What Is Vascular Disease

Introduction to vascular disease

Definition and overview of vascular diseases

A vascular disease affects the body’s vascular system - the arteries, veins and capillaries. The disease may affect these blood vessels in different ways, such as by blocking the flow of blood or weakening them so they can no longer effectively transport blood around the body. This can have further consequences as the lack of oxygenated blood may lead to damage in the organs or tissue. 

Significance in the context of cardiovascular health

This may be particularly harmful if the associated blood vessels are related to the heart. For example, any veins or arteries that supply blood to/from the heart can become blocked or obstructed. This means that the muscles of the heart will not receive oxygenated blood and this lack of oxygen (hypoxia) can cause permanent damage to the heart muscles. This damage may be irreversible and lead to further complications. Such conditions are known as cardiovascular disease. 

Anatomy of the vascular system

Explanation of the vascular system's components

The vascular system in the body is made up of different components such as arteries, veins and capillaries. The main purpose of the vascular system is to carry blood around the body and to provide oxygen to the muscles. Arteries take the oxygenated blood away from the heart around the body while the veins bring the deoxygenated blood back to the heart. Arteries have very thick walls made up of muscle and elastin to cope with the high pressure of blood travelling out of the heart. Veins have thinner walls than arteries but are also made of smooth muscle and elastin. Veins also contain valves to prevent the backflow of blood as it returns to the heart. Capillaries are extremely small blood vessels (only a single epithelial cell thick) that transport oxygenated blood to the cells. 

Types and classification

Overview of different types of vascular diseases (e.g., atherosclerosis, peripheral artery disease)

There are different types of vascular diseases. The first type is those that affect the arteries- the blood vessels that leave the heart while carrying oxygenated blood. This can include the coronary arteries (the arteries that supply blood to the heart), the carotid artery (which supplies blood to the brain), and the peripheral arteries (which supply blood to the rest of the body). There may be a buildup of plaque (a deposit made up of fat and cholesterol which narrows and may eventually block your arteries), which is known as atherosclerosis.¹ The buildup of plaque can cause ischemia (when there is an insufficient amount of blood reaching the tissues) that may in turn cause further damage.

Examples of peripheral artery diseases:

• Renal artery disease: this artery leads to the kidney, and the blockage of this artery can eventually cause kidney failure
• Intestinal Ischemic Syndrome: these blood vessels lead to your gastrointestinal system
• Peripheral artery disease² This refers to the arteries in your legs, and a blockage in this region can have particularly serious complications such as gangrene (tissue death) and loss of limbs. 

Classifying vascular diseases based on affected vessels and symptoms

Other types of diseases may affect the carotid arteries which can lead to complications such as a stroke.

Some diseases affect the veins and the blood vessels that bring blood back to the heart. A common example of this is varicose veins. The valves in the veins become damaged, resulting in the veins having a swollen, bulging and purple appearance under the skin. This is commonly seen in the lower legs. Similarly, spider veins are when the capillaries in the legs (around the knees, calves, and thighs) become swollen and create red or purple bursts under the skin. A different type of venous disease is chronic venous insufficiency which is the result of the valves in the leg veins not working properly, which makes it harder for the blood to return to the heart.

Another type of disease is linked to the formation and movement of thrombus’ (blood clots) through the blood vessels. These can also cause blockages. Deep vein thrombosis (DVT)³ is when a clot forms in a deep vein under the skin. This is more common in the legs but can also occur in other regions like the arms. The clot can cause blockages in the veins but may also travel through the veins and reach the lungs, where it causes a pulmonary embolism. Without urgent treatment, a pulmonary embolism will prove to be fatal.

Vasculitis is an inflammation of a blood vessel and may lead to the formation of an aneurysm (when a blood vessel is weakened, and an area forms a bulge that may go on to burst).⁴

Causes and risk factors

Common causes of vascular disease (e.g., plaque buildup, inflammation)

The most common cause of vascular diseases is the buildup of plaque in the blood vessels, leading to a blockage. This blockage is what results in further complications. The formation of plaque is initially symptomless and can go on for many years without notice. Plaque is caused by poor lifestyle choices like obesity, bad diet and lack of exercise.

Another cause is genetics, as some people are simply born with differences in their vascular system that may lead to disease. A family history of certain vascular diseases (such as cardiovascular disease) also increases your chances of developing the disease.

Some diseases that are caused by inflammation may be linked to infection. In the case of Vasculitis, an inflammation of the blood vessels may have initially been caused by an infection that later on goes to become an aneurysm. 

Risk factors (age, genetics, lifestyle choices)

Certain risk factors that increase your chances of developing vascular diseases. This can include being above the age of 50, so it is important to have regular checkups after that age if you are considered to be at risk of developing a vascular disease. Another risk factor is genetics; if you have a family history of individuals developing vascular diseases early on in life (under 55 for men and 65 for women), it is recommended to have regular checkups with your general practitioner or healthcare provider. Furthermore, your lifestyle choices can also increase your chances of developing a vascular disease. This includes lifestyle choices such as smoking, unhealthy diet (leading to obesity), lack of exercise and excessive drinking. Certain ethnic backgrounds are at a higher risk of developing vascular diseases; this includes a South Asian, Black African and Caribbean background.

Symptoms and clinical presentation

The symptoms of each vascular disease differ greatly. In the case of DVT, the area with the clot may become swollen and feel warmer and red in appearance. There may also be pain or tenderness in the region, but that may only be felt with movement or standing. But in some cases, there are no clear symptoms, so it is extremely important to seek medical attention if you suspect DVT.

In the cases of peripheral artery diseases, the areas with the blockages may show a colour change compared to the rest of the skin, and your skin may feel colder in comparison.

Diagnosis and evaluation

It is very important to diagnose vascular diseases early on to improve your outcome following treatment. Your doctor may carry out a vascular ultrasound, CT scan or MRI scan to diagnose the disease. They may also refer you to a specialist for further treatment. 

Treatment and management

It is very important to follow the treatment plan created for you. This may include lifestyle changes such as modifications to your diet or stopping smoking. Or you may be prescribed medication such as statins to reduce your cholesterol levels. 

Complications and consequences

Complications can be severe. Blockages in certain blood vessels can lead to a heart attack, stroke, or even the loss of a limb. However,  early detection and following the treatment plan can greatly reduce your chances of such complications. 

Prevention and risk reduction

Strategies for preventing vascular diseases

If you believe yourself to be at risk of developing a vascular disease or have a family history of vascular diseases, it is best to consult your general practitioner to monitor your health and catch the early signs of any vascular diseases. 

Managing modifiable risk factors (cholesterol, blood pressure)

There are also some changes you can make in your daily life to reduce the risk of developing vascular diseases. If you spend a lot of time sitting down or do not get enough exercise, try to gradually increase the amount of exercise you do per week. It is best to start with gentler and low-impact activities if you do not have a high level of fitness or are unused to regular exercise. Daily walks are a good way to increase the amount of physical activity you do per week. Swimming can also be a gentler activity for your joints when compared to running.

Additionally, reducing the amount of alcohol you drink can be greatly beneficial to decreasing your risk of developing vascular diseases. The average adult should not consume more than 14 units of alcohol per week. It may be helpful to seek the advice of your doctor or healthcare provider to find ways to reduce the amount of alcohol you consume.

Furthermore, a healthier diet can allow you to lose weight, as obesity increases your chances of developing a vascular disease. Regular exercise and a diet that is higher in wholegrains and vegetables while being lower in salt, sugar and saturated fats can also contribute to a lower cholesterol level. 

Living with vascular disease

If you are struggling with making lifestyle changes, help is available. Speak to your GP about changes you can make to your daily life to help reduce the risk factors. They can also provide further support for the symptoms of various vascular diseases. 

Conclusion

Vascular diseases can affect any blood vessel in the body and may become more severe over time. It is important to seek treatment if you suspect you have a vascular disease, as early detection can greatly improve your quality of life and prognosis.