subject: Vascular disease Causes and Treatment for Peripheral Vascular Disease [print this page] Vascular disease Causes and Treatment for Peripheral Vascular Disease
Vascular disease is mainly caused by hardening of the arteries (atherosclerosis) due to a thickening of the artery lining from fatty deposits or plaques (atheroma).
The arteries are blood vessels that supply blood, oxygen and nutrients to the body from the heart. Narrow, hardened arteries make it more difficult for blood to flow through and reach the tissue in question.
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Those parts of the body most affected by this disease suffer the consequences of an inadequate blood supply: poor function, tissue damage and, in worst cases, death.
There are different symptoms, depending on where the vascular disease is. It most commonly affects the arteries of the heart, brain and legs.
Causes of Vascular Dementia
Common causes of vascular dementia include:
1. Advanced age
2. High blood pressure
3. Smoking and passive smoking
4. High cholesterol levels
5. Diabetes
6. Heart disease and other existing heart conditions.
Symptoms of Vascular Dementia
The onset of vascular dementia often goes unnoticed in the early stages, particularly when the first strokes that eventually lead to dementia are very minor. Sometimes, symptoms such as cognitive and intellectual impairment and difficulty carrying out everyday tasks may become apparent only in the mid-to-late-stages of vascular dementia. In addition, symptoms may even improve, or at least stabilize for a while, until the next stroke.
Symptoms of vascular dementia vary according to the severity of the strokes, but include:
1. Memory loss
2. Confusion
3. Forgetfulness
4. Poor concentration
5. Inability to cope with simple daily activities
6. Language impairment, slurred speech
7. Inability to follow simple instructions
8. Behavioral changes
Hypertension also interferes with the reninangiotensin-aldosterone system, resulting in ischemia and reduced blood volume to the kidneys. Water and sodium reabsorption are increased in an attempt to increase the glomerular filtration rate, resulting in volume overload and higher vascular pressure, which cause sclerosis of the glomeruli.
Noninvasive tests for peripheral vascular disease include segmental pressure measurements, anklebrachial indexes, and pulse volume recordings.
For a segmental pressure measurement, blood pressure cuffs are placed at four sites: on the thigh, directly above the knee, directly below the knee, and at the ankle. Then, the pressure cuffs are inflated sequentially. If systolic pressure decreases by 15% or more from one site to another, the patient may have significant lesions.
A physician may order an exercise stress test along with an anklebrachial index and pulse volume recording. During the test, the patient exercises until he develops significant claudication. Then an anklebrachial index is performed by taking systolic blood pressures in the ankle and arm simultaneously. Severe claudication causes a significant difference between the ankle and brachial blood pressures during low-level exercise.
Pulse volume recordings are obtained at the same time as the anklebrachial index. If the patient has significant occlusions, the volume's amplitude will be reduced, and the height of its contour will be decreased.
Two invasive diagnostic tests, color flow Doppler ultrasonography and angiography, also can detect peripheral vascular disease. These procedures are performed to pinpoint the area of the lesion when surgery or angioplasty is planned. Color flow Doppler ultrasonography allows direct visualization of the major vessels and blood flow. Angiography provides information on the location and extent of the atherosclerotic disease.
