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Peripheral Angioplasty:
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Peripheral
angioplasty is a procedure
that has grown rapidly in the
last two decades. The same atherosclerosis
that involves the heart arteries
can involve any artery in the
body. The most common arteries
to be involved are those which
supply the legs (causing cramps
when walking, known as claudication),
those to the brain known as the
carotid arteries (causing strokes)
and the arteries to the kidneys
(causing high blood pressure).
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The
same risk factors for coronary artery disease
are associated with peripheral vascular
disease. Controlling these factors can help
control symptoms.
There
are noninvasive tests, which may help your
doctor learn if the blood flow through the
arteries is impeded and if so may order
an angiogram. The procedure of peripheral
angioplasty is performed using a catheter
and a balloon to expand a narrowed artery.
Stents are often used to help keep an artery
opened. The procedure is performed under
local anesthesia and sedation. You may have
your procedure as an outpatient or stay
overnight. Light activity may be resumed
shortly after the procedure and full activity
in about one week.
Risk
Factors for Coronary Artery Heart Disease
Smoking
is one of the most important risk factors
for developing coronary artery disease.
Smokers have a significantly increased risk
of early heart attack. There are a number
of factors that are important in promoting
coronary artery disease. Many of these factors
cause an abnormal arterial wall lining to
develop and lead to hardening of the arteries
(atherosclerosis). Once arteriosclerosis
does develop smoking may cause a heart attack
to happen.The
positive effects of stopping smoking are
seen within a matter of hours. It is never
too late to stop smoking. Those patients
who stop smoking after a heart attack, angioplasty
or bypass surgery have a much better prognosis
than those who continue to smoke do.
High
blood pressure
hypertension is one of the most common risk
factors for heart disease and stroke. Hypertension
can be a silent killer, for until the disease
is very advanced, there are no symptoms
of high blood pressure. It is important
to have your blood pressure checked regularly
and to follow-up with your doctor is high
readings are seen. Normal blood pressure
is less than or equal to 120 over 80 (120/80).
High blood pressure is greater than 140/90.
The top number is the systolic blood pressure
and the bottom number is the diastolic.
Blood pressure can often be lowered, when
it is high, by exercise, weight reduction
and a low salt diet. These measures should
be undertaken only under the supervision
of your doctor. There are a number of excellent
medications to treat high blood pressure
and when successful, lower the risk of heart
attack and stroke.
Physical
Activity: Those of us who lead
a sedentary life style have a higher risk
of developing heart disease than those who
lead an active life style. Walking briskly
for 20 minutes three times a week can have
significant positive health benefits. Exercise
can help control weight and lower blood
pressure. You should check with your doctor
before beginning an exercise program.
Age:
Cardiovascular disease becomes more common
with age. About 10,000 women and: 18,000
men under age 45 die of cardiovascular disease
each year in the United States. Between
the ages of 45 and 64, that figure climbs
to about 40,000 women and 85,000 men. From
ages 65 and 84, it soars to about 240,000
women and 260,000 men. That is why it becomes
increasingly important as you age to pay
careful attention to diet, fitness and other
factors that can prevent or reduce the risk
of heart disease. Years or decades of a
poor diet take their toll as you age and
fatty plaques that have collected along
artery walls slow or impede blood flow.
People who do not exercise regularly are
more likely to develop other cardiovascular
risk factors such as high blood pressure
and diabetes. The effects of age also are
felt directly by the blood vessels and the
heart. As blood vessels age, they become
less flexible and thus make it harder for
blood to move through them. Exercise, a
low fat diet and body weight control help
to slow the process of hardening of the
arteries (atherosclerosis).
Diabetes:Diabetes
is responsible for many health complications,
including an increased risk of blood vessel
disease and coronary artery disease. Diabetes
increases the risk of heart disease 5-fold
in a woman and 2-fold in a man. In fact,
about 80 percent of people with diabetes
die of heart disease or stroke. Part of
the reason is that diabetes raises cholesterol
and triglyceride levels. In Type 2 (also
called "non-insulin-dependent"
or "adult-onset") diabetes, the
body’s cells become resistant to insulin
and the pancreas cannot produce enough insulin
to overcome the resistance. Insulin is the
hormone that permits blood glucose (sugar)
to move into the body’s cells where
it is used for energy. Insulin also reduces
the amount of glucose released by the liver.
When the body fails to respond to normal
insulin levels, insulin production increases.
Elevated levels of insulin, however, can
raise blood pressure and encourage the deposition
of fat in artery walls. The result is clogged
coronary arteries, plus a variety of other
vascular problems, such as the leg pain
of peripheral artery disease. Weight loss
can decrease the demand for insulin and
exercise can help you to use excess blood
glucose, preventing or slowing the onset
of diabetes.
Sex
and Menopausal Status:Men
are at increased risk for coronary artery
disease. While the reasons for this are
not entirely known, lipid status (cholesterol
and fats) seem to play a role. Premenopausal
women tend to have higher levels of HDL
(‘good cholesterol’) and this
may have a protective effect. Premenopausal
women may still develop coronary artery
disease, however the risk increases significantly
in postmenopausal women. Many physicians
think that estrogen replacement in postmenopausal
women may lower the risk of coronary artery
disease, however this is not certain and
this decision must be made on an individual
basis.
Cholesterol
and Lipids:The
blood levels of cholesterol and triglycerides
are also important risk factors for coronary
artery disease. The level of cholesterol
is directly related to the risk of coronary
artery disease. Cholesterol is measured
as LDL or ‘bad cholesterol’
and as HDL or ‘good cholesterol’.
The level of cholesterol that your doctor
will consider "good" for you will
depend on many factors. Levels of total
cholesterol are often best kept below 220.
We can lower the level of our cholesterol
by eating a diet low in fats and cholesterol.
Avoiding fried and fatty foods can be an
important part of controlling blood cholesterol.
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