Peripheral vascular disease (PVD) is any disease or disorder that affects the circulatory system outside of the heart and brain, especially in the extremities. Because veins and arteries deliver blood carrying oxygen and nutrients to organs and tissues, PVD can affect the health of tissue in the arms, legs and body core.

Causes of peripheral vascular disease

PVD is most often caused by a narrowing of blood vessels that supply blood to the arms and legs. The narrowing is usually caused by a buildup of plaque called atherosclerosis. The build-up occurs over long periods of time and increases with:

  • High blood pressure
  • High cholesterol
  • Diabetes
  • Smoking

Other conditions that can slow blood flow include blood clots and inflammation of the blood vessels. Certain conditions like congenital heart disease can also decrease the amount of oxygen-rich blood that reaches the arms and legs.

Risk factors for peripheral vascular disease

PVD is more common in men and in people over 50 years of age. Other factors that may increase your risk include:

  • Smoking
  • Family history of PVD
  • Diabetes
  • High blood pressure or family history of high blood pressure
  • Stroke or family history of stroke
  • High cholesterol or family history of high cholesterol
  • Coronary artery disease (CAD)
  • Metabolic syndrome
  • HIV infection

Symptoms of peripheral vascular disease

Symptoms of PVD will depend on the area that is most affected. Common symptoms include:

  • Pain, fatigue, aching, tightness, weakness, cramping or tingling in the leg(s), brought on by exercise, that goes away when resting
  • Numbness and pain of the legs or feet at rest
  • Cold hands, legs or feet
  • Loss of hair on the legs and/or feet
  • Paleness or blueness of the legs
  • Weak or absent pulse in the leg
  • Sores, ulcers or infection of the feet, and legs that heal slowly
  • Erectile dysfunction
  • Swelling in lower extremities
  • Muscle atrophy (loss of muscle)

Screening for peripheral vascular disease

The Vascular Disease Foundation recommends that men and women over the age of 40 be screened for vascular disease. Even if you don’t exhibit symptoms of PVD, during regular check-ups, your physician may perform one of more of the following:

  • Blood pressure readings
  • Blood tests to check your cholesterol and blood sugar levels
  • Body weight checks, such as checking your body mass index (BMI) and waist size
  • Asking about your habits, such as eating, smoking and exercise

Diagnosing peripheral vascular disease

If you exhibit symptoms or are at high risk of PVD, your physician may also perform:

  • Visual exam – to detect changes in skin texture and color, sores or nonhealing wounds
  • Pulse readings – to detect unusual sounds in the arteries and weak pulses in the hands and feet
  • Ankle-brachial index (ABI) – pressure readings in both arms and ankles using a blood pressure cuff and an ultrasound.
  • Treadmill exercise test
  • MRI scan
  • Angiogram/arteriogram
  • Doppler ultrasound
  • Electrocardiogram (ECG or EKG)

Treatments for peripheral vascular disease

Early treatment can slow or stop the disease. Treatment options include:

  • Lifestyle changes, including quitting smoking, eating a heart healthy diet and increasing physical activity
  • Management of related medical conditions, including high blood pressure, high cholesterol and diabetes
  • Medications to improve blood flow—such as blood thinners to reduce blood clots, statins to lower cholesterol and vasodilators to widen arteries—and pain medication to help manage discomfort
  • Invasive procedures to quickly increase blood flow, including balloon angioplasty, stent implant, laser treatment or atherectomy
  • Surgery to open severely blocked arteries, including endarterectomy or bypass surgery

Types of peripheral vascular disease

  • Arteriosclerosis (sometimes referred to as hardening of the arteries) – occurs when arteries carrying oxygen and nutrients from the heart to the rest of the body become thick and stiff, potentially restricting blood flow to organs and tissues
  • Atherosclerosis – the build-up of plaque in artery walls, which can restrict blood flow
  • Peripheral artery disease (PAD) – a form of PVD that affects only the arteries, outside of the heart or brain. Untreated, peripheral artery disease can lead to problems like tissue death, infection, gangrene and amputation, and can increase a person’s risk of heart attack and stroke.
  • Ehlers-Danlos syndrome – a group of inherited conditions that weaken the body’s connective tissues, including in the skin, joints and blood vessel walls. Ehlers-Danlos syndrome, vascular type can cause the walls of the blood vessels to rupture. While there is no cure for the condition, symptoms can be managed through medication or surgery to repair ruptured blood vessels.
  • Managing risk factors for peripheral vascular disease

Overwhelmingly, the best way to avoid PVD is to quit smoking.

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Vascular disease specialists

The experienced heart and vascular specialists at Houston Heart are experts at diagnosing and treating all types of vascular disease.

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