smoking
  • drug use

Treatments

How do you treat PVD?

The two main goals of PVD treatment is to stop the disease from progressing and to help you manage your pain and symptoms so you can remain active. The treatments will also lower your risk for serious complications.

First-line treatment typically involves lifestyle modifications. Your doctor will suggest a regular exercise program that includes walking, a balanced diet, and losing weight.

If you smoke, you should quit. Smoking directly causes reduced blood flow in vessels. It also causes PVD to get worse, as well as increasing your risk of heart attack and stroke.

If lifestyle changes alone aren’t enough, you may need medication. Medications for PVD include:

  • cilostazol or pentoxifylline to increase blood flow and relieve symptoms of claudication
  • clopidogrel or daily aspirin to reduce blood clotting
  • atorvastatin, simvastatin, or other statins to lower high cholesterol
  • angiotensin-converting enzyme (ACE) inhibitors to lower high blood pressure
  • diabetes medication to control blood sugar, if you have diabetes

Significant artery blockages may require surgery like angioplasty or vascular surgery. Angioplasty is when your doctor inserts a catheter or long tube into your artery. A balloon on the tip of the catheter inflates and opens up the artery. In some cases, your doctor will place a small wire tube in the artery, called a stent, to keep it open.

Vascular surgery allows for blood to bypass the narrow area through vein grafting.