Almost everyone in this country knows about heart disease--the importance of prevention, detection, and treatment and the huge impact it has on people's health. But they know very little about vascular disease outside the heart.
That's despite the fact that many vascular diseases can produce strokes, which are the third leading cause of death in the United States. Stroke is also the leading cause of disability in the U.S., and more than $70 billion is spent annually on the care of stroke patients, according to the American Vascular Association (AVA).
An estimated 20 to 30 million Americans are at risk for various vascular diseases, including stroke, peripheral arterial disease (PAD), carotid artery disease and aortic aneurysms. And according to the AVA, vascular disease outside the heart causes almost as much death and disability as heart disease, and more than any cancer.
This became evident during one of the AVA's first ever free national screening
studies which was held at 17 sites throughout the U.S.
in May 2002. The study yielded some disturbing results: Thirteen percent of
people screened had signs of vascular conditions, including blocked carotid
arteries, aortic aneurysms and PAD. Most people who were screened
didn't know they had a problem and had never been tested for vascular disease.
It's important to understand that vascular disease outside the heart does occur in a variety of different locations -- the carotid arteries in the neck, the aorta, the arteries in the legs and arms and even disease in the veins. Most of these problems are very similar to heart disease in the sense that they are atherosclerosis (hardening of the arteries) of the arteries. It just occurs in different arteries than the coronary arteries to the heart.
It's also important to understand the potential severity of these diseases. Just like heart disease, each one of those problems has consequences that can be fatal or can be very serious and lead to hospitalization and severe disability long term.
Carotid artery disease, PAD and aortic aneurysms are probably the three most serious non-cardiac vascular diseases that afflict Americans and are certainly the ones that produce the most potential for death and disability.
Carotid artery disease typically occurs when the carotid arteries, the main blood vessels to the brain, develop a buildup of plaque caused by atherosclerosis, or a hardening of the arteries. When the buildup becomes severe, it can cause a stroke, which can be fatal or permanently disabling. However, if carotid artery disease is detected and treated, doctors can prevent most strokes.
Aortic aneurysms occur when the wall of the aorta, the main artery in the chest and abdomen, progressively weakens. This causes a dilation of the vessel. If not diagnosed and treated, the aneurysm will grow larger and eventually rupture. According to the AVA, a ruptured abdominal aortic aneurysm (AAA) is the tenth leading cause of death in men over age 55 in this country.
An aneurysm that ruptures has an 80 percent fatality rate and the vast majority of people with aneurysms are never diagnosed and many are never diagnosed until they experience fatal rupture, but if the AAA is detected and treated electively the risk is more in the range of 2 to 3 percent; it really is a fatal disease that can be cured.
PAD is a blockage in the circulation to the arms or legs due to atherosclerois or other diseases, which may threaten the limbs. PAD can impair circulation to the legs and lead to serious disability or amputation. Between 25 and 30 million people over 70 have PAD. These people are three times as likely to die of heart attacks and strokes as those without the disease.
In most cases, with early detection, vascular disease can be treated effectively. There are several simple screening tests that detect these problems, all of which are non-invasive and painless.
Screening is useful in certain high-risk groups in the elderly population. Anyone over the age of 55-60 has a higher risk of atherosclerosis and therefore would have a greater chance of developing vascular disease. Other well recognized risk factors include:
A full range of noninvasive tests are available at the Maryland Vascular Center's Non Invasive Vascular Laboratory, including tests for:
The University of Maryland Medical Center offers one of the most comprehensive array of examinations to evaluate all of the major vascular systems. Our physicians perform a lot of specialized exams, which can even include measuring the circulation in patient's eyes, kidneys, and transplanted organs.
Over 700 people a month are examined in the lab.
The University of Maryland also has a strong interest in stroke care since it is a priority for this country. Strokes due to carotid disease can be prevented if diagnosed early and medical treatment is undertaken.
By Michelle Weinstein
University of Maryland Medical System Web Site Writer