What is Peripheral Vascular Disease (PVD)?
Peripheral vascular disease (PVD), also known as peripheral artery disease, is a circulation disorder. It’s caused by narrowing blood vessels to parts of the body other than the brain and the heart. PVD is a broad term for a condition that can affect any blood vessels outside of the heart, including the arteries and veins. However, the most common type is lower-extremity PVD, where blood flow is reduced to the legs and feet.
While it can also happen in your arms, hands, and fingers, it’s rarer and makes up only about ten percent of all cases.
Types of Peripheral Vascular Disease
There are two main types of peripheral vascular disease: occlusive and functional.
- Occlusive peripheral vascular disease - This is the blockage or narrowing of an artery. It most commonly occurs in the arteries in the legs but can also happen in the arteries of the shoulders or the arms. The most common cause is atherosclerosis, or cholesterol deposits in the arteries. Other less common causes include:
- Abnormal muscle growth in the artery wall (fibromuscular dysplasia)
- Inflammation (vasculitis)
- Pressure from outside the blood vessel walls by a mass like a tumor or a cyst
- Functional peripheral vascular disease - Much less common than occlusive peripheral vascular disease. The arteries in the arms and legs normally dilate and constrict in response to environmental changes, such as temperature fluctuations. But sometimes, this response can be exaggerated due to the:
- An inherited blood vessel defect
- Nerve disturbances
Common examples of functional peripheral arterial diseases include acrocyanosis, erythromelalgia, and Raynaud syndrome.
Signs & Symptoms Peripheral Vascular Disease
The classic symptom is leg pain that worsens with physical activity. But up to 40 percent of people with PVD don’t have this symptom. Other signs of PVD include:
- Limb pain that affects sleep
- Sores or wounds that don’t heal or heal slowly
- Pale or blueish feet and/or toes
- Cold or numb toes
- Poor nail growth on the toes or little hair growth on the legs
- Erectile dysfunction, especially in men with diabetes
It’s important to remember that one in five people with PVD are asymptomatic, which is why talking to your doctor if you have risk factors is crucial.
Causes of Peripheral Vascular Disease
The leading cause of PVD is atherosclerosis, or the buildup of plaque—a mix of fat, cholesterol, and other substances—inside your artery walls. The plaque builds up enough to narrow a peripheral artery and reduces blood flow, which can lead to symptoms of PVD such as pain, skin color changes, trouble walking, and sores.
Other causes of PVD can include:
- Blood clots - A blood clot can fully block a peripheral artery
- Diabetes - If diabetes isn’t well controlled, high blood sugar levels can damage blood vessels
- Vasculitis - This condition inflames the arteries and can cause them to narrow or weaken
- Infection - This is extremely rare. Two specific infections, salmonellosis (infection with Salmonella bacteria, usually through food) and the sexually transmitted infection syphilis both, can damage blood vessels.
- Injury - Blood vessels can be injured in accidents like a car collision or a bad fall
Risk Factors for Peripheral Vascular Disease
While peripheral vascular disease can affect anyone, some people are more likely to develop the condition than others. Risk factors for peripheral vascular disease include:
- Age - The older you are, the more likely you are to develop PVD. It occurs in about 10% of people in their 70s and more than 20% of people in their 80s.
- Race - African Americans are more than twice as likely to have PVD than other ethnicities
- Smoking - Those who smoke or have a smoking history have up to a four times greater risk of PVD
- High blood pressure -It raises the risk that you will develop plaque in your arteries
- Existing heart disease - If you already have heart disease, you have a one in three chance of developing PVD
- Sedentary lifestyle
- Diabetes - It’s estimated that one in three people with diabetes over the age of 50 has PVD
- Elevated cholesterol - High blood cholesterol and fat in your blood cause more plaque to form, which may block blood flow to your limbs
If left untreated, peripheral vascular disease (PVD) can lead to complications that include:
- Intermittent claudication - This is the most common complication, characterized by pain or cramping in the leg while walking
- Critical limb ischemia - This is a severe artery blockage that dramatically reduces blood flow. It can lead to gangrene and tissue death that may require amputation.
- Infections - They can develop due to infected sores, particularly on your feet. People with diabetes are particularly at risk for these complications, especially infections that spread to the bloodstream.
- Acute limb ischemia - This sudden drop in blood flow to your leg is considered a serious medical emergency
People who smoke or have diabetes are particularly at risk for complications.
Prevention of Peripheral Vascular Disease
There are certain risk factors for PVD that you can’t change, like age or your race. But there are also some risk factors that you can, like smoking or high blood pressure. Here are some ways to reduce your risk of contracting PVD.
- Stop smoking - It’s a significant risk factor for PVD. Ask your doctor to help you develop a smoking cessation plan that may include behavior modification and medications.
- Lower your numbers - If you have elevated blood pressure, cholesterol and/or blood glucose levels, work with your doctor on ways to lower them through lifestyle modifications or, if necessary, medication
- Exercise - Aim for at least thirty minutes of moderate activity, such as walking most days of the week. This will help you lower your risk of developing a health condition that raises the risk of PVD, such as high blood pressure or type two diabetes.
- Eat a healthy diet - A diet low in sodium and saturated fat can help lower blood pressure and cholesterol levels. Aim for a healthy diet that’s rich in fruits, vegetables, whole grains, fish, low-fat dairy, and healthy fats such as olive oil.
- Lose weight - Research shows that people who are obese are more likely to develop PVD than those who are at an average weight
Trust NewYork-Presbyterian for Peripheral Vascular Disease Care
It’s important to get PVD treatment early to improve quality of life and to prevent the need for leg or foot amputation. At NewYork-Presbyterian, we understand this risk, and our team of cardiologists and other heart specialists work hard to avoid it by treating you quickly and effectively.
We’ll first try to treat your PVD with medication and lifestyle changes. Still, if those therapies aren’t enough, we’ll offer minimally invasive endovascular procedures to relieve blood vessel narrowing, increase blood flow, and supply blood to your affected limbs.