Most people understand what heart health is, but John Hornick, MD, also wants you to take charge of your vascular health. It’s a matter of managing your risk factors and knowing what symptoms to look for, he says.
As a cardiologist and vascular medicine specialist at UPMC, Dr. Hornick explains what vascular wellness is and why healthy veins and arteries matter.
The short answer: Vascular disease not only raises your risk of a heart attack, but it also affects your quality of life. In some cases, untreated vascular problems may require emergency procedures or surgery.
What Is Vascular Disease?
Your heart and blood vessels work together to circulate blood and keep you healthy. These blood vessels include arteries that lead away from your heart and veins that return blood to it.
Blood circulation problems involving these blood vessels are called vascular diseases. This includes vascular conditions like peripheral artery disease, venous insufficiency, and varicose veins. There are also more life-threatening conditions, such as aortic aneurysm and deep vein thrombosis.
“Vascular doctors are uniquely equipped to help manage these vascular problems,” says Dr. Hornick, who works closely with vascular surgeons at UPMC.
The symptoms of poor vascular health aren’t always obvious, he says. Here’s what to know about the most common vascular conditions he sees.
What Is Peripheral Artery Disease?
Your peripheral arteries include any artery not involved with the heart or brain. When doctors refer to peripheral arteries, they’re usually talking about arteries in the leg, Dr. Hornick says.
Peripheral artery disease, or PAD, is the buildup of plaque and cholesterol in these arteries. It can lead to pain while walking, usually in the leg, thigh, or calf.
“This is pain that’s unusual for you and for your level of activity,” Dr. Hornick says. “Gradually, the pain happens with less and less exertion.”
The discomfort from PAD can worsen to the point that people avoid their usual activities. But lack of movement can make it even worse. You can also have skin changes and problems with wounds not healing.
PAD can affect your arms, too, but it’s not nearly as common.
Older people are more at risk for PAD than younger people. Other risk factors include:
- Diabetes (especially uncontrolled diabetes).
- High blood pressure.
- High cholesterol.
- Smoking.
The number one thing you can do if you have PAD is to quit smoking, Dr. Hornick says. It’s also important to see a specialist to discuss better controlling your other risk factors to decrease your risk of PAD progression, as well as decrease your risk of cardiovascular disease. In addition, “we also recommend a supervised exercise training program,” he says.
People with more severe PAD may need an intervention like a stent or surgery.
What Vascular Problems Can Leg Veins Cause?
In addition to artery problems in your legs, you can also have vein problems. “Your veins might struggle to return blood to your heart because of structural issues,” Dr. Hornick says.
The two main problems are varicose veins and venous insufficiency.
Varicose veins are large, rope-like veins you can feel through your skin. While for some people they’re mostly a cosmetic issue, others can have symptoms like pain and swelling.
Venous insufficiency is a bit different. It tends to cause spider veins on your ankles and feet, and usually comes with swelling. You might also notice your skin becoming darker around your calf or shin.
“The swelling gets worse as the day goes on because your veins are fighting against gravity,” Dr. Hornick says.
He treats both varicose veins and venous insufficiency with compression stockings first. “You should also elevate your legs when you can,” he says. “This encourages the blood to flow back upward.”
If you’re still having pain, there are procedures a vascular surgeon can do to remove or close off troublesome veins.
What Is Deep Vein Thrombosis (DVT)?
DVT is when a blood clot forms deep in a leg vein, stopping blood flow. It causes swelling, tenderness, redness, and pain in one leg.
DVT can be life-threatening, Dr. Hornick says, so always seek help right away.
DVT tends to have specific triggers. The two main ones are prolonged sitting from long car rides, flights, or recent surgery (within the last 100 days). Other DVT risk factors include:
- Age.
- Family history.
- Oral contraceptives (for some women).
- Smoking.
A doctor can diagnose DVT with an ultrasound. The standard treatment is blood thinners.
What Is an Abdominal Aortic Aneurysm?
An aneurysm is a weakness in an artery that causes it to increase in size. If it grows too large, it can burst, which is a life-threatening emergency.
Your aorta is your heart’s largest artery. You can have an aneurysm in any part of it, but they’re most common in the portion leading to the abdomen.
For most people, abdominal aortic aneurysms are asymptomatic (without symptoms). Often, the aneurysm is discovered during imaging for another condition. Even then, it may or may not need treatment.
Things like smoking and high blood pressure can contribute to the growth of this type of aneurysm. In addition, some are genetic, making family history a risk factor.
Good screening for aortic aneurysms now allows doctors to catch an aneurysm before it becomes a problem. “If you’re a man ages 65 to 75 with any history of smoking, you should have a one-time ultrasound of your belly,” Dr. Hornick says.
How Can I Improve My Vascular Health?
If there’s one single thing that improves circulation and overall vascular health, it’s quitting smoking. “Smoking is the top risk factor for many vascular diseases,” Dr. Hornick says.
Other ways to improve circulation and keep your blood vessels healthy include:
- Drinking plenty of water.
- Eating a diet lower in saturated fat, like the Mediterranean diet.
- Get regular exercise, especially walking.
Dr. Hornick also emphasizes that you should never ignore leg or arm pain and swelling, especially with skin changes, or dismiss certain symptoms as a normal part of the aging process. If you’re having pain, swelling, or other symptoms that are making you change your routine, always mention it, he says.
“If you feel something isn’t right with your arm or leg, bring it up with your provider,” he says.
Primary care providers can treat many vascular health issues. But seeing a trained vascular medicine specialist can ensure you get the right care at the right time.