Blood Vessels

• Macrovascular disease refers to changes in the medium to large-size blood vessels. The blood vessel walls thicken and become hard and non-elastic (arteriosclerosis). Blood vessels also become clogged with mounds of plaque (atherosclerosis). Eventually, the flow of blood may be blocked. Three types of this disease are:

• Peripheral vascular disease refers to diseased blood vessels that supply the legs and feet. If blood flow is only partially interrupted, cramps, weakness, "charley horse," or pain in the legs when walking (claudication) may result. A completely blocked artery will cause severe pain and the leg will become cold and pale. Treatments include replacing the diseased artery surgically or opening the blood vessel by compressing plaque against the artery wall (angioplasty).

• Coronary artery disease refers to diseased heart arteries. Cramping and angina may occur when blood flow is decreased. Complete blockage of an artery results in myocardial infarction (heart attack). Symptoms of angina and heart attack include chest pressure, cramping, heavy feeling in the chest, shortness of breath, and extreme fatigue. Treatments include coronary bypass surgery and angioplasty.

• Cerebral vascular disease refers to diseased arteries in the brain. Partial blockage may result in temporary reductions of blood supply to a part of the brain (transient ischemic attacks). A complete loss of blood supply to an area of the brain due to clogging or breaking of a blood vessel results in a cerebral vascular accident (stroke). Symptoms include lightheadedness, dizziness, loss of ability to speak, slurred speech, confusion, and inappropriate behavior.

If you experience symptoms of any form of macrovascular disease, go to a hospital emergency room at once.

To minimize the risk of macrovascular disease:

• Keep your blood sugar level in good control.

• Maintain normal blood pressure. If you take medication for high blood pressure, don't forget it.

• If overweight, try to reduce your weight.

• Reduce fats and cholesterol in your diet.

• Exercise in moderation, after consulting with your doctor or diabetes educator.

• See your doctor regularly.

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