Vascular disease

Vascular disease
Veins and arteries
Classification and external resources
Specialty	angiology
ICD-10	G45-G46, I60-I95
ICD-9-CM	325, 430-459
MeSH	D014652

Veins and arteries

Vascular disease is a class of diseases of the blood vessels – the arteries and veins of the circulatory system of the body. It is a subgroup of cardiovascular disease. Disorders in this vast network of blood vessels, can cause a range of health problems which can be severe or prove fatal.^[1]

Associated medical conditions

Types

There are several types of vascular disease, (which is a subgroup of cardiovascular disease) among them are:^[2]

• Peripheral artery disease – happens when atheromatous plaques build up in the arteries that supply blood to the arms and legs, plaque causes the arteries to narrow or become blocked.^[3]
• Renal artery stenosis - is the narrowing of renal arteries that carry blood to the kidneys from the aorta.^[4]
• Buerger's disease – is due to small blood vessels that inflame and swell, vessels then narrow or are blocked by blood clots.^[5]
• Raynaud's disease – a rare disorder of constriction of the peripheral blood vessels, in the fingers and toes when the person is cold.^[6]
• Disseminated intravascular coagulation – a widespread activation of clotting in the smaller blood vessels.^[7]
• Cerebrovascular disease–a group of vascular diseases that affect brain function.

Mechanism

Endothelium lines the inner wall of the vessel

Vascular disease is a pathological state of large and medium muscular arteries and is triggered by endothelial cell dysfunction.^[8] Because of factors like pathogens, oxidized LDL particles and other inflammatory stimuli endothelial cells become active.^[9] The process causes thickening of the vessel wall, forming a plaque that consists of proliferating smooth muscle cells, macrophages and lymphocytes.^[10][11] The plaque results in a restricted blood flow which will decrease the amount of oxygen and nutrients that reach certain organs,^[12] the plaque might rupture causing the formation of clots.

Diagnosis

It can be difficult to make a Vascular disease diagnosis since there are a variety of symptoms that a person can have, also family history and a physical examination are important. The physical exam may be different depending on the type of vascular disease. In the case of a peripheral vascular disease the physical exam consists in checking the blood flow in the legs.^[13][14]

Treatment

Peripheral vascular disease-ulcer

Treatment varies with the type of vascular disease; in the case of renal artery disease, information from a meta-analysis indicated that balloon angioplasty results in improvement of diastolic blood pressure and a reduction in antihypertensive drug requirements.^[15] In the case of peripheral artery disease, preventing complications is important; without treatment, sores or gangrene (tissue death) may occur. Among the treatments are:^[16]

• Quitting smoking
• Lowering cholesterol
• Lower blood pressure
• Lower blood glucose
• Physical activity

References

1. "Vascular Diseases: MedlinePlus". www.nlm.nih.gov. Retrieved 2015-06-23.
2. "ACC/AHA 2005 Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic): A Collaborative Report from the American Association for Vascular Surgery/Society for Vascular Surgery,⁎ Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Peripheral Arterial Disease)". content.onlinejacc.org. Retrieved 2016-02-02.
3. "Peripheral Arterial Disease: MedlinePlus". www.nlm.nih.gov. Retrieved 2015-06-23.
4. "Renal Artery Stenosis". www.niddk.nih.gov. Retrieved 2015-06-23.
5. "Thromboangiitis obliterans: MedlinePlus Medical Encyclopedia". www.nlm.nih.gov. Retrieved 2015-06-23.
6. "Raynaud's Disease: MedlinePlus". www.nlm.nih.gov. Retrieved 2015-06-23.
7. "Disseminated intravascular coagulation (DIC): MedlinePlus Medical Encyclopedia". www.nlm.nih.gov. Retrieved 2015-06-25.
8. Rajendran, Peramaiyan; Rengarajan, Thamaraiselvan; Thangavel, Jayakumar; Nishigaki, Yutaka; Sakthisekaran, Dhanapal; Sethi, Gautam; Nishigaki, Ikuo (2013). "The Vascular Endothelium and Human Diseases". International Journal of Biological Sciences 9 (10): 1057–1069. doi:10.7150/ijbs.7502. ISSN 1449-2288. PMC 3831119. PMID 24250251.
9. Bikfalvi, Andreas (2013-12-19). Encyclopedic Reference of Vascular Biology & Pathology. Springer. ISBN 9783642570636.
10. Rubin, Emanuel; Damjanov, Ivan (2013-11-11). Pathology Reviews · 1989. Springer Science & Business Media. ISBN 9781461245025.
11. Gunstone, Frank D.; Harwood, John L.; Dijkstra, Albert J. (2007-03-13). The Lipid Handbook with CD-ROM, Third Edition. CRC Press. ISBN 9781420009675.
12. Rolfes, Sharon Rady; Pinna, Kathryn; Whitney, Ellie (2011-06-20). Understanding Normal and Clinical Nutrition. Cengage Learning. ISBN 084006845X.
13. "How Is Peripheral Arterial Disease Diagnosed? - NHLBI, NIH". www.nhlbi.nih.gov. Retrieved 2015-06-23.
14. Andras, Alina; Ferket, Bart (2014). Screening for peripheral arterial disease. John Wiley & Sons, Ltd.
15. Jenks, Sara; Yeoh, Su Ern; Conway, Bryan R. (2014). "Balloon angioplasty, with and without stenting, versus medical therapy for hypertensive patients with renal artery stenosis". The Cochrane Database of Systematic Reviews 12: CD002944. doi:10.1002/14651858.CD002944.pub2. ISSN 1469-493X. PMID 25478936.
16. "How Is Peripheral Arterial Disease Treated? - NHLBI, NIH". www.nhlbi.nih.gov. Retrieved 2015-06-23.

Further reading

• "The effects of lowering LDL cholesterol with statin therapy in people at low risk of vascular disease: meta-analysis of individual data from 27 randomised trials". www.crd.york.ac.uk. Retrieved 2015-06-23.