Ask the Expert: Poor Circulation and Your Health

The circulatory system comprises a sophisticated highway of blood vessels. These vessels include arteries, which transport oxygen- and nutrient-rich blood throughout the body, and veins, which carry oxygen-depleted blood and waste to be filtered out from the body.

Peripheral vascular disease (PVD) primarily affects arteries throughout the body. Dr. Thomas Terramani, a Sharp Grossmont Hospital-affiliated vascular surgeon, answers questions about vascular diseases, which can be life-threatening if left untreated.

What is peripheral vascular disease and which is the most common?
Peripheral vascular disease, also commonly known as peripheral arterial disease (PAD), is any disorder or disease of the circulatory system that results in hardening and narrowing of arteries. PAD typically develops when blood vessels become completely or partially blocked as a result of atherosclerosis — buildup of fatty “plaque” along the walls of the vessels.

Who is at risk for developing PAD?
Individuals who pose a greater risk for developing PAD include those who are:

• Diabetics
• Diagnosed with high blood pressure or high cholesterol or LDL (the “bad cholesterol”), plus high triglycerides and low HDL (the “good cholesterol”)
• Inactive, or maintain a sedentary lifestyle
• Known to have a positive family history of premature heart attacks or strokes
• Older than 50 years
• Overweight or obesity
• People with coronary heart disease or a history of heart attack or stroke generally also have an increased frequency of having peripheral vascular disease
• Smokers  

What makes PAD a serious threat to your health?
If left untreated, PAD can result in limb loss due to lack of blood supply. The lower extremities are commonly affected. In the early stages of PAD, patients suffer from leg pain associated with walking. This pain, known as intermittent claudication, can limit one’s ability to walk and exercise. PAD is also associated with heart and cerebral vascular disease resulting in an increase in frequency of heart attacks and strokes.

Are there symptoms associated with the disease?
Yes. In the early stages of PAD, intermittent claudication can typically occur. Another symptom may be a cut or injury to an extremity that has difficulty healing (nonhealing ulcer). Severe PAD can lead to an onset of gangrene, resulting in possible loss of limb.

How is PAD treated?
The first step in managing PAD is to identify and modify vascular risk factors. If a patient’s PAD is mild, a walking exercise program, combined with medication, can reduce claudication symptoms. A more advanced PAD involves a second step — diagnostic angiogram. The diagnostic angiogram is a method of taking detailed pictures of the affected arteries and determining the best treatment option, which range from minimally invasive angioplasty and stenting to surgical bypass graft.

What is the best way to reduce your risk of developing PAD?
Controlling and reducing your risk factors in the following ways will help you reduce your risk of PAD:

• Alter an inactive lifestyle and begin an exercise program
• Diabetics should tightly manage blood sugar
• High cholesterol or triglycerides should be controlled with diet, and in many cases medications 
• If you are classified as obese, try losing weight
• Quit smoking

For More Information
For more information about heart and vascular care at Sharp or to find a Sharp-affiliated doctor, search for a San Diego cardiologist or call 1-800-82-SHARP (1-800-827-4277), Monday through Friday, 8 am to 6 pm. To find general information about heart and vascular care, visit Cardiovascular Diseases in Adult Health or read the Heart and Cardiovascular News archive.