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Wednesday, December 12, 2012
Peripheral Vascular Disease / Peripheral Artery Disease (PVD)
 
by Ryan Chaney 


As the prevalence of cardiovascular diseases (CVD) has increased over the years, patients are experiencing signs and symptoms within the extremities known as Peripheral Vascular Disease (PVD). According to the Centers for Disease Control (CDC), approximately 8 million people in the United States have PVD, including 12-20% of individuals over the age of 60. CVD involves blocked arteries within critical regions of the body. The mode by which coronary, carotid, and peripheral artery disease occurs is the same in all three – sticky, fatty substances, called plaque, build up in the inner lining of the arteries.

Peripheral Vascular Disease is often overlooked because immediate symptoms (pain in one or both calves, thighs and/or hips) often occur in the arms and legs, and are common for a number of conditions. However, over time, the brain and heart can become directly affected by PVD. According to the A.D.A.M Medical Encyclopedia, PVD can lead to blood clots or emboli that block off small arteries, coronary artery disease, impotence, open sores (ischemic ulcers) on the lower legs, and/or tissue death (gangrene). Initial testing for the disease involves a qualitative analysis of patient symptoms followed by blood pressure measurements in the extremities. Computerized tomography angiography (CTA) and similar advanced technology may yield a more accurate depiction of circulation.

Like most cardiovascular diseases, prevention is the first line of defense. The CDC mentions that controlling high blood pressure, cholesterol and diabetes can be a preventative measure against PVD along with physical activity, exercise and abstinence from smoking. According to the American College of Sports Medicine adults should get at least 150 minutes of moderate-intensity exercise per week. These exercise recommendations can be met through 30-60 minutes of moderate-intensity exercise (five days per week) or 20-60 minutes of vigorous-intensity exercise (three days per week).

Researchers have found that high and low intensity exercise programs were equally effective during a 3-month aerobic exercise protocol (Purr 2006). A significant amount of research has been found to support exercise programs in the aquatic environment. One of the leaders in aquatic research, Dr. Bruce Becker, explains that the relationship of heart rate to oxygen consumption (VO2) during water exercise parallels that of land-based programs, although aquatic exercise heart rates are lower due to a number of reasons. During exercise, there is an increase in systolic pressure with increasing workload, approximately 20% less when immersed in the aquatic environment than on land. The hydrostatic pressure of water exerts more compression on the lower extremities facilitating fluid movement towards the center of the body, reducing edema.

Peripheral Vascular Disease is very serious but treatable condition that will impede blood flow to the vital organs of the body. Exercise completed in the aquatic environment may be even more beneficial than exercise on land. The unique properties of water result in noticeable physiological changes in the cardiovascular system that will assist in a much faster recovery for patients with Peripheral Vascular Disease.

References
Vein Directory. 16 March 2012 http://www.veindirectory.org/glossary/2007/9/peripheral_vascular_disease_1.html#b#ixzz1pt45ECJu

Centers for Disease Control and Prevention. 20 March 2012
http://www.cdc.gov/DHDSP/data_statistics/fact_sheets/fs_PAD.htm

A.D.A.M Medical Encyclopedia. 22 March 2012
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001223/

Becker B.E. Aquatic Therapy: Scientific Foundations and Clinical Rehabilitation Applications. 1 (9) 2009, 859-872

Ryan Chaney is currently enrolled in the Undergraduate Division of Exercise Physiology in the West Virginia University School of Medicine. He currently works, part-time, as a Cardiac Monitor Technician at Ruby Memorial Hospital. After finishing his undergraduate degree, Ryan plans to enroll in the School of Occupational Therapy at West Virginia University.
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