Heart Diseases: strong vessels - long life

heart disease or cardiovascular disease, is a known concept. Most people are aware of the risks associated with heart disease and stroke. But very few are familiar with peripheral arterial disease (PAD). When atherosclerosis affects the arteries in the lower extremities, it is called peripheral arterial disease. Atherosclerosis is known that most of the development of plaque inside the artery walls. Atherosclerosis is a complex inflammatory process involving the smooth muscle cells in the artery walls, lime scale and structure of lipids such as cholesterol and triglycerides. Atherosclerosis, the arteries in the brain, the heart or the legs, and the result is decreased blood flow in the affected area.

In the early stages, atherosclerosis causes no symptoms and most people have some form of atherosclerosis, even at a young age. If the plaques in the arteries build, the arteries narrow and blood flow is restricted. Blood brings oxygen and important nutrients to cells throughout the body, and if blood flow is restricted, the cells are starved for oxygen and nutrients. As atherosclerosis progresses, the artery walls are being violated and the body reacts with inflammation and blood clotting. This combination further narrows the artery walls and can lead to plaques that break off and travel downstream. The plaques Lodge in smaller vessels and completely block flow to an area. This can cause a stroke, heart attack or gangrene, depending on the area or blockage.

Reduced blood flow in the lower limbs in diabetics and people who smoke. Smoking accounts for nearly 75% of all cases of peripheral arterial disease. Without sufficient circulation of the feet, small cuts and abrasions to be extremely difficult to heal. People with PAD are more prone to infection because the body the immune response is delayed. As the arteries become thickened and calcified, the immune cells and other nutrients have difficulties in the artery walls of the surrounding tissue. Persons with peripheral arterial disease are at risk for ulcers, infections, gangrene and amputation.

very little has been done on peripheral arterial disease. A recent meta-analysis identified that only 18 studies, the 5269 participants with peripheral arterial disease. The researchers found that 8.9% of 2823 patients taking aspirin had cardiovascular events (heart attacks that included both fatal and non-fatal and nonfatal stroke) compared to 11% of 2446 participants in the control group. Aspirin therapy was associated with a reduction in the number of nonfatal strokes, but there was no association between aspirin and reductions in deaths related to cardiovascular events. Although aspirin was associated with a reduction in nonfatal cardiovascular events and nonfatal stroke, the decline was not significant. There was no evidence of an increased risk of bleeding with aspirin.

The authors of this study concluded that patients with peripheral arterial disease treated with aspirin had a reduction of cardiovascular events and nonfatal stroke, but the reduction was not statistically significant for cardiovascular events. Additional studies of aspirin therapy in peripheral arterial disease are necessary to address the benefits and risks.

Berger JS et al. Aspirin for the prevention of cardiovascular events in patients with peripheral arterial disease. A meta-analysis of randomized trials. JAMA. 2009, 301 (18) :1909-1919.

Christine Dobrowolski, DPM is a podiatrist and owner of Northcoast footcare, Inc an online resource for foot health information and foot care products. More information on Aspirin and PAD.

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