Vascular disease

There are several types of vascular disease, and signs and symptoms can vary depending on the disease type. These types include:[5]

• Erythromelalgia - a rare peripheral vascular disease with syndromes that include burning pain, increased temperature, erythema and swelling that generally affect the hands and feet.
  

  Erythromelalgia in a 77-year-old woman
  [6]
• Peripheral artery disease – occurs when atheromatous plaques build up in the arteries that supply blood to the arms and legs, causing the arteries to narrow or become blocked.[1]
• Renal artery stenosis - the narrowing of renal arteries that carry blood to the kidneys from the aorta.[2]
• Buerger's disease – inflammation and swelling in small blood vessels, causing the vessels to narrow or become blocked by blood clots.[7]
• Raynaud's disease – a rare peripheral vascular disorder that causes constriction of the peripheral blood vessels in the fingers and toes when a person is cold or experiencing stress.[8]
• Disseminated intravascular coagulation – a widespread activation of clotting in the smaller blood vessels.[9]
• Cerebrovascular disease – a group of vascular diseases that affect brain function.[10]

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.[11] Because of factors like pathogens, oxidized LDL particles and other inflammatory stimuli endothelial cells become active.[12] The process causes thickening of the vessel wall, forming a plaque that consists of proliferating smooth muscle cells, macrophages and lymphocytes.[13][14] The plaque results in restricted blood flow, decreasing the amount of oxygen and nutrients that reach certain organs.[15] This plaque can also rupture, causing the formation of clots.[16]

Diagnosing vascular disease can be complex due to the variety of symptoms vascular diseases can cause. Reviewing a patient's family history and conducting a physical examination are important steps in making a diagnosis. Physical exams may differ depending on the type of vascular disease suspected. For example, in the case of a peripheral vascular disease, a physical exam consists of checking blood flow in a patient's legs.[17][18]

Peripheral vascular disease-ulcer

Treatment varies based on the type of vascular disease being treated. In treating renal artery disease, a 2014 study indicates that balloon angioplasty can improve diastolic blood pressure and potentially reduce antihypertensive drug requirements.[19] In the case of peripheral artery disease, treatment to prevent complications is important; without treatment, sores or gangrene (tissue death) may occur.

More generally, treatments for vascular disease may include:[4]

• Lowering cholesterol levels
• Lowering blood pressure
• Lowering blood glucose
• Changes in diet
• Increasing physical activity (as recommended by a healthcare provider)
• Weight loss
• Quitting smoking
• Stress reduction

• "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.