What Is Peripheral Vascular Disease (PVD)?

Peripheral vascular disease (PVD) is a progressive circulatory condition that involves the narrowing, blockage, or spasms of blood vessels located outside the heart. It is sometimes referred to as peripheral artery disease (PAD); however, peripheral artery disease is a specific type of peripheral vascular disease that only affects the arteries. Peripheral vascular disease is an umbrella term for circulatory conditions that affect the arteries, veins, or lymphatic vessels. Because PVD involves the narrowing, blockage, or spasms of blood vessels, blood flow is restricted in the affected vessel which reduces the transport of oxygen and nutrients to specific areas of the body. The affected area of the body depends on the location of the narrowed or blocked vessel(s); however, PVD most commonly affects the limbs, especially the legs.

Symptoms

Approximately 50% of people with peripheral vascular disease are asymptomatic; however, if symptoms are experienced, they include, but are not limited to, the following:

• Intermittent claudication — Cramping (most commonly in the calves) that occurs during exercise and ceases during rest. Pain may occur in one or both legs depending on the location of the narrowed artery. The pain might disappear after a few minutes of rest depending on the severity and location of the narrowed blood vessel.
• Rest pain — Insufficient oxygen and blood supply due to severe PVD may cause burning or aching pain during rest. It is usually severe and most commonly affects the toes when the body is lying flat, facing up.

Other symptoms of PVD include the following:

• Muscle heaviness, weakness or numbness
• Decreased temperature in the affected limb(s)
• Weakened pulse in the affected limb(s)
• Skin changes (thin, shiny, brittle skin), usually on the legs and feet
• Hair loss of the affected limb
• Thickening of toenails or fingernails
• Wounds that heal poorly, especially on pressure points, such as the heels or ankles
• Gangrene (dead tissue) and painful ulcers, usually on the toes
• Erectile dysfunction
• Mobility issues
• Blue, red, or purple discoloration of the extremities
• Paleness in the legs when elevated
• Extreme pain if a blood vessel is blocked or very narrowed

Causes

Peripheral vascular disease is often caused by plaque build-up in the artery walls (atherosclerosis). This decreases the blood flow to the limbs and the delivery of oxygen and nutrients to the tissues. Blood vessel inflammation, limb injuries, muscle or ligament deformities, infections, or radiation exposure can also lead to the onset of the disease.

Risk factors

Peripheral vascular disease affects approximately 8.5 million adults in the United States. Males and postmenopausal women over the age of 50 are at highest risk. Other factors that increase the risk of developing PVD include the following:

• High levels of triglycerides and LDL cholesterol in the blood
• Low levels of HDL cholesterol in the blood
• High blood pressure
• Coronary artery disease
• Habitual use of tobacco products
• Family history of hypertension, high cholesterol, heart disease, atherosclerotic disease, or peripheral vascular disease
• Diabetes
• Physical inactivity
• Obesity