Article - Vital Signs - Aug 27, 2013

Article - Vital Signs - Aug 27, 2013

Vital Signs:  Learn Your Risks for Vascular Diseases and Talk with Doctor about Screenings


By Ivan Crosby, M.D.

University of Virginia Vascular and Endovascular Surgery


The Daily Progress, Tuesday August 27, 2013, Charlottesville, VA

Vital Signs is a community health promotion column sponsored by University of Virginia Health System, Martha Jefferson Hospital, Region Ten and the Thomas Jefferson Health District.


With an aging population comes an increase in cardiovascular disease. In fact, the prevalence is as high as 70 percent in U.S. men and women between the ages of 60 and 79, according to the American Heart Association. Among the most common problems as we get older are diseases of the blood vessels, or vascular system.


Vascular disease can lead to serious, disabling or even fatal conditions like heart attack or stroke. Unfortunately, symptoms are often mild or nonexistent, so there are few early warning signs. That’s why screening for vascular disease is so important. With early detection and treatment, the risk for these adverse complications is reduced significantly.


The three vascular conditions of most concern are:

  • Aortic aneurysm:A weakening and bulging of the aorta, the body’s largest artery carrying blood from the heart to the abdomen. The aneurysm may occur in the chest (thoracic aneurysm), in the abdomen (abdominal aneurysm), or across both areas (thoracoabdominal aneurysm). If left untreated, the aneurysm eventually will expand and rupture, which is a catastrophic event in a majority of cases.
  • Carotid artery stenosis (CAS):The buildup of plaque in the carotid arteries, the primary blood vessels to the brain located on either side of the neck. If the blockage of the arteries becomes significant, it can lead to stroke.
  • Peripheral artery disease (PAD):A lack of circulation to the extremities caused by atherosclerosis, or hardening of the arteries. Left untreated, those with PAD may require limb amputation, and they have a significantly greater risk for heart attack and stroke.


Know your risk

With the exception of aortic aneurysm, which has shown to be most prevalent in a particular group (white males ages 65 to 75 who have smoked), widespread screening for these conditions is not recommended. Instead, physicians rely on risk factor assessments and family history to determine if individuals should be tested as part of their preventive treatment.


Some of the primary risk factors for vascular disease include:

  • Advanced age (65 and older)
  • Diabetes
  • Obesity
  • High blood pressure
  • High cholesterol
  • Smoking
  • A family history of vascular disease


Men and women are equally susceptible to vascular disease, however, there does appear to be a higher incidence of aortic aneurysm among men, as mentioned above. If you have one or more of these risk factors, and especially if you have a family history of vascular disease, talk to your doctor about screening, as well as preventive steps you can take.


Types of vascular screening

The technology used for vascular screening has improved significantly over the past several decades, allowing for improved accuracy and earlier diagnosis with simple, non-invasive tests.

Those commonly used include:

  • Abdominal duplex:Ultrasound of the aorta to detect aneurysm;
  • Carotid duplex:Ultrasound of the carotid arteries to detect carotid stenosis; and
  • Ankle-brachial index:A measurement of blood pressure in the legs to detect reduced blood flow to the extremities.


Should you require treatment, your physician may recommend medical management, close monitoring, lifestyle modification (smoking cessation, dietary alterations) or a surgical procedure. In many instances, especially with aneurysm or a blockage in a leg artery, the condition may be treated using a minimally invasive stenting procedure, which has a shorter recovery period than traditional surgery.


At University of Virginia Health System, we carefully evaluate the health of each individual to determine the need for vascular screening. Typically, we err on the side of caution because we know that the first signs of a problem can be a devastating event. The full realm of preventive care —including the tests and our specialists who treat these complex conditions —are available both in Charlottesville and at our new Zion Crossroads location, opening Aug. 26.


Vascular surgeon Ivan Crosby is the co-director of the UVa Heart and Vascular Center.


Find out more:  Visit for more information on vascular disease, and go to to learn more about the services available at the new Zion Crossroads location.