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Peripheral Vascular Disease

Peripheral vascular disease (PVD) refers to a variety of conditions that primarily affect the arteries of the body, with the exception of the coronary arteries that supply blood to the heart. (Those are covered in the article on cardiovascular disease.) The most common areas for PVD are the arteries of the legs and upper arms, the carotid (neck) arteries, the abdominal aorta and its branches, and the renal (kidney) arteries.

The cause of most types of PVD is hardening of the arteries (atherosclerosis), which itself has many causes. Conditions affecting the veins, such as chronic venous insufficiency, varicose veins, and hemorrhoids, are not usually included in PVD.

PVD of the carotid arteries is a major cause of stroke. Intermittent claudication refers to pain in the lower legs after walking short distances and is caused by PVD of the leg arteries. One cause of erectile dysfunction may be PVD of the penis. Raynaud’s disease is a painful condition caused by spasms of arteries after exposure to cold. Thromboangiitis obliterans (TAO), also known as Buerger’s disease, is an uncommon PVD that occurs in both arteries and veins. This condition causes tender areas of inflammation in the arms or legs, followed by cold hands or feet.

Aneurysm is a ballooning of an artery due to weakening of the blood vessel walls. Aneurysms may be an inherited disorder or may be due to atherosclerosis.1 2 The most common aneurysm is abdominal aortic aneurysm (AAA), which occurs in the large artery that carries blood from the heart to the lower body. AAA is much more common in men, and risk increases with age. Large AAAs are usually surgically repaired because they can undergo life-threatening ruptures.

 

Rating Nutritional Supplements Herbs
f
Inositol hexaniacinate
 
vv
Copper (for abdominal aortic aneurysm)
Folic acid (for thromboangiitis obliterans)
 
Reliable and relatively consistent scientific data showing a substantial health benefit.
Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.
For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support and/or minimal health benefit.

 

What are the symptoms of peripheral vascular disease?

People with peripheral vascular disease may have symptoms of pain, aching, cramping, or fatigue of the muscles in the affected leg that are relieved by rest and worsened by elevation. Other people with peripheral vascular disease may have swollen feet and ankles accompanied by a dull ache made worse with prolonged standing and relieved by elevation. People with chronic peripheral vascular disease may have darkened areas of skin, leg ulcers, and varicose veins.

Lifestyle changes that may be helpful for peripheral vascular disease

People with TAO are usually heavy smokers, and this is considered a major cause of the disease.3 It is important for people with TAO to quit smoking.

Nutritional supplements that may be helpful for peripheral vascular disease

As with other vascular diseases, people with TAO are more likely to have high levels of homocysteine and low levels of folic acid.4 However, no research has tested folic acid as prevention or treatment for this disease.

One controlled study compared a type of niacin (vitamin B3) known as inositol hexaniacinate to the drug pyridinolcarbamate for the treatment of skin ulcers caused by PVD.5 A placebo was not included in this trial, and both 1.2 grams daily of inositol hexaniacinate and 1.5 grams daily of the drug produced beneficial results in about half of the patients.

As in many vascular diseases, people with AAA often have abnormal cholesterol and triglyceride levels,6 and their blood vessel walls contain evidence of free radical damage.7 8 However, it is not known whether lowering blood fats or taking free radical-destroying antioxidants will reduce the risk of AAA. The arterial walls of AAA are depleted of large molecules related to cartilage, including chondroitin sulfate,9 10 but no research has investigated whether supplements of chondroitin sulfate might help prevent problems with AAA. Copper is required for normal artery structure.11 Animal studies have shown that copper deficiency leads to weak aortic walls12 and rupture of the aorta.13 Combating deficiency with copper supplements prevented rupture in an animal study.14 Copper deficiency in humans with AAA has been suggested in some studies,15 16 but not in others.17 18 19 No studies have been done using copper supplements to prevent or manage aneurysms.

Are there any side effects or interactions with peripheral vascular disease?

Refer to the individual supplement for information about any side effects or interactions.

Holistic approaches that may be helpful for peripheral vascular disease
Intravenous chelation therapy has been reported to be an effective treatment for PVD.20 21 A partially controlled study reported improvements after ten chelation treatments.22 However, two double-blind studies found no difference between chelation therapy and a placebo in patients with intermittent claudication.23 24

Preliminary reports suggest acupuncture may reduce pain and improve blood flow in TAO,25 26 but controlled studies are needed to better evaluate these claims.

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