Peripheral vascular disease is a term to describe the phenomenon of narrowed veins or arteries outside of those that supply the heart, brain, or lungs (Gardner, 2012). The most common form of peripheral vascular disease occurs in the legs and feet, and can be a side-effect of diabetes. The main symptoms of peripheral vascular disease are blue skin, the development of skin ulcers, cold skin, and poor growth of hair and nails in the affected area (Gardner, 2012). Although peripheral vascular disease is treatable, particularly if caught early, complications include infections and tissue death that can require amputation (Lockhart et al., 2012). A major risk factor for the development of peripheral vascular disease is cigarette smoking, although it can also be associated with high blood pressure and high levels of cholesterol (Lockhart et al., 2012). The purpose of this paper is to describe peripheral vascular disease as a complication, including the causes, signs and symptoms, populations, and general prognosis for patients.
Causes of Peripheral Vascular Disease
Peripheral vascular disease is a complication of a number of other conditions and lifestyle factors. As noted above, tobacco smoking is one of the major causes of peripheral vascular disease in adults, with an approximately tenfold increase in the chances of developing the disease (Lockhart et al., 2012). Diabetes mellitus is associated with a fourfold increase in the chance of developing the disease. The other major causes include vascular spasm, dyslipidemia, hypertension, and individuals with a family history of peripheral vascular disease. The disease is more common in those who have leg pain and those who are 65 years of age or older.
Signs and Symptoms
Approximately half of all individuals who have peripheral artery disease show no signs or symptoms of having it (Gardner, 2012). Intermittent claudication is one of the most common signs of peripheral vascular disease, which means pain in the affected muscles when using them, a pain that is relieved by resting those muscles (Go et al., 2014). The cause of this pain is the fact that there is an unmet oxygen demand when using those muscles. Other signs include changes in color or temperature in the skin of the affected area (blueness and cold temperature), pallor upon elevation of the limb, and a reduced hair and nail growth in the area (Go et al., 2014). It should be noted that screening for the disease is not always useful in detecting it.
Populations
The populations who are most at risk from peripheral vascular disease are associated with the major causes. This includes individuals who have a history of cardiovascular disease, those with a family history of the disease, and those who have diabetes or other issues. The disease is also most common in those over the age of 65, and affects approximately 20% of the over 70s (Go et al., 2014). It is estimated that around 10 million Americans have peripheral vascular disease (Clark et al., 2012).
General Prognosis
One of the major complications of peripheral vascular disease is cardiovascular events, including cardiac arrest, heart disease, and stroke (Clark et al., 2012). There is also a chance that untreated and unmonitored peripheral vascular disease will lead to ischemia and therefore amputation, with around 7% requiring this surgery (Lockhart et al., 2012). The 5-year mortality rate from the disease is 30%, compared with 10% in the general control population in matched trials (Lockhart et al., 2012). Overall, the prognosis for peripheral vascular disease is therefore negative and should therefore be closely controlled and monitored by health care staff. It is also important to note that lifestyle factors such as diet and exercise can greatly improve the prognosis for those who are suffering from the disease, and ensuring that diabetes is kept under control can also be a protective measure.
References
Clark, C. E., Taylor, R. S., Shore, A. C., Ukoumunne, O. C., & Campbell, J. L. (2012). Association of a difference in systolic blood pressure between arms with vascular disease and mortality: a systematic review and meta-analysis. The Lancet, 379(9819), 905–914.
Gardner, A. W. (2012). Peripheral arterial disease. Encyclopedia of Exercise Medicine in Health and Disease, 697–700.
Go, A. S., Mozaffarian, D., Roger, V. L., Benjamin, E. J., Berry, J. D., Blaha, M. J., others. (2014). Heart disease and stroke statistics-2014 update. Circulation, 129(3). Retrieved from http://mayoclinic.pure.elsevier.com/en/publications/heart-disease-and-stroke-statistics--2014-update(fa810d37-c8d6-40bf-af86-0bb7d4f0142a).html
Lockhart, P. B., Bolger, A. F., Papapanou, P. N., Osinbowale, O., Trevisan, M., Levison, M. E., others. (2012). Periodontal disease and atherosclerotic vascular disease: does the evidence support an independent association? A scientific statement from the American Heart Association. Circulation, 125(20), 2520–2544.
