Prevention of Peripheral Vascular Disease in Old Age People

Introduction:

Peripheral vascular disease (PVD) or peripheral arterial disease (PAD) is a gradually progressing circulatory disorder that results in blockage or narrowing of the blood vessel walls due to the deposition of plaque-like material. Narrowing the artery walls affects the circulation of blood drastically to various organs like the heart, brain, and extremities (upper and lower). The arteries, veins, and lymphatic vessels outside the heart are also affected by peripheral vascular disease. The blockage or narrowing of the arteries, veins, and lymphatic vessels affects the functioning of different organs drastically. The buildup of these plaque-like substances (made of fat, cholesterols, etc.) in the artery wall is referred to as arteriosclerosis. The upper and lower extremities are most commonly affected by peripheral arterial disease (PAD) or peripheral vascular disease (PVD).

The reduction in the blood supply to different organs of the body makes it deprived of the nutrition and nourishment required to function normally, thereby resulting in damage or death of the affected organ.

Who Is at Risk of Peripheral Arterial Disease?

A few risk factors associated with peripheral vascular disease are:

• Older Age People: People in old age (above the age of 50 years) are at higher risk.

• Systemic Disease: People with systemic conditions like high blood pressure, diabetes, and high cholesterol are at greater risk. People with previous heart conditions like coronary artery disease are at risk of peripheral arterial disease.

How to Prevent Peripheral Vascular Diseases in Older People?

For preventing peripheral vascular disease in the older age group, the main focus should be the reduction of the risk of cardiac diseases like stroke or heart attacks and changes in lifestyle.

Such different factors, like early diagnosis of the condition and its treatment and lifestyle modifications, can help to combat peripheral vascular disease effectively and can also prevent the worsening of the condition.

Various methods that can help in the prevention and treatment of peripheral vascular disease are:

1. Lifestyle Modifications: A few changes in the daily lifestyle can help to reduce the risk of peripheral vascular diseases. Changes in the lifestyle that can be inculcated are:

2. Avoid Smoking and Tobacco Products: Avoid tobacco products and smoking. Nicotine or smoking cessation centers in the locality can be joined to quit the habit in case of addiction. Nicotine replacement chewing gums and candies can help in quitting the habit steadily.

3. Healthy and Balanced Diet: Try to avoid fatty foods and trans fats that are high in cholesterol. In case of obesity, try shedding some weight with regular yoga and exercises. Green leafy vegetables and fruits should be inculcated into the diet. Daily sodium intake should be minimized. One can take help from a dietician to make a proper diet plan based on the body mass index and health condition.

4. Exercise: Regular exercise daily, like walking and yoga, helps to reduce the pain in the lower extremities and also reduces the body aches.

5. Minimize the Stress Levels: In today's life, the level of stress has increased dramatically among the population. Try minimizing stress by practicing morning meditations and yoga.

6. Management of Underlying Disease: In case of underlying systemic conditions like hypertension, diabetes, and high cholesterol, meet the doctor immediately for early diagnosis and management of the underlying disease.

Pharmacological Management - Few medications are prescribed by the doctor to treat the underlying conditions like:

• Hypertension: High blood pressure is common among the older age group. Anti-hypertensive medications are prescribed by the doctor to control hypertension.

• Cardiac Stroke: The risk of cardiac stroke and heart attack can be minimized with antiplatelet medications like Aspirin and Clopidogrel under the doctor's supervision.

• Claudication: Medications like Cilostazol are prescribed by the doctor to patients having pain on walking.

• Exercise Programs: Supervised exercise programs help to improve symptoms of peripheral vascular diseases like claudication (pain in the lower extremities while walking). Patients with peripheral vascular disease are advised to walk for at least 30 to 60 minutes until the mild pain starts and to stop or relax until the pain resolves. Patients are asked to walk again after the pain resolves. These exercise programs are called “Start-Stop” exercises.

Surgical Management: Different surgical interventions that are done to treat a peripheral vascular disease are:

1. Angioplasty: Balloon angioplasty is done by the cardiac surgeon in patients with peripheral vascular disease. In this technique, a balloon catheter is inserted into the arteries to expand the arterial walls. This technique helps to improve blood circulation to the affected organs. Currently, laser angioplasty procedures are used to burn or vaporize the accumulated plaque in the arterial walls and clear the blockage. An angiogram is recommended by the doctor before performing the angioplasty procedure.

2. Cardiac Stents: These are small metal stents that are placed inside the artery to expand the arterial walls to restore blood circulation.

3. Cardiac Bypass Surgery: In this surgery, a portion of a healthy vein is used to create a bypass for blood circulation.

4. Atherectomy: In this technique, the plaque or cholesterol buildup in the artery walls is removed by a blade through the catheter by the cardiac surgeon to improve the blood circulation in the affected organs.

What Are the Complications Associated With the Treatment of Peripheral Vascular Disease?

A few complications associated with peripheral vascular disease treatment are:

• Shortness of breath.

• Dizziness.

• Pain in the chest.

• Pain and swelling in legs.

• Abdominal pain.

• Delay or poor wound healing.

Conclusion:

Peripheral vascular disease or peripheral arterial disease has become a very common problem in the older age group population. Peripheral vascular disease can lead to various symptoms like pain in the legs while walking, non-healing foot sores, tiredness, and color changes in the toes and feet. Early diagnosis and treatment of the condition are very crucial to preventing and treating peripheral vascular disease. Various prevention techniques like lifestyle modifications, medical management of the systemic conditions, stress reduction, and start or stop exercises along with management of the underlying disease help to prevent peripheral vascular disease. It also prevents the worsening of the symptoms in patients with peripheral arterial disease.