Arterial Disorder

Arterial disorders affect the blood vessels that carry oxygen-rich blood throughout your body, potentially leading to serious complications if blood flow becomes restricted or blocked.

Table of contents

• What Are Arterial Disorders?
• Types of Arterial Disorders
• Causes and Risk Factors
• Signs and Symptoms
• Diagnosis
• Treatment Options
• Lifestyle Changes and Daily Management
• Potential Complications

What Are Arterial Disorders?

Arterial disorders include any condition that affects the arteries, the elastic-like tubes that carry oxygen-rich blood from your heart to every part of your body. When these blood vessels become narrowed, blocked, or weakened, they cannot deliver enough blood to your organs and tissues.^[1][2]

Arteries are blood vessels with smooth inner linings that normally prevent blood from clotting and allow steady blood flow. When problems develop in these vessels, the reduced blood flow can affect any part of your body, from your brain and heart to your legs and kidneys.^[2]

• Arteries
• Heart
• Brain
• Legs
• Arms
• Kidneys
• Intestines

Types of Arterial Disorders

Arterial disorders can affect different parts of your body depending on which arteries are involved. The most common type is peripheral artery disease, or PAD, which typically affects the legs.^[1][3]

Peripheral artery disease happens when arteries become narrow, most often in the legs. This is the narrowing or blockage of the vessels that carry blood from the heart to the legs, primarily caused by fatty deposits building up in the arteries.^[3] About 12% to 20% of Americans aged 60 years and older have PAD, with prevalence increasing to nearly 50% in those 85 years and older.^[4]

Other arterial disorders include problems in specific body areas. Carotid artery disease affects the blood vessels in your neck that supply your brain. This can lead to stroke if left untreated.^[2] Coronary artery disease affects the main blood vessels that supply blood to the heart muscle.^[8]

Arterial disorders can also affect the intestines (called intestinal ischemic syndrome), the kidneys (renal artery disease), and other organs. Some conditions cause narrowing in multiple arteries throughout the body.^[2]

Causes and Risk Factors

The most common cause of arterial disorders is atherosclerosis, which happens when fatty deposits called plaque build up inside artery walls. Plaque is made up of cholesterol, fat, and other substances. Over time, these deposits narrow the arteries, restricting blood flow.^[1][3]

The plaque deposits often have a hard outer surface and soft interior. Sometimes the hard surface can crack or tear, allowing blood-clotting particles called platelets to gather at the site. Blood clots can form around the plaque, making the artery even narrower.^[9]

Several factors increase your risk of developing arterial disorders:

• Smoking, which is the most significant risk factor for PAD^[3]
• Diabetes (both type 1 and type 2)^[3]
• High blood pressure^[3]
• High cholesterol levels^[3]
• Age over 60 years^[3]
• Family history of arterial disease or heart disease^[4]
• Being overweight or obese^[4]

The risk of having arterial disease increases with each additional risk factor. Having three or more risk factors can increase your odds by up to 10 times.^[14] Both men and women can develop arterial disorders, though African American people face a higher risk of PAD compared to other groups.^[3][9]

Signs and Symptoms

Many people with arterial disorders have no symptoms at all. Up to 4 in 10 people with PAD experience no leg pain.^[3] However, when symptoms do occur, they vary depending on which arteries are affected.

The classic symptom of peripheral artery disease is pain in the legs during physical activity, such as walking. This pain, called intermittent claudication (which means “to limp”), happens because leg muscles don’t get enough blood during exercise. The discomfort typically goes away after a few minutes of rest.^[1][3]

You may feel this leg discomfort as pain, cramping, numbness, or fatigue in your calves, thighs, or buttocks. The exact location depends on which artery is narrowed. Symptoms occur below the affected artery.^[9]

Other physical signs in the legs that may indicate arterial problems include:

• Muscle weakness^[3]
• Hair loss on legs and feet^[3]
• Smooth, shiny skin^[3]
• Skin that feels cool to the touch^[3]
• Decreased or absent pulses in the feet^[3]
• Sores or ulcers on the legs or feet that don’t heal^[3]
• Cold or numb toes^[3]
• Changes in skin color, such as turning paler than usual or blue^[6]
• Brittle, slow-growing toenails^[6]

As the disease progresses, you may develop leg or foot pain even when resting. This often happens when lying flat, and dangling your leg over the edge of your bed may relieve the pain.^[9]

Males might also experience erectile dysfunction related to arterial disease when there’s narrowing of arteries in the pelvic area.^[9]

If you notice a sudden change in skin color (turning purple, green, black, or very pale) or if your skin feels very cool with a “pins and needles” sensation, seek medical care immediately. These are signs of severe arterial problems.^[9]

Diagnosis

If you have symptoms suggesting an arterial disorder or have risk factors for the disease, your doctor will perform a physical examination. This includes checking the pulses in your legs and listening for unusual sounds in your arteries called bruits.^[3]

The main test used to diagnose peripheral artery disease is called an ankle-brachial index, or ABI. This simple, noninvasive test compares the blood pressure in your ankle with the blood pressure in your arm, both at rest and after exercise. A difference between the two measurements may indicate arterial disease.^[3][10]

If you have symptoms of arterial problems but a normal resting ABI, your doctor may recommend exercise ABI testing. This involves taking measurements after you walk on a treadmill.^[3]

Other tests your doctor may order include:

• Ultrasound of the legs or feet, which uses sound waves to create pictures of blood flow through your vessels^[10]
• Angiography, which uses imaging and a special dye to look for blockages in arteries^[10]
• Blood tests to check for conditions that increase risk, such as high cholesterol and high blood sugar^[10]

Routine screening for arterial disease is not recommended for people without symptoms or increased risk factors.^[3]

Treatment Options

Treatment for arterial disorders aims to manage symptoms, improve artery health, and reduce the risk of serious complications like heart attack and stroke. The approach depends on how severe your condition is.^[10]

Most people can manage arterial disorders through lifestyle changes and medications. These treatments help reduce symptoms and prevent the disease from getting worse. In some cases, you may even reverse symptoms.^[10]

Medications

Your doctor may prescribe several types of medicines:

Antiplatelet medicines, such as aspirin, help prevent blood clots from forming. These medicines reduce the risk of serious complications from arterial disease.^[3][12]

Statins help lower cholesterol levels by reducing production of “bad cholesterol” (LDL cholesterol) in your liver. Most people taking statins have no or very few side effects, though some may experience indigestion, headaches, feeling sick, or muscle aches.^[12]

Blood pressure medicines called angiotensin-converting enzyme inhibitors, or ACE inhibitors, help control high blood pressure and have been shown to reduce complications from arterial disease. Side effects may include dizziness, tiredness, headaches, or a dry cough.^[12]

Some people may also receive medicine to help improve blood flow to the legs and reduce pain during walking.^[1]

Procedures and Surgery

When lifestyle changes and medicines don’t adequately control symptoms, or when arterial blockages are severe, procedures may be necessary:^[10]

Balloon angioplasty involves threading a tiny balloon attached to a thin tube through the blocked blood vessel. Doctors use X-ray guidance to position the balloon correctly, then inflate it to open the blood vessel and restore normal blood flow.^[15]

Stenting may be used if balloon angioplasty doesn’t work well enough. Doctors place a metal tube called a stent where the blockage is located. The stent holds the artery open to maintain blood flow.^[15]

Atherectomy removes hardened plaque that narrows arteries. Doctors use a rotating blade or grinding device attached to a catheter to remove these blockages.^[15]

Surgical bypass creates a new route for blood flow around severely blocked arteries. This surgery may be needed if you have blockages in several arteries or if other treatments haven’t worked.^[10]

If you develop sudden, severe symptoms or signs of limb-threatening problems, you should be referred immediately to a vascular surgeon.^[4]

Lifestyle Changes and Daily Management

Making healthy lifestyle changes is one of the most important parts of managing arterial disorders. These changes can significantly improve symptoms and prevent complications.^[11]

Exercise

Regular physical activity is crucial for managing arterial disease. Exercise improves circulation, strengthens muscles, and reduces symptoms. Walking is one of the best exercises you can do.^[3][11]

A supervised exercise program is often recommended as one of the first steps for managing arterial disease. This typically involves two hours of supervised exercise per week for three months, often in group sessions with a trainer.^[12]

When walking with arterial disease, use a “stop-start” method: walk as far as you can until pain becomes uncomfortable, then rest until the pain fades. Start walking again and repeat this pattern for at least 30 minutes total, several times a week. You may need to start slowly, but the more you walk, the farther you’ll be able to go.^[12][17]

Other beneficial exercises include swimming, cycling, light resistance training, and gentle stretching to improve flexibility.^[17]

Quit Smoking

If you smoke, quitting is the single most important thing you can do. Smoking is the main risk factor for arterial disease. Quitting reduces your risk of the disease getting worse and lowers your chances of developing other serious heart and blood vessel problems.^[3][12]

It’s also important to avoid secondhand smoke. For help quitting, talk to your doctor about support programs, nicotine replacement therapy, or other strategies.^[11]

Healthy Eating

What you eat directly impacts your vascular health. A heart-healthy diet can improve blood flow, reduce plaque buildup, and promote overall well-being.^[11]

Focus on eating plenty of fruits, vegetables, and whole grains. Choose healthy fats from sources like avocados, nuts, and olive oil while avoiding trans fats and saturated fats found in fried and processed foods. Increase your fiber intake and stay well hydrated by drinking plenty of water.^[17][23]

Daily Living Tips

Managing arterial disease in daily life involves several practical strategies:

• Wear comfortable, well-fitting shoes to make walking easier and reduce pain^[17]
• Check your feet and toes daily for sores, cracks, or anything unusual, as wounds may not heal well^[17]
• Plan rest breaks into your daily routine when doing activities that require standing or walking^[17]
• Choose locations that are easy to navigate with seating areas and short walking distances^[17]
• Keep warm, as cold can worsen symptoms^[17]

Weight and Diabetes Management

If you are overweight, losing even 3% to 5% of your current weight can help manage risk factors like high cholesterol and diabetes.^[11] For people with diabetes, properly managing blood sugar levels is essential, as poorly controlled diabetes can make arterial disease symptoms worse.^[12]

Potential Complications

Arterial disorders are serious conditions that can lead to life-threatening complications if not properly managed. Having arterial disease in one part of your body increases your risk of having similar problems elsewhere.^[16]

People with peripheral artery disease face an increased risk of developing other forms of cardiovascular disease, including coronary heart disease, stroke, and heart attack. In fact, most people who die with peripheral artery disease do so because of associated heart disease.^[3][5]

If blood flow to the legs becomes severely restricted, a condition called critical limb ischemia can develop. This is an extremely serious complication with symptoms including severe burning pain in legs and feet that continues even at rest, wounds and ulcers that don’t heal, and changes in skin appearance. In the most severe cases, tissues may die (called gangrene), requiring amputation.^[6]

When an organ or tissue is suddenly deprived of oxygen due to a complete blockage, it can fail within hours. This is why recognizing symptoms early and seeking prompt medical attention is crucial.^[16]

However, with proper treatment including lifestyle changes, medications, and when necessary, procedures or surgery, many people with arterial disorders maintain stable symptoms or even experience improvement. Early diagnosis and consistent management significantly lower the risk of serious complications.^[10]