According to the Centers for Disease Control and Prevention, 5 percent of adults aged 40 or over have peripheral arterial disease, or PAD, and 4 million Americans have cerebrovascular disease resulting in 600,000 strokes and 158,000 deaths annually. Twelve million Americans have coronary heart disease, which is the major cause of death in the U.S.; stroke is the third major cause of death. Arterial stenosis is the major cause for all of these diseases, and exercise can positively affect the outcome for these conditions.
Anatomy
The arteries most often affected by stenosis are the carotid arteries, coronary arteries and the arteries of the lower extremities. The carotid arteries originate at the aortic arch and supply blood flow to the brain. The internal and external iliac, femoral, popliteal and anterior and posterior tibial arteries provide blood flow from the lower aorta to the legs. The right and left coronary arteries and their branches supply blood to the heart.
Pathology
The major cause of arterial stenosis is plaque formation created by deposits of cholesterol and other substances that cause the inside of the arteries to become narrow, resulting in reduced blood flow over time, which reduces the supply of oxygen and nutrients to tissues. The degree of occlusion can be mild, moderate, severe or total. Symptoms of arterial stenosis involving the blood supply to the brain, heart or legs occur when supplies of oxygen and nutrients are insufficient to meet metabolic demands during exercise or at rest. Symptoms are worse if there is more than one occlusion.
Symptoms
Peripheral arterial disease can manifest as loss of lower extremity hair, shiny appearance and coolness of the skin, and leg pain or heaviness during exercise. The pain can occur in the thigh or calf, depending on the location of the blockage. Carotid artery stenosis can present as episodes of blurred vision, stroke-like symptoms such as numbness and or weakness in the face, arm or legs, and difficulty speaking or understanding speech. These are symptoms of impending stroke and immediate medical help should be sought if any of these symptoms occur. Inadequate blood supply to the heart via the coronary arteries results in myocardial ischemia that can manifest as severe chest pain or angina, nausea, vomiting, profuse sweating, dizziness and loss of consciousness. Again, immediate medical attention is necessary.
Exercise Is Therapeutic
According to "Healthy People 2010," "everyone can benefit from physical activity. Even when physical activity is less than vigorous, it can still produce health benefits." Exercise improves overall health and improves the risk factors associated with arterial stenosis, such as obesity, hypertension, diabetes and elevated cholesterol and triglycerides. If you have arterial stenosis, have your exercise regimen supervised by a qualified healthcare practitioner.
References
- MedlinePlus; Carotid Artery Disease; May 2011
- Cardiovascular Physiology Concepts; Hemodynamics of Single and Multiple Arterial Stenotic Lesions; Richard E. Klabunde, PhD; November 2007
- "Healthy People 2010": Heart Disease and Stroke
- CDC's "Morbidity and Mortality Weekly Report": Lower Extremity Disease Among Persons Aged >40 Years With and Without Diabetes -- United States, 1999-2002; November 2005
