It can affect arteries, veins, or capillaries

By Heidi Moawad, MD 

Updated on September 26, 2023

 Medically reviewed by Anthony Pearson, MD

Vascular disease is a process that affects the blood vessels of the body. This condition increases the risk of many different health problems that occur as a result of blood flow blockage or insufficient blood flow. Vascular disease can affect any blood vessel of the body.

Generally, it develops gradually over time, and it doesn’t usually cause noticeable symptoms until it has advanced. Factors that contribute to the development of vascular disease include smoking, hypertension (chronically high blood pressure), sedentary lifestyle, high blood cholesterol and fat levels, and a hereditary predisposition.

Often, vascular disease is widespread, affecting many regions of the body and several types of blood vessels. Treatment can include lifestyle strategies, medication, and sometimes surgery. 

Christoph Burgstedt / Science Photo Library / Getty Images

Types 

It’s common for vascular disease to affect many blood vessels and types of blood vessels throughout the body. But often, specific types of vascular disease are described based on symptoms or diagnostic tests. And you might develop one or more of these types, but not necessarily all of them.

Types of vascular disease include:

• Peripheral artery disease: This condition affects the arteries in the legs and/or arms and may cause problems with wound healing and/or claudication (pain with movement, especially when walking).

• Coronary artery disease (CAD): Disease of the arteries in the heart can predispose to blood clots, which may cause a heart attack. Sometimes a blood vessel in the heart can become severely narrowed or completely blocked off due to CAD.

• Carotid disease: Disease of the carotid arteries can lead to diminished blood flow to the brain and may increase the risk of blood clots traveling to the brain, causing a stroke.

• Cerebrovascular disease: Narrowing of the blood vessels in the brain can lead to complete blockage of a blood vessel, which may result in a stroke.

• Pulmonary vascular disease: Pulmonary hypertension can develop with severe heart and/or lung disease, resulting in worsening respiratory disease and overall health, often with impaired breathing.

• Retinopathy: Diabetes and hypertension may lead to narrowing and irregularity of the blood vessels in the eyes, which can lead to vision loss.¹ Sometimes retinopathy can occur in babies who are born premature as well.

• Chronic venous insufficiency: Disease of the veins may cause swelling of the extremities (especially the legs), as well as discomfort. Skin changes can occur as well.

• Renal artery disease: The blood vessels of the kidneys can become narrowed and damaged due to chronic disease, potentially leading to kidney failure of one or both kidneys.

• Raynaud’s disease: This condition is characterized by intermittent narrowing of the blood vessels and it is believed to be hereditary, not associated with lifestyle habits. However, the symptoms can be exacerbated by lifestyle habits, like smoking.

• Vasculitis: Inflammation of the blood vessels can occur as a result of chronic conditions, like systemic lupus erythematosus (SLE) or rheumatoid arthritis (RA). It can also develop as the result of an infection that causes severe inflammation or reaches the blood vessels.

• Varicose veins: Distension of the veins of the extremities (usually in the legs) can cause the veins to be visible. This condition may cause cosmetic concerns, but it rarely causes any medical problems.

• Aneurysm: A defect in a blood vessel, like the abdominal aorta or a cerebral blood vessel, can lead to rupture, with potentially life-threatening bleeding.

Vessels Affected

Vascular disease can affect arteries, veins, and/or capillaries:²

• Arteries are blood vessels that, with the exception of the pulmonary arteries, carry oxygen-rich blood from the heart to the organs. To accommodate the higher pressure in the arterial circulation, arteries have smooth muscle in their lining.

• Veins, with the exception of the pulmonary veins, carry oxygen-poor blood from the body organs and muscles back to the heart. They are thin-walled, lacking the smooth muscle of arteries.

• Capillaries are tiny blood vessels that reach individual cells for the direct exchange of oxygen, nutrients, and waste, such as carbon dioxide.

Vascular Disease Symptoms 

The effects of vascular disease can be widespread, and may include gradually worsening leg problems (like pain or impaired healing), or severe consequences like a heart attack or a stroke.

You might notice some mild effects for years, or you might not experience or notice any early symptoms—and a serious complication could be the first clinical manifestation of your vascular disease. 

The first effects of vascular disease may include:

• Dry skin on the feet, toes, and rarely, the fingers

• Non-healing wounds on the feet, toes, or fingers

• Claudication (pain, cramping, or discomfort)

• Skin changes, like leathery skin, pale skin, or cold clammy skin on the feet, toes, or fingers

• Pain of the feet, toes, or fingers 

• Shortness of breath with exertion 

• Angina (chest pain) with exertion or at rest, can include stable angina or unstable angina

• Transient ischemic attacks (TIAs), which can include brief episodes of dizziness, speech impairment, and/or weakness on one side of the body 

Complications 

Vascular disease can worsen gradually and quietly.³ It may lead to serious problems due to insufficient blood flow and/or blood clots. Complications correspond to the area of the body in which blood flow is impeded. 

Serious effects of vascular disease include:

• Leg ischemia and gangrene

• Deep vein thrombosis (DVT) in the arm or leg

• Pulmonary embolus (PE)

• Kidney failure 

• Stroke 

• Heart attack 

• Intestinal ischemia, mesenteric ischemia (blockage of blood vessels supplying the gastrointestinal system)

Other health factors, such as a blood clotting disorder, cancer, or inflammatory disease can increase your risk of complications if you have vascular disease by contributing to your tendency to develop blood clots.

 How Ischemia Affects Different Parts of the Body

Causes 

There are a number of risk factors associated with vascular disease. The condition develops as the inner lining of the blood vessels becomes damaged, often leading to irregularities in the lumen (opening) and intermittent areas of narrowing throughout the blood vessels. 

Risk factors include:³

• Smoking 

• Hypertension 

• Diabetes 

• High blood triglyceride levels

• High blood levels of low-density lipoprotein (LDL) 

• Low blood levels of high-density lipoprotein (HDL) 

• Damage due to toxins, including trans fats

• Chronic inflammation

• Autoimmune disease

• Chronic emotional stress 

• Obesity 

• Sedentary lifestyle, lack of regular exercise 

• Family history of vascular disease 

The risk of vascular disease is amplified when you have more risk factors. And the longer you have these risk factors, the higher your likelihood of developing vascular disease—and of having complications.

Optimal levels:

• Blood pressure: Below 120/80 mmHg

• Total cholesterol: Below 200 milligrams (mg)/ deciliter (dL.)

• LDL cholesterol: Below 100 mg/dL

• HDL cholesterol: Above 41 mg/dL

• Triglycerides: Below 150 mg/dL

• Body mass index (BMI) between 18.5-24.9

Process 

The process by which vascular disease develops is gradual. The blood vessel lumen can become damaged by factors like hypertension, inflammation, toxins, smoking, and more.

A buildup of cholesterol and fat or inflammatory by-products may further damage the vessel lumen, leading to atherosclerosis, the formation of plaque that can narrow the vessel and impede blood flow.²

This process can occur in many blood vessels throughout the body, leading to a variety of potential symptoms and long term health effects. 

Sometimes a few blood vessels can be more severely affected by vascular disease, potentially leading to symptoms. When vascular disease affects certain organs of the body (like the heart and brain) it is more likely to manifest with serious or life-threatening effects (like a heart attack or a stroke).

Diagnosis 

The diagnosis of vascular disease is tailored to the symptoms and the location in which vascular disease is suspected. Your healthcare provider will listen to your medical history, ask further questions, and do a physical examination.

Signs of vascular disease that can be detected with a physical examination differ depending in the type of vascular disease and the severity.

Physical exam findings include:

• High blood pressure

• Diminished pulses

• Pale or bluish discoloration of the extremities with peripheral vascular disease

• Swelling of the extremities with venous insufficiency

• Murmurs, irregular heart rhythm, or other alterations in heart sounds with CAD

• Carotid artery bruits (an audible vascular sound) with carotid artery disease

• Swelling or throbbing of the abdomen with an abdominal aortic aneurysm

• Neurological abnormalities with cerebrovascular disease

• Swelling of the veins with varicose veins

• The appearance of vascular disease seen with an eye examination¹

You might not have any signs of vascular disease, however, even if your condition is very advanced.

Diagnostic Tests

Diagnostic tests can include imaging tests that directly visualize the blood vessels. Angiography, which can be done with computerized tomography (CT) or magnetic resonance imaging (MRI) can provide a picture of the blood vessels.

Tests like an echocardiogram or carotid ultrasound can provide a visualization of blood flow in the vessels, as well as visualization of the structure of the blood vessels.

Invasive tests like interventional angiography involve the placement of a catheter (tube) into a blood vessel so it can be visualized from the inside. This test poses more risk than non-interventional imaging tests, but it may provide information that cannot be obtained with a non-invasive test. Sometimes therapeutic treatment is done at the same time as a catheter-assisted angiography.

You might also have tests that assess vascular disease risk factors, including:

• Blood cholesterol and triglyceride levels

• Blood glucose levels and hemoglobin A1C (a measure of your blood glucose over the past few months)

• Blood tests that indicate chronic inflammation, like erythrocyte sedimentation rate (ESR)

The diagnosis of vascular disease involves a combination of these tests to determine the type of vascular disease you have, the severity, and the cause.

If your preliminary testing suggests that you have experienced consequences of your vascular disease, you may have diagnostic tests that can detect these complications, such as blood tests that assess kidney function.

Treatment 

Treatment of vascular disease is aimed at managing the risk factors, promoting healthy blood vessels, and treating any consequences of vascular disease that have occurred. Treatment can involve lifestyle preventative strategies, medication, and/or interventional procedures.

Medications used to treat vascular disease include those that treat:

• Hypertension

• High cholesterol

• Diabetes

• Inflammation

If you have vascular disease, your healthcare provider may advise you to take an over the counter (OTC) or prescription blood thinner to help prevent a stroke or another type of blood clot. Additionally, anti-arrhythmic medication may be prescribed to regulate your heart rhythm if you have an arrhythmia (irregular heart rate), because this is a stroke risk factor.

Surgery

Sometimes, an interventional treatment might be needed to manage severe disease in a blood vessel. It is generally not possible for widespread vascular disease in many blood vessels to be surgically repaired.

This type of treatment is reserved for localized and severe vascular disease that could lead to serious health consequences or localized, severe vascular disease that is causing intolerable symptoms and is not improving with non-surgical treatment. Generally, a fixable area of the blood vessel is identified prior to surgery with the aid of diagnostic tests.⁴

Sometimes surgery for vascular disease is done as an emergency, and sometimes it is planned in advance to prevent a serious outcome from happening.

Surgical procedures for vascular disease include:

• Coronary artery bypass graft (CABG) for vascular disease in the heart

• Peripheral artery bypass for severe peripheral artery disease

• Carotid endarterectomy

• Brain aneurysm repair

• Abdominal aortic aneurysm repair

These procedures may involve removal of plaques, removal of a blood clot, removal of a severely diseased section of a blood vessel, placement of a stent (artificial material to maintain an open blood vessel), placement of a graft (an artificial section used to patch a blood vessel), and/or placement of a filter (to prevent a blood clot from reaching a vital organ, like the lungs).⁴

These procedures may be done with minimally invasive techniques or as open surgeries, depending on the situation.

Prevention 

Since vascular disease can have such serious consequences, prevention is important. Prevention primarily relies on lifestyle habits. You should start preventative approaches as early in your life as possible, but it’s never too late to adopt the strategies that can help you steer clear of vascular disease. 

You can avoid vascular disease with the following approaches:

• Don’t smoke.

• Stop smoking if you already smoke.

• Control hypertension with moderate salt intake if that’s what your healthcare provider recommends, and take blood pressure lowering medication if needed.

• Exercise regularly.

• Manage your stress.

• Maintain optimal fat and cholesterol levels by avoiding a high fat or high cholesterol diet, and taking medication if necessary.

Regularly maintaining your medical appointments can help identify early signs of vascular disease risk, like hypertension and elevated cholesterol, even before vascular disease develops. But it is important to use all of these strategies to help prevent vascular disease, whether you have developed signs of the condition or of risk factors—or not.