What Is Peripheral Artery Disease Of The Legs?
Maybe you walk less than you used to because of muscle aches in your legs. Or you've had a sore on your foot that seemed to take forever to heal. Perhaps you've also heard you have "poor circulation." These are the sneaky symptoms of peripheral artery disease. It narrows the arteries in the legs, limiting blood flow to your muscles. It can take you by surprise, causing no symptoms at all or symptoms you may think are something else. And even mild cases can be a signal that you might have problems with other arteries, too. It usually happens because your arteries harden and narrow. (That's called atherosclerosis). Smoking, high blood pressure, high cholesterol, and not being active are the main causes. If you have diabetes, you're more likely to get a worse case of peripheral artery disease that improves less with treatment. When atherosclerosis narrows the long arteries of the legs, your leg muscles don't get enough blood flow. As a result, you may feel muscle pain. It usually comes on with exercise and stops when you rest. It can affect different muscle groups, including: Calf (most common) Buttock and hip Thigh Foot (less common) Some people feel burning or numbness. Others have severe blockages with no pain at all, usually because the body grows blood vessels that go around the blockages. Other signs and symptoms of peripheral artery disease include: Wounds that heal poorly Legs are cooler than the arms Shiny skin over the legs The tests you'll take to see if you have peripheral artery disease are simple and painless. Doctors usually start by checking your "ankle-brachial index," which compares your blood pressure at your ankle and upper arm. Those measurements should be about the same. If your blood pressure in your ankle is a lot lower, you may have peripheral arte Continue reading >>
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Peripheral Artery Disease And Intermittent Claudication
Description An in-depth report on the causes, diagnosis, and treatment of peripheral artery disease (PAD). Alternative Names Peripheral arterial disease; PAD; Peripheral vascular disease; Highlights Peripheral Artery Disease Peripheral artery disease (PAD) is a type of atherosclerosis. It occurs when arteries in the limbs (most often the legs) become narrowed by cholesterol-rich material called plaque. Because PAD interferes with circulation, advanced cases increase the risk for gangrene and amputation. Patients with PAD are also at increased risk for other types of atherosclerosis, including heart attacks and strokes. Risk Factors of PAD The main risk factors of PAD include: Smoking Diabetes Unhealthy cholesterol and lipid levels High blood pressure Advancing age Symptoms Many people with PAD do not have symptoms. When symptoms do occur, crampy leg pain (intermittent claudication) is the main symptom. This symptom occurs off and on, usually with exercise, and disappears when at rest. When PAD becomes more severe, symptoms can include: Pain or tingling in the feet or toes, even at rest Weakened calf muscles Painful non-bleeding ulcers on the feet or toes that do not heal Treatment Treatment for PAD includes both lifestyle measures and medications that help reduce symptoms and prevent disease progression. These include: Smoking cessation Regular exercise, which is essential for patients with mild-to-moderate PAD Heart-healthy diet, low in saturated fat, to reduce unhealthy cholesterol levels Medications to help control high blood pressure and cholesterol. Other drugs that may help include antiplatelet medications to prevent blood clots. In severe cases, procedures may be needed to open blocked blood vessels. Introduction Peripheral artery disease (PAD) occurs when the ar Continue reading >>
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- Diagnostic accuracy of resting systolic toe pressure for diagnosis of peripheral arterial disease in people with and without diabetes: a cross-sectional retrospective case-control study
Peripheral Arterial Disease (pad)
Peripheral arterial disease (PAD) happens when buildup on the walls of blood vessels causes them to narrow. It commonly affects people with type 2 diabetes, who are also prone to high cholesterol and heart disease. According to the American Diabetes Association, about 1 in 3 people with diabetes over the age of 50 have PAD. Doctors most often diagnose PAD when it’s causing leg or foot problems. Since buildup and narrowing of the arteries occur in all arteries in the body, people with PAD are at high risk of heart attack and stroke. If you suspect you have PAD, it’s important to talk to your doctor. They can help you take steps to treat your symptoms and protect your heart and blood vessels. PAD affects millions of Americans, reports the National Heart, Lung, and Blood Institute. However, people often don’t notice it. Many doctors and patients overlook subtle signs of the condition. Possible signs of PAD include: a pain in your calves when you’re walking or exercising that goes away with rest, which is called “claudication” numbness, tingling, or a feeling of pins and needles in your lower legs or feet cuts or sores on your legs or feet that don’t heal or heal slowly Sometimes, the symptoms of PAD are so subtle that you may not suspect you have a problem. In some cases, you may dismiss mild leg pain from PAD as a sign of aging and nothing more. That’s why it’s so important to pay attention to your body and take potential symptoms of PAD seriously. Early treatment is essential to protecting your vascular system. If you have PAD, plaque builds up on your blood vessel walls and restricts the flow of blood and oxygen to your legs and feet. Depending on its severity, this can cause pain in your lower legs when you’re walking. It can also cause numbness, ti Continue reading >>
- Diagnostic accuracy of resting systolic toe pressure for diagnosis of peripheral arterial disease in people with and without diabetes: a cross-sectional retrospective case-control study
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Peripheral Vascular Disease
A condition in which the arteries in the legs, and sometimes the arms, are narrowed by fatty plaque buildup (atherosclerosis). Peripheral vascular disease is 20 times more common in people with diabetes than in the general population. Along with diabetes, other risk factors for peripheral vascular disease are smoking, inactivity, and high blood lipid levels (cholesterol and triglycerides). In people with diabetes, chronic high blood glucose raises the risk of developing peripheral vascular disease. The most common symptom of peripheral vascular disease is intermittent claudication, which is cramping leg pain brought on by walking (and usually relieved by rest) as a result of an inadequate blood supply. As the arterial blockage progresses, the pain may occur after walking less than one city block and may interfere with daily life, necessitating treatment. Another sign of peripheral vascular disease is that minor cuts or abrasions on the feet don’t heal. Peripheral vascular disease can eventually become a very serious problem. People with poor circulation in their legs tend to develop foot ulcers that don’t heal, gangrene, and the need for amputation. If you experience intermittent claudication or very slow healing of wounds on your feet, be sure to consult your health-care team. Severe, limb-threatening peripheral vascular disease is sometimes treated with surgery or endovascular techniques. Bypass surgery involves grafting a blood vessel from another part of the body to bypass the blockage in the affected vessel to restore blood flow. Endovascular (meaning “inside the blood vessel”) techniques include percutaneous transluminal angioplasty (also called balloon angioplasty), atherectomy (cutting away plaque deposits), and use of lasers to clear out blood vessels. Continue reading >>
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Peripheral Arterial Disease In People With Diabetes
ABI, ankle-brachial index CABG, coronary artery bypass graft CAPRIE, Clopidogrel versus Aspirin in Patients At Risk of Ischemic Events CLI, critical limb ischemia CRP, C-reactive protein eNOS, endothelial cell nitric oxide synthase FDA, Food and Drug Administration FFA, free fatty acid MI, myocardial infarction MRA, magnetic resonance angiogram NF-κB, nuclear factor-κB PAD, peripheral arterial disease PAI-1, plasminogen activator inhibitor-1 PI, phosphatidylinositol PKC, protein kinase C PVR, pulse volume recording RAGE, receptor for advanced glycation end products UKPDS, U.K. Prospective Diabetes Study VSMC, vascular smooth muscle cell Peripheral arterial disease (PAD) is a condition characterized by atherosclerotic occlusive disease of the lower extremities. While PAD is a major risk factor for lower-extremity amputation, it is also accompanied by a high likelihood for symptomatic cardiovascular and cerebrovascular disease. Although much is known regarding PAD in the general population, the assessment and management of PAD in those with diabetes is less clear and poses some special issues. At present, there are no established guidelines regarding the care of patients with both diabetes and PAD. On the 7–8 of May 2003, a Consensus Development Conference was held to review the current knowledge regarding PAD in diabetes. After a series of lectures by experts in the field of endocrinology, cardiology, vascular surgery, orthopedic surgery, podiatry, and nursing, a vascular medicine panel was asked to answer the following questions: 1) What is the epidemiology and impact of PAD in people with diabetes? 2) Is the biology of PAD different in people with diabetes? 3) How is PAD in diabetes best diagnosed and evaluated? 4) What are the appropriate treatments for PAD in peo Continue reading >>
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No Title
Citation Nr: 1511071 Decision Date: 03/16/15 Archive Date: 03/27/15 DOCKET NO. 08-37 263 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Houston, Texas THE ISSUE Entitlement to service connection for peripheral vascular disease, left lower extremity, secondary to service connected diabetes mellitus. REPRESENTATION Appellant represented by: Texas Veterans Commission ATTORNEY FOR THE BOARD James G. Reinhart, Counsel INTRODUCTION The Veteran served on active duty from June 1961 to December 1971. This matter comes to the Board of Veterans' Appeals (Board) on appeal from a September 2006 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Houston, Texas. The Board most recently remanded this matter in July 2014 to the agency of original jurisdiction (AOJ) for additional development. The requested development completed, the matter has properly been returned to the Board for appellate consideration. See Stegall v. West, 11 Vet. App. 268, 271 (1998). FINDING OF FACT Peripheral vascular disease of the Veteran's left lower extremity was caused by the Veteran's service-connected diabetes mellitus. CONCLUSION OF LAW The criteria for service connection for peripheral vascular disease of the Veteran's left lower extremity have all been met. 38 U.S.C.A. §§ 1110, 5107 (2014); 38 C.F.R. §§ 3.102, 3.310 (2014). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran contends that his current peripheral vascular disease of the left lower extremity is due to his service-connected diabetes mellitus. Service connection was established for diabetes mellitus in a September 2006 rating decision. Service connection was established for peripheral vascular disease, status post above the knee amputation, right lower extremity, in a Continue reading >>
Diabetes And Vascular Disease
Diabetics have a high incidence of stroke. Diabetes is a disease in which the body does not produce or properly use insulin. Insulin is a hormone that is needed to convert sugar, starches, and other food into energy needed for daily life. There are several types of diabetes: Type 1 diabetes (previously called “juvenile diabetes”) is an autoimmune disorder, in which the insulin producing beta cells are destroyed by the body’s immune system. As a result, the body cannot produce insulin, the hormone that allows glucose to enter and fuel the cells. To survive, individuals with type 1 diabetes must take insulin every day. It is estimated that 5-10% of Americans who are diagnosed with diabetes have type 1 diabetes. Type 2 diabetes (previously called “adult onset diabetes”) is the most common type of diabetes, accounting for 90-95% of all diabetes. In type 2 diabetes, the body does not produce enough insulin and/or the body’s cells become resistant to insulin. Gestational diabetes occurs in some women who have high blood glucose levels during pregnancy but have never had diabetes. It affects about 4% of all pregnant women, with about 135,000 cases in the United States each year. Women who have gestational diabetes have a 20-50% chance of developing type 2 diabetes in the next five to ten years. Prediabetes is a condition that occurs when a person’s blood glucose levels are higher than normal but not high enough for a diagnosis of type 2 diabetes. There are 41 million Americans who have prediabetes, in addition to the 20.8 million with diabetes. If you do not manage your diabetes or maintain healthy habits, you could develop serious health conditions, including blindness, severe kidney disease, stroke, heart attack, sores in your feet, or gangrene (dead tissue) th Continue reading >>
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Peripheral Arterial Disease
Definition Peripheral arterial disease (PAD), cerebrovascular disease, and coronary artery disease (CAD) are the three major syndromes of atherothrombosis. Whereas luminal stenosis (or occlusion) and end-organ ischemia are late manifestations of this progressive process, the diagnosis of PAD is largely viewed as a measure of the individual's global systemic atherosclerotic burden. Thus, even the asymptomatic form of PAD is of great significance to both the patient and clinician. The discussion here will focus on lower extremity PAD. Prevalence With an age-adjusted prevalence of approximately 12%, PAD affects at least 8 to 12 million Americans.1,2 The disease prevalence increases with age and 12% to 20% of Americans age 65 and older (4.5 to 7.6 million) have PAD. As the population ages, the prevalence could reach 9.6 to 16 million in those age 65 and older and 19 million overall by 2050 (Box 1 and Fig. 1).1 Although PAD affects men and women equally, worse outcomes have been observed in diabetic women compared with diabetic men. Studies have suggested a disproportionately higher PAD prevalence among African Americans compared with non-Hispanic whites (odds ratio [OR], 2.3).3 This ethnic propensity is independent of susceptibility to known cardiovascular risk factors such as diabetes, hypertension, and obesity.4,5 The major impediments to improving the care of patients with PAD are related to the lack of disease recognition, poor understanding of its impact on the patient, and the gross underuse of safe, effective, and widely available therapies. The PARTNERS (Peripheral Arterial Disease Awareness, Risk, and Treatment: New Resources for Survival) program has evaluated 7000 at-risk individuals seen in primary care practices.2 In this population, the program uncovered sever Continue reading >>
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Peripheral Arterial Disease
Peripheral arterial disease, also called peripheral vascular disease, is a narrowing of the blood vessels (arteries). It mainly occurs in arteries that supply blood to the legs. The main symptom is pain in one or both legs when you walk. Treatment usually includes stopping smoking (if you smoke), regular exercise, medication to lower your cholesterol level, a daily aspirin and lowering your blood pressure if it is high. Medicines to open up the arteries may help. Surgery may be needed in severe cases. What is peripheral arterial disease (PAD)? PAD is narrowing of one or more blood vessels (arteries). It mainly affects arteries that take blood to your legs. (Arteries to the arms are rarely affected and are not dealt with further in this leaflet.) The condition is also known as peripheral vascular disease (PVD). It is also sometimes called hardening of the arteries of the legs. In the UK, around 1 in 5 men and 1 in 8 women aged 50-75 years have PAD. It becomes more common with increasing age. What causes peripheral arterial disease (PAD)? The narrowing of blood vessels (arteries) is caused by atheroma. Atheroma is like fatty patches (plaques) that develop within the inside lining of arteries. A patch of atheroma starts quite small and causes no problems at first. Over the years, a patch of atheroma can become thicker. (It is a bit like scale that forms on the inside of water pipes.) A thick patch of atheroma makes the artery narrower. This reduces the flow of blood through the affected section of artery. Tissues downstream have a reduced blood supply, which can lead to symptoms and problems. Atheroma can develop in any artery but the common arteries affected are: Arteries taking blood to the heart - this is called coronary heart disease and may lead to problems such as an Continue reading >>
- Diagnostic accuracy of resting systolic toe pressure for diagnosis of peripheral arterial disease in people with and without diabetes: a cross-sectional retrospective case-control study
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Peripheral Vascular Disease - Symptoms
A A A Peripheral Vascular Disease (cont.) Peripheral vascular disease (PVD) is a circulation disorder that causes narrowing, blockage, or spasms of blood vessels to parts of the body other than the brain and heart. The most common cause of peripheral vascular disease is atherosclerosis, or hardening of the arteries, a gradual process by which cholesterol plaques (material) builds up and causes inflammation in the inner walls of the arteries. This cholesterol plaque builds up over time and may block, narrow, or weaken the blood vessel walls, which results in restricted or blocked blood flow. Other causes of peripheral vascular disease include: Diabetes: Over the long-term, the high blood sugar level of persons with diabetes can damage blood vessels. This makes the blood vessels more likely to become narrowed or weakened. Plus, people with diabetes frequently also have high blood pressure and high fats in the blood, which accelerates the development of atherosclerosis. Inflammation of the arteries: This condition is called arteritis and can cause narrowing or weakening of the arteries. Several autoimmune conditions can develop vasculitis, and, besides the arteries, other organ systems are also affected. Infection: The inflammation and scarring caused by infection can block, narrow, or weaken blood vessels. Both salmonellosis (infection with Salmonella bacteria) and syphilis have been two infections traditionally known to infect and damage blood vessels. Structural defects: Defects in the structure of a blood vessel can cause narrowing. Most of these cases are acquired at birth, and the cause remains unknown. Takayasu disease is a vascular disease affecting the upper vessels of the body and affects usually Asian females. Injury: Blood vessels can be injured in an accident Continue reading >>
Peripheral Vascular Disease (pvd, Peripheral Artery Disease, Peripheral Arterial Disease, Pad)
There are two ways atherosclerosis causes disease; 1) atherosclerosis can limit the ability of the narrowed arteries to increase delivery of blood and oxygen to tissues during periods of increased oxygen demand such as during exertion, or 2) complete obstruction of an artery by a thrombus or embolus (thrombus and embolus are forms of blood clots; see below) resulting in tissue necrosis (death of tissue). Exertional angina and intermittent claudication are two examples of insufficient delivery of blood and oxygen to meet tissue demand; whereas strokes and heart attacks are examples of death of tissue caused by complete artery obstruction by blood clots. There are many similarities between coronary artery diseases (atherosclerosis involving the arteries of the heart) and peripheral artery disease, and the two conditions may coexist in the same individual. For example, patients with exertional angina typically have no symptoms at rest. But during exertion the critically narrowed coronary arteries are incapable of increasing blood and oxygen delivery to meet the increased oxygen needs of the heart muscles. Lack of blood and oxygen causes chest pain (exertional angina). Exertional angina typically subsides when the patient rests. In patients with intermittent claudication, the narrowed arteries in the lower extremities (for example, a narrowed artery at the groin) cannot increase blood and oxygen delivery to the calf muscles during walking. These patients experience pain in the calf muscles that will only subside after resting. Patients with unstable angina have critically narrowed coronary arteries that cannot deliver enough blood and oxygen to the heart muscle even at rest. These patients have chest pain at rest and are at imminent risk of developing heart attacks. Patient Continue reading >>
- Diagnostic accuracy of resting systolic toe pressure for diagnosis of peripheral arterial disease in people with and without diabetes: a cross-sectional retrospective case-control study
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- Essential Keys To Diagnosing And Treating PAD In Patients With Diabetes
Peripheral Arterial Disease (pad)
Tweet Peripheral arterial disease (PAD) is a complication of diabetes that happens when blood vessels in the legs become blocked or narrowed due to fat deposits. The result is reduced blood flow to the feet and legs. The condition affects around 1 in 3 people with diabetes over the age of 50, and increases the risk of heart attack and stroke. How does diabetes cause PAD? Diabetes increases the likelihood of PAD, heart attack and stroke. Having diabetes increases the risk, but smoking, high blood pressure, higher blood cholesterol levels, being overweight, not being physically active, having a history of heart disease and other factors further increase PAD risk. What are the symptoms of PAD? Unfortunately, for many people, PAD does not present any symptoms. If symptoms do occur, they may include: Leg cramps in the calves brought on by walking or climbing stairs Further symptoms of PAD include: Feeling numb or cold in the lower legs Pale or blue tinged legs Infections or sores on the feet or legs Hair loss on the legs or feet Extended healing process. How do doctors diagnose PAD? Healthcare professionals use the ankle brachial pressure index (ABPI) to diagnose PAD. This test compares blood pressure in the ankle with blood pressure in the arm. If the former is lower then you may have PAD. Other tests to diagnose PAD may include angiograms, ultrasound, and MRI. How is PAD treated for people with diabetes? PAD treatment is based around managing cardiovascular risk factors. Some quick ways to treat PAD include quitting smoking, keeping your HbA1c under 6.5%, lowering blood pressure and LDL cholesterol. Aspirin may also be effective. Walking and other exercise can be used both to treat and prevent PAD. Tweet Type 2 diabetes mellitus is a metabolic disorder that results in hype Continue reading >>
- Diagnostic accuracy of resting systolic toe pressure for diagnosis of peripheral arterial disease in people with and without diabetes: a cross-sectional retrospective case-control study
- Essential Keys To Diagnosing And Treating PAD In Patients With Diabetes
- Drinking Red Wine With Type 2 Diabetes: Resveratrol Benefits Heart Health By Reducing Arterial Stiffness
The Interventional Therapy For Diabetic Peripheral Artery Disease
Abstract Diabetic peripheral arterial disease is the main cause of lower limb amputation in patients with diabetes. To summarize the technique and experiences and evaluate the clinical effects of blood vessel intervention operation on diabetic peripheral artery disease. Methods 81 patients with diabetic peripheral artery disease from October 2007 to September 2011, 81 cases of the observation group were treated by balloon PTA. By adopting the Seldinger puncture technology, intubation was placed into a cobra catheter or a pig tail artery catheter and directed to the ipsilateral lower extremity artery. A guidewire was used to reach the lesion part of patients and a long balloon with a diameter of 4–6 mm was used to expand the artery with a pressure of 6–10 atm. 81 patients in the observation group received the PTA surgery. The technical succesful rate was 100%, no complication happened. The skin temperature increased after treatment. The blood supply improved significantly. The pulsation of the foot dorsal artery was strengthened. The numbness and pain symptoms were moderated significantly. We observed better results in the observation group in lower limb vessel diameter and foot ulceration healing. None of the patients received amputation surgery. Its short-term effects were satisfactory. PTA is a feasible technique for diabetic peripheral artery disease. It has great clinical significance in treating diabetic peripheral arterial disease. Although its short-term effects is satisfactory, the long-term effects is necessary for follow up. Background Peripheral arterial disease (PAD) is a group of disorders characterized by narrowing or occlusion of the arteries resulting in gradual reduction of blood supply to the limbs. PAD may be asymptomatic until it reaches an advan Continue reading >>
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Heart Information Center
Peripheral vascular disease (PVD) involves damage to or blockage in the blood vessels distant from your heart—the peripheral arteries and veins. Your peripheral arteries and veins carry blood to and from your arm and leg muscles and the organs in and below your stomach area. PVD may also affect the arteries leading to your head (see Carotid Artery Disease). When PVD affects only the arteries and not the veins, it is called peripheral arterial disease (PAD). The main forms that PVD may take include blood clots (for example, deep vein thrombosis or DVT), swelling (inflammation), or narrowing and blockage of the blood vessels. Diseases of the arteries may lead to Disease of the veins may lead to Much like the coronary arteries, the peripheral arteries can be blocked by plaque. What causes arterial blockage? PVD can result from a condition known as atherosclerosis, where a waxy substance forms inside of the arteries. This substance is called plaque. When enough plaque builds up on the inside of an artery, the artery becomes clogged, and blood flow is slowed or stopped. This slowed blood flow may cause "ischemia," which means that your body's cells are not getting enough oxygen. Clogged peripheral arteries in the lower part of the body (also referred to as peripheral artery disease or PAD) most often cause pain and cramping in the legs. The risk factors for atherosclerosis in the peripheral arteries are the same as those for atherosclerosis in the coronary arteries. Smoking, diabetes, high blood pressure, and high cholesterol are believed to lead to the development of plaque. What are the symptoms and signs? Patients may feel pain in their calves, thighs, or buttocks, depending on where the blockage is. Usually, the amount of pain you feel is a sign of how severe the block Continue reading >>
What Causes Of Peripheral Vascular Disease?
Peripheral vascular disease (PVD) is usually caused by a build-up of fatty deposits on the walls of the arteries inside the legs. The fatty deposits, called 'atheroma', are made up of cholesterol and other waste substances. The build-up of atheroma on the walls of the arteries makes the arteries narrower and restricts the flow of blood to the legs. This process is called 'atherosclerosis'. People with PVD can experience painful cramps in their leg muscles during physical activity because the muscles are not receiving the blood supply that they need. Like all tissue in your body, the muscles in your legs need a constant supply of blood to function properly. When you are using your leg muscles, the demand for blood increases tenfold. But if the arteries in your legs are blocked, the supply of available blood cannot meet the demand. This shortfall between supply and demand causes your muscles to experience painful cramps, which only get better after you rest your legs. Risk factors for PVD Over time as you get older, your arteries naturally begin to harden and get narrower, which can lead to atherosclerosis and then PVD. However, there are many factors that can dangerously speed up this process. These are described below. Smoking The single most important risk factor for PVD is smoking. Smoking can damage the walls of your arteries. Tiny blood cells, known as 'platelets', will then collect at the site of the damage to try to repair it. This can cause your arteries to narrow. It is estimated that smokers are six times more likely to develop PVD than non-smokers and more than 80% of people who develop PVD are current or former smokers. Diabetes If you have poorly controlled type 1 or type 2 diabetes, the excess glucose in your blood can damage your arteries. People with diab Continue reading >>
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