Blood is the carrier of the all-important oxygen molecule. Through a series of reactions in which oxygen is involved, energy is produced, which is necessary for driving our cells’ metabolic reactions. So when blood does not reach a part of the body, the conditions that result from it are the consequences of oxygen deprivation. The heart, through its pumping action, maintains the pressure required for the blood to reach all parts of the body. Under normal circumstances, arteries, veins and capillaries, through which blood travels, are quite flexible. When they harden or get blocked, blood cannot flow through them to reach the organs. Hardening or blocking of blood vessels occur due to many reasons. Deposition of cholesterol and fat, clumping of platelets to form clots, and inflammation, all of these can lead to the narrowing of the diameter of blood vessels.
Problems in circulation also occur if the heart cannot pump blood efficiently. This can occur due to a number of reasons, but mostly is due to the same factors that are involved in blood vessel narrowing. Here are some conditions in which the blood circulation of an individual may get compromised.
It is the leading cause of narrowed blood vessels that ultimately lead to all kinds of problems in the body. Atherosclerosis is a gradual process of hardening and loss of flexibility of the arteries as a result of deposition of cholesterol and fats inside their lumen. These deposits are called plaques. When this deposition reaches a significant level, the arteries become partially or fully blocked. Blood cannot flow with the same efficiency through them, and the organ to which they supply suffers ischemia, a condition of oxygen deprivation. Atherosclerosis is the cause of many diseases like myocardial infarction, brain strokes, renal stenosis, and pain and cramps in the hands or legs. The disease which a person gets, depends on which arteries have significant blockage in them. Cholesterol is needed and manufactured naturally by the body, and it also comes into the body by the consumption of food, and excess amounts are stored. The same goes for fat – especially trans fat. A high fat diet is therefore one of the main culprits in causing atherosclerosis, although other factors like genetics are also important.
- Angioplasty – This procedure involves inserting a flexible tube in the artery and inflating it to increase its diameter.
- Bypass Surgery – When the arteries supplying the heart (coronary arteries) are completely blocked, they are ‘bypassed” by using a blood vessel from some other part (e.g. leg). By surgically attaching this blood vessel to the heart, the blood supply is redirected via this, to the heart.
- Preventive Measures – Changes in lifestyle, such as following a low-fat diet, exercising, reducing alcohol consumption, and cessation of smoking are necessary to avoid buildup of plaque in the arteries. Some drugs like statins can be used to lower cholesterol levels in the body, but they have many side-effects too.
This disease has two forms, a primary one, and a secondary form (called Raynaud’s phenomenon). The primary form does not occur in association with some other disease, but the secondary form does. In people suffering from this condition, some parts of the body such as the fingers, toes, nose, lips and ears feel very cold under conditions of low temperature or stress. This happens because some small arteries in these body parts constrict, reducing blood flow, causing the feeling of numbness and cold experienced by people suffering from this disorder. During an attack, the affected body parts blanch, and then turn blue. When blood flow is slowly restored, they turn red along with a burning, throbbing sensation. Many people with Raynaud’s disease experience all this only in their extremities. Its prevalence is greater among women as compared to men.
People with Raynaud’s disease are advised to wear warm clothes and not expose themselves to cold. They are also advised to stay away from drugs that cause blood vessel constriction. Most treatment options aim at dilating the constricted blood vessels which lead to the symptoms of Raynaud’s disease. If a patient has secondary Raynaud’s disease, the treatment for the underlying condition encompasses the treatment for Raynaud’s disease. If the patient does not get relief from these, or if the symptoms are very severe, surgical intervention or some other options may be resorted to.
- Calcium Channel Blockers – These dilate blood vessels so that proper circulation to the extremities is restored. Some drugs in this category that are used are nifedipine, nicardipine and diltiazem.
- Alpha-receptor Blockers – These drugs bind to alpha-1 receptors because of which norepinephrine is unable to bind to them. This prevents the constrictive effect of norepinephrine on the blood vessels. Some drugs in this class that are used are prazosin and doxazosin.
- Nerve Excision – Nerves that supply the blood vessels of the affected body part are cut so that they cannot cause them to constrict.
- Amputation – Sometimes, gangrene develops in the part where the blood supply has been blocked. It needs to be surgically removed to prevent further spread.
- Nerve Blockage – The nerves supplying the affected body part can be temporarily blocked to prevent blood vessel constriction.
Diabetes, as is well-known, is a complex metabolic disorder. The inability of the body to utilize glucose has system-wide effects, leading to all kinds of problems, from impaired wound-healing to neuropathies. One among the many problems stemming from diabetes is poor circulation. A high level of cholesterol and glucose in the blood, as well as high blood pressure, causes the blood vessels to thicken and lose their flexibility. This leads to insufficient blood supply to various organs, especially the hands and feet. The consequences of this reduced blood supply are many, like infections, delayed and impaired wound healing, numbness and coldness, tingling and difficulty in walking. If care is not taken, sores develop on the feet, which may advance to gangrene. Adding to the problem is the fact that diabetics often are overweight and have high blood pressure. All of these put them at an increased risk of heart problems as well. Diabetics often experience pain and cramping in the legs after a long walk or exercise. This is known as claudication.
Mostly, preventive measures undertaken to deal with atherosclerosis are recommended to patients with diabetes, for improving circulation. Without these, no amount of medication is enough to prevent circulation problems.
- Quitting Smoking – Smoking has been strongly associated in a number of studies with the development of atherosclerosis. Quitting smoking is one of the most important steps that people with diabetes need to take to stop atherosclerosis.
- Exercise – Physical activity, such as a daily walk, and exercise under supervision, greatly helps with improving circulation.
- Other preventive measures include a healthy diet, not exposing the extremities to cold, and checking the feet for injuries, regularly.
Also known as Thromboangiitis obliterans, it is a disease of unknown cause, that has a strong association with smoking or chewing tobacco. This disease is characterized by inflammation of the veins and arteries of the extremities. They become inflamed and swell up, restricting blood flow to the hands and feet. Blood clots also form and further block the blood vessels. It is believed that some factors trigger the immune system to attack the blood vessels and cause inflammation. Insufficient blood supply to the limbs has the same effect on the hands and feet, as in other diseases, resulting from such a deficit – greater risk of infections, gangrene and tissue damage.
Most patients of Buerger’s disease are habitual tobacco users. Since tobacco use plays an important part in the genesis and progression of the disease, stopping smoking is the most important step in slowing the progression of the disease. Cessation of smoking improves the outcome of treatment, and slows the condition from aggravating further. Other than this, a treatment plan for Buerger’s disease involves therapies that increase blood flow to the limbs.
- Streptokinase – This is an enzyme that is used to dissolve blood clots. It has been shown to be beneficial to a certain extent in patients of Buerger’s disease.
- Synthetic Prostacyclin Analogues – Drugs belonging to this class, like iloprost, treprostinil and cicaprost, have been used with some success in dilating blood vessels in patients.
- Surgery – Surgical options include sympathectomy (cutting off the nerve supply to the blood vessels), and in case of gangrene, amputation of the gangrenous part(s).
- Some experimental therapies like the use of drugs to stimulate new blood vessels to grow are also being tried out.
There are a number of diseases that are caused due to formation of clots in the blood vessels, especially the veins. Valve defects, being on birth control pills for a long time, certain genetic conditions, injury, inflammation, certain congenital defects, some cancers, and many other factors predispose a person’s arteries or veins toward blood clot formation. These can be dangerous if not dealt with immediately.
It depends upon whether the clots are in the arteries or the veins.
- Arterial Clots – Aspirin and clopidogrel, both prevent the blood platelets from sticking to each other. This helps in preventing clot formation. Heparin and some thrombolytic agents are also used to prevent clot formation.
- Venous Clots – Heparin and warfarin, both are used to prevent clot formation in the veins.
Although some conditions in which there is a problem with blood flow are genetic in nature, most are preventable by bringing about lifestyle changes, such as following a healthy high-fiber diet, giving up smoking, and reducing consumption of alcohol.