by Katherine Brind’Amour, PhD
Peripheral vascular disease is disease or damage in blood vessels other than (peripheral to) those in the heart or brain. (1) It is known by several names, including its medical abbreviation PVD and peripheral venous disease. Although some people use PVD interchangeably with peripheral artery disease (or PAD), the two are not quite the same (keep reading to find out why!).
Despite the difference, most statistics on how common peripheral vascular disease is actually measure peripheral artery disease. And it’s quite common. An estimated 8.5 million Americans have PAD, including up to 1 in every 5 people aged 60 or older. (2) Left untreated, PAD can lead to gangrene, limb amputation, heart attack and stroke. (3)
Thankfully, these diseases are preventable and treatable. People at the highest risk of developing peripheral vascular disease, or its complications, should start taking action sooner rather than later to decrease their chances of a diagnosis. And although the steps for natural prevention and treatment of PVD and PAD are simple to list, there is a reason for the phrase “Easier said than done.” Avoiding or overcoming vascular disease takes a long-term commitment to a healthy lifestyle.
What Is Peripheral Vascular Disease?
What is a basic definition of peripheral vascular disease, you may ask? A simple way to remember the peripheral vascular disease definition is to remember that it is disease in the blood vessels in the periphery — meaning the outlying areas of the body, such as the arms and legs. (4)
There are two types of peripheral vascular disease: functional and organic.
- Functional PVD is the type with no physical damage to the structure of your blood vessels. However, you can still feel pain or spasms indicating there is a problem in how the blood vessels are working.
- Organic PVD happens when there is an actual change in the structure of the blood vessels. For example, they may be inflamed or damaged.
Peripheral artery disease is a type of organic PVD. When fat builds up inside the blood vessels, it blocks blood flow, causing peripheral artery disease. (5) This specific plaque build-up is a common condition as well and is called atherosclerosis.
Peripheral vascular disease pathophysiology (abnormal changes) often involves the narrowing of blood vessels. The most common vessels affected are in the arms, legs, stomach and kidneys. (6) When PAD narrows these blood vessels, blood has trouble reaching your extremities and organs.
For example, PAD in the legs (narrowing of the blood vessels in the legs) may cause leg pain during and after exercise, since your legs don’t get enough blood. With PAD, your chances of a blockage in a blood vessel — and stroke or heart attack — are much higher. (7) People with PAD are also much more likely to have coronary heart disease. (8)
How do they test for peripheral artery disease?
Thankfully, this condition is fairly easy to diagnose using a peripheral artery disease test called the ankle-brachial pressure index (ABPI). This is a non-invasive test. A health care provider will strap a blood pressure cuff to your arm and one to your ankle. If the blood pressure in your ankle is lower than it is in your arm, there is a pretty good chance you have some problems with blood flow to your legs, which is a sign of peripheral vascular disease and PAD. (9)
The ABPI test is one of a few heart disease tests — such as an ultrasound of your blood vessels, treadmill test, magnetic resonance angiogram or computerized tomography angiography — that you may be given if your doctor suspects you have circulation problems or blocked blood vessels. (10)
PVD Signs & Symptoms
What are the symptoms of peripheral disease?
Peripheral vascular disease symptoms can range from very subtle (a lower temperature in one leg compared to the other) to severe (leg numbness). (11) In early disease, symptoms may include cramping, tired muscles, or heaviness in the leg, hip or buttocks during activity (like walking or climbing stairs) that usually disappears when you rest. (12, 13) You may also have high blood pressure or kidney function problems, even if you don’t feel ill. (14)
- Pain, aching, heaviness or numbness in one or both legs when walking or exercising
- A difference in temperature between the two legs
- Slower or less hair growth on the legs
- Slower or less nail growth on the toes
- Cool, smooth or shiny skin
- A change in skin color to bluish or pale
- Cold or numb toes
- Wounds or sores on the feet or legs that do not heal well (slowly or not at all)
- Weak or no pulse in the feet
- Muscle loss in the legs
- Erectile dysfunction, especially if you have diabetes
Some people don’t even know they have peripheral vascular disease or peripheral artery disease until they have a serious complication, such as a heart attack, stroke or transient ischemic attack. In fact, the Centers for Disease Control and Prevention (CDC) say that 40 percent of people don’t experience the typical leg pain associated with peripheral vascular disease. (17)
Causes & Risk Factors
What are the causes of peripheral vascular disease?
Peripheral vascular disease causes include blood vessels that are not working either because of a functional problem, like spasms, or because of a structural problem, such as blocked arteries.
So what are the causes of peripheral artery disease, then?
Peripheral artery disease causes include buildup of fat, or plaque, in the blood vessels that send blood to your arms and legs. This blocks the flow of blood to those areas and results in symptoms. This type of blockage is called atherosclerosis. It is the most common cause of PAD. (18) However, PAD can also be caused by injury to the arms or legs, inflammation of the blood vessels, unusual growth of your muscles or ligaments, or exposure to radiation. (19)
- Black race/ethnicity
- High cholesterol
- High blood pressure
- Poor kidney function
- Age (being 50 years old or older)
- Obesity (BMI greater than 30)
- Family history of heart disease, stroke or PAD
- High homocysteine in the blood (which causes blood vessel narrowing or blockage)
Most often, medical peripheral vascular disease treatment involves lifestyle changes, medicine or surgery, depending on how severe the disease is and what caused the problem. Peripheral artery disease treatment is aggressive when it has advanced to a point that threatens your health.
Medication and Lifestyle Changes
In mild cases where there is a low level of blockage or low risk of a serious complication, management may just involve lifestyle changes (see the natural treatments discussed below).
In cases requiring medication, some people start with aspirin or a blood thinner to keep the blood from being “sticky.” This helps it pass more easily through narrow blood vessels and lowers your chance of a stroke or heart attack caused by a blood clot. (23)
For people with PAD who also smoke, medicine to help you quit may also be prescribed. Likewise, people with high cholesterol, high blood pressure or diabetes may be prescribed disease-specific medications. This may help control some of the health problems that can make PAD worse. (24)
If you have symptoms such as leg pain, you may also take a medicine to help reduce the pain. One such medication is cilostazol, which thins the blood and helps open up the vessels so that your legs get more blood circulating. (25)
In some cases, particularly advanced PAD or in people for whom a complication is very likely, surgery or angioplasty may help:
- Angioplasty is a treatment in which your surgeon inserts a tube (catheter) into the affected blood vessel. A balloon is then blown up to flatten the plaque against the wall of the blood vessel and to stretch the blood vessel so that blood can flow through it more easily. (26) If needed, the surgeon may also insert a stent, which holds the blood vessel open wide enough for blood to pass. (27)
- In other cases, a bypass operation may be done. This involves the creation of a new blood vessel — made out of your own tissue or a special fabric — that helps carry blood around the blocked blood vessel. (28) This effectively bypasses the main trouble spot (hence the name) and allows blood to flow more freely again.
- If there is a particular clot in the blood vessel and health care professionals know where it is, they may be able to inject a drug straight into the clot to break it up. (29) As the clot dissolves, blood should flow better, which may reduce the chance of a heart attack or stroke.
10 Natural Treatments for Peripheral Vascular Disease
Thankfully, most people with peripheral vascular disease or PAD can work to improve their health and reduce symptoms by making lifestyle changes. In some cases, natural supplements may also be useful. However, since certain supplements can interact with medications that are commonly prescribed to treat PAD or its related conditions, you should always let your health care provider know about everything you are taking.
Consider these options to naturally treat PVD/PAD: (30)
- Talk with your health care provider before beginning a new routine. You should aim for 30 minutes of exercise (this includes walking, dancing, etc.) several times per week.
- Quit smoking. Smoking is a key risk factor for this disease. The sooner you stop, the better chance you have of improved vascular health.
- Eat a heart-healthy diet, low in saturated fat. If you have another health condition, such as diabetes, follow an appropriate diet for that as well. This helps optimize your health and minimizes the addition of plaque to your artery walls caused by too much dietary fat.
- Treat any health conditions you have that may make PVD/PAD worse. If you have diabetes, high cholesterol, high blood pressure or another type of heart disease, work with a health care provider to treat it. This will slow the impact those diseases may have on the progression of your PVD/PAD.
- Avoid cold and allergy medications with pseudoephedrine. These can constrict your blood vessels and make your vascular symptoms worse.
- Take good care of your feet and nails. Pay attention to any sores, cracked skin, numbness or other changes and see a health care provider to treat any bunions, calluses, wounds or other injuries.
- Sleep with the head of your bed raised up to 6 inches. This can increase the amount of blood available to your legs while you sleep and may reduce your leg pain.
- Avoid the cold. Cold temperatures make your blood vessels constrict and can make your symptoms worse. Dress warmly if you can’t stay out of the cold.
- Ask about L-arginine supplements. Oral doses of 10 grams per day or less for up to six months may be beneficial. (31) Having enough arginine compounds in the blood may help improve tissue function and reduce the chances of certain PVD/PAD complications, including death. (32)
- Ask about oral mesoglycan supplements. In a study that gave 50 milligrams of mesoglycan by mouth twice per day for two months, then stopped for two months, then started at the same dose again for two months, people taking mesoglycan had improvements in the damage to their blood vessels and their symptoms compared to people who didn’t take the supplement. (33) In another study, patients took aspirin and nothing, or aspirin and mesoglycan (30 mg/day injections for three weeks, then 100 mg/day by mouth for 20 weeks). People who took mesoglycan and aspirin were more likely to have symptom and quality of life improvements during the study. (34)
Can you reverse peripheral artery disease?
In many cases, yes! But it takes work and time, and it might not happen for people with advanced disease. Exercise and other lifestyle changes can dramatically slow the progression of plaque buildup and blood vessel damage. In some cases, the overall improvement in health helps your body repair the damage, improve circulation, and reverse the course of the disease. (35)
However, you must maintain your efforts in order to keep reaping the health benefits. And in some people, disease is too advanced to be treated or reversed by natural remedies and lifestyle changes alone. Surgery or medication may be required to help treat or reverse the condition. (36)
Dietary supplements can have potent health effects. When they are combined with conventional medications, they can interact and cause dangerous side effects or complications. Always talk to a health care professional before adding a supplement to your treatment regimen, and let them know about everything you are already taking.
Similarly, undertake a new exercise program with caution. Although exercise is essential for improving and maintaining good heart and vascular health, it may not be a great idea to go “from zero to 60” too quickly, or to begin a high-intensity program right off the bat. This is because peripheral vascular disease by definition involves damage to your blood vessels. If blood can’t circulate well enough, you are at risk of having pain — or worse, a heart attack or stroke — because of the extra strain you put on your body during activity.
Always talk with a health care professional before beginning a new exercise regimen so that you can get advice about what to do and for how long. Your health care provider can also advise you on how to increase your activity over time and increase your comfort when you are active.
- Peripheral vascular disease is disease or damage in blood vessels other than (peripheral to) those in the heart or brain.
- There are two types of peripheral vascular disease: functional and organic. Peripheral artery disease is a type of organic PVD. When fat builds up inside the blood vessels, it blocks blood flow, causing peripheral artery disease.
- Peripheral vascular disease and peripheral artery disease can be life-threatening, so let a diagnosis be a life-changing wake-up call. Follow your health care provider’s advice for a treatment plan and work hard to keep the disease from getting worse.
10 Natural Ways to Treat PVD & PAD
- Start a new exercise routine. Speak with your health care provider first.
- Quit smoking.
- Eat a heart-healthy diet.
- Treat any other health conditions you have that may make PVD/PAD worse.
- Don’t take cold medications containing pseudoephedrine.
- Take care of your feet and nails.
- Raise the head of your bed 6 inches to help circulation in your legs.
- Avoid the cold.
- Try L-arginine supplements. Speak with your health care provider first.
- Try oral mesoglycan supplements; again, speak with your doctor first.
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