Peripheral Vascular Disease (PVD) and Chronic Venous Insufficiency (CVI), also known as Poor Circulation! Dr. Claire Arcidiacono, ND Anyone who has ever had to stand for long periods of time knows what it feel like when you start moving around. That tired, cramping and overall …
Tag: circulatory health
Written by Dr.Claire Arcidiacono, ND
For further questions or concerns email me at [email protected]†
Last week we began our conversation on the topic of strokes or CVA and even talked about TIAs. As I said last time this will be a 3 part blog. We will be continuing with part 2 of this topic today. In this blog, we will review what actually causes a stroke? What are the risk factors you should be aware of and what are the most common complications after a stroke?†
What actually causes a stroke to occur? Well as you can most likely guess anything that affects blood flow to the brain can potentially cause a stroke to occur. In the case of hemorrhagic stroke, some causes include but are not limited to: hypertension, ruptured aneurysms, ruptured AV fistula, prior ischemic stroke and drug- induced bleeding. (1) An ischemic stroke is caused basically by blood clots or anything that blocks the flow of blood. For example in addition to blood clots blood flow can be blocked by cancer cells, fat, and even clumps of bacteria from infections such as infectious endocarditis.† (2)
Now as I’ve said anything that blocks blood flow to the brain is a risk factor for strokes. But what does this mean in terms of risk factors that we can reduce or even eliminate? What do we need to look out for? Obviously as I mentioned in my prior blog having a TIA is a huge risk factor for developing a stroke. Another one of the biggest risk factors for having a stroke is high blood pressure. (3) Unfortunately high blood pressure is very often asymptomatic. This means that you have high blood pressure but don’t know. That is why it is often referred to as a silent killer. In some cases of high blood pressure the presence of high blood pressure can be indicated by headaches, lightheartedness, vertigo or tinnitus. (4) In my clinical experience I have found it is important for anyone with these symptoms to monitor their blood pressure. Another very common risk factor for a stroke is having high cholesterol. (5) Other risk factors that can increase stroke risk include having diabetes, kidney disease, and atrial fibrillation as well as being obese. Tobacco use can also increase stroke risk. (6) Having a brain aneurysm can increase the risk of a hemorrhagic stroke. (7) Having atherosclerosis is another huge risk factor for having a stroke. (8) Using stimulants such as cocaine increase stroke risk greatly. (9) Alterations in blood vessels that can increase stroke risk include, cerebral amyloid angiopathy, cerebral arteriovenous malformations and intracranial aneurysm.(10) Head trauma can also increase the risk of a stoke by either weakening the blood vessels so that they rupture or by disrupting blood clotting in the brain. (11) Having chronic or long term inflammation has also been found to increase stroke risk. Certain chronic conditions such as Lupus, Rheumatoid arthritis, and sickle cell anemia can also increase the risk of strokes. Having a history of COVID -19 may also increase the risk of a stroke however, more research is needed on this topic.† (12)
There are certain risk factors that increase risk of stroke especially in women. I would like to take a few minutes to review these particular risk factors. One very common risk factor for women is the use of oral contraception pills. These pills have been found to increase the risk of blood clots and thus can increase the risk of a stroke. Pre-eclampsia which is high blood pressure during pregnancy can also increase the risk of a stroke.†(13)
Lastly if you have a family history of strokes or TIA you are more likely to have a stroke. Race also appears to affect the risk of stroke. For those of African American, Alaska Native, American Indian and Hispanic descent there is a higher risk than in those of a causation descent.† (12)
What are the most common complications after a stroke?
The complications of a stroke can be physical, mental and/or emotional. In 75% of stroke survivors the physical disability is bad enough to decrease a person ability to work. (14) In some individuals this can also impact their ability to carry out activities of daily living. In up to 10% of individuals there is an increased risk of developing seizures. (15) Urinary incontinence occurs in approximately 15% of stroke survivors. (16) Sexual dysfunction occurs in up to 50% of people after a stroke. (17) Other physical changes can include but are not limited to muscle weakness, numbness, pressure sores, apraxia, as well as decreased appetite, vision and speech loss.† (18)
There may be anxiety, panic attacks, flat affect as well as mania, apathy and psychosis after a stroke. (19) There may also be changes in your ability to communicate. In up to 50% of stroke survivors there is depression. (20) In up to 20% of survivors there is emotional lability. (21) Cognitive changes after a stroke include perceptual disorders, aphasia, dementia, reduced attention span and decrease in memory. (22)Lastly there may be hemi spatial neglect, where a person is unable to process and perceive any stimulus on the opposite side that the stroke occurred on.†(23)
In our next blog we will review signs and symptoms of a stroke. We will also cover ways to help mitigate risk factors and how to help aid in the healing process after a stroke has occurred.†
Smith WS, English JD, Johnston SC (2012). “Chapter 370: Cerebrovascular Diseases”. In Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J (eds.). Harrison’s principles of internal medicine (18th ed.). New York: McGraw-Hill. pp. 3270–3299. ISBN 978-0-07-174889-6.
- Kumar V (2009). Robbins and Cotran Pathologic Basis of Disease, Professional Edition (8th ed.). Philadelphia: Elsevier. ISBN 978-1-4377-0792-2.
- Strandgaard S (October 1996). “Hypertension and stroke”. Journal of Hypertension Supplement. 14 (3): S23-7. doi:1097/00004872-199610003-00005. PMID 9120662. S2CID 11817729.
- Fisher ND, Williams GH (2005). “Hypertensive vascular disease”. In Kasper DL, Braunwald E, Fauci AS, et al. (eds.). Harrison’s Principles of Internal Medicine (16th ed.). New York: McGraw-Hill. pp. 1463–1481. ISBN 978-0-07-139140-5.
- “Cholesterol, diastolic blood pressure, and stroke: 13,000 strokes in 450,000 people in 45 prospective cohorts. Prospective studies collaboration”. Lancet. 346 (8991–8992): 1647–53. 1995. doi:1016/S0140-6736(95)92836-7. PMID 8551820. S2CID 12043767.
- “Who Is at Risk for a Stroke?”. www.nhlbi.nih.gov. March 26, 2014. Archived from the original on 27 February 2015. Retrieved 27 February 2015.
- “Types of Stroke”. www.nhlbi.nih.gov. March 26, 2014. Archived from the original on 19 March 2015. Retrieved 27 February 2015.
- Adams HP, Bendixen BH, Kappelle LJ, Biller J, Love BB, Gordon DL, Marsh EE (January 1993). “Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment”. Stroke. 24 (1): 35–41. doi:1161/01.STR.24.1.35. PMID 7678184.
- Osterweil N (26 December 2006). “Methamphetamine May Trigger Ischemic Stroke”. Medpage Today.
- “Articles”. Cedars-Sinai. Archived from the original on 2020-05-30. Retrieved 2022-04-26.
- Coffey CE, Cummings JL, Starkstein S, Robinson R (2000). Stroke – the American Psychiatric Press Textbook of Geriatric Neuropsychiatry (Second ed.). Washington DC: American Psychiatric Press. pp. 601–17. ISBN 9780880488419.
- Reith J, Jørgensen HS, Nakayama H, Raaschou HO, Olsen TS (August 1997). “Seizures in acute stroke: predictors and prognostic significance. The Copenhagen Stroke Study”. Stroke. 28 (8): 1585–9. doi:1161/01.STR.28.8.1585. PMID 9259753.
- Thomas LH, Coupe J, Cross LD, Tan AL, Watkins CL (February 2019). “Interventions for treating urinary incontinence after stroke in adults”. The Cochrane Database of Systematic Reviews. 2019 (2): CD004462. doi:1002/14651858.CD0
- Stratton H, Sansom J, Brown-Major A, Anderson P, Ng L (May 2020). “Interventions for sexual dysfunction following stroke”. The Cochrane Database of Systematic Reviews. 2020 (5): CD011189. doi:1002/14651858.CD011189.pub2. PMC 7197697. PMID 32356377.
- Burn J, Dennis M, Bamford J, Sandercock P, Wade D, Warlow C (December 1997). “Epileptic seizures after a first stroke: the Oxfordshire Community Stroke Project”. BMJ. 315 (7122): 1582–7. doi:1136/bmj.315.7122.1582. PMC 2127973. PMID 9437276.
- an KM (2014). “Disorders of emotional communication after stroke”. In Schweizer TA, Macdonald RL (eds.). The behavioral consequences of stroke. New York [u.a.]: Springer. pp. 119–33. doi:1007/978-1-4614-7672-6_7. ISBN978-1-4614-7671-9.
- Senelick RC, Rossi PW, Dougherty K (1994). Living with Stroke: A Guide for Families. Contemporary Books, Chicago. ISBN 978-0-8092-2607-8. OCLC 40856888.
- Coffey CE, Cummings JL, Starkstein S, Robinson R (2000). Stroke – the American Psychiatric Press Textbook of Geriatric Neuropsychiatry (Second ed.). Washington DC: American Psychiatric Press. pp. 601–17. ISBN 9780880488419.
- Kuźma E, Lourida I, Moore SF, Levine DA, Ukoumunne OC, Llewellyn DJ (November 2018). “Stroke and dementia risk: A systematic review and meta-analysis”. Alzheimer’s & Dementia. 14 (11): 1416–1426. doi:1016/j.jalz.2018.06.3061. PMC 6231970. PMID 30177276.
- Murray ED, Buttner N, Price BH (2012). “Depression and Psychosis in Neurological Practice”. In Bradley WG, Daroff RB, Fenichel GM, Jankovic J (eds.). Bradley’s neurology in clinical practice. Vol. 1 (6th ed.). Philadelphia: Elsevier/Saunders. pp. 100–01. ISBN 978-1-4377-0434-1.
Subscribe Today! Please see below for a complete transcript of this episode. THE UNDERSTIMATED BENEFITS OF CRANBERRY, INVITE HEALTH PODCAST, EPISODE 652 Hosted by Jerry Hickey, PH *Intro Music* InViteⓇ Health Podcast Intro: [00:00:04] Welcome to the InViteⓇ Health Podcast, where our degreed health …
Please see below for a complete transcript of this episode.
CIRCULATION SOLUTIONS & TIPS FOR HEALTHY VESSELS, INVITE HEALTH PODCAST, EPISODE 646
Hosted by Amanda Williams, MD, MPH
InViteⓇ Health Podcast Intro: [00:00:04] Welcome to the InViteⓇ Health Podcast, where our degreed health care professionals are excited to offer you the most important health and wellness information you need to make informed choices about your health. You can learn more about the products discussed in each of these episodes and all that Invite Health has to offer at, invitehealth.com/podcast. First time customers can use promo code podcast at checkout for an additional 15% off your first purchase. Let’s get started. † [00:00:34]
Amanda Williams MD, MPH: [00:00:41] Having good circulation is key to aging gracefully. We know that there are many things that can disrupt our healthy circulatory system and create problems for us. Not just having problems such as blood pressure regulation. But when you look at the effects that this can have on cerebral circulation. So, the blood that travels to the brain as well as looking at particular conditions that are quite prevalent especially here in the United States. I’m Dr. Amanda Williams, scientific director at Invite Health. And today I want to talk about those factors because I have many individuals who come to me who complain about aching legs, maybe your legs feel heavy, maybe when you’re walking, you feel like the legs themselves get tired out very fast. Or you feel like there’s muscle cramping that occurs. This may be something that’s more problematic than you actually realize. We know that conditions such as chronic venous insufficiency, as well as peripheral artery disease, are very prevalent here in the United States. When you look at the statistics on both of these conditions, it is actually quite high, the number of people who are dealing with these different problems, peripheral artery disease, we recognize, affects close to 20% of the U.S. population. Now, this usually goes hand in hand with coronary artery disease and cerebrovascular issues as well. So, once we have one area of circulation that is giving us a problem, this is going to affect all areas, which is why when people have high blood pressure, for example, it starts to affect kidney health and the circulation that feeds into the kidneys, which is why blood pressure regulation is so critical. We can also look at problems which we refer to as intermittent claudication and having claudication, this is when you have those pains in the legs as you are walking or any type of movement in general brings about excessive pain. Some people can actually recognize this in the form of swelling. This is more geared towards chronic venous insufficiency. When you get a lot of the swelling and the edema that’s associated with this. Chronic venous insufficiency is a little bit different than peripheral artery disease; one is. dealing with arteries, the other is dealing with veins. But the both of them, at the end of the day, it comes down to lack of proper circulation, usually brought on because of ejection fraction decreasing. So, the way that the heart itself is pumping and forcing the blood and the oxygen out to the tissues. So, when we look at conditions such as chronic venous insufficiency, as well as peripheral artery disease. We always have to go to the primary source, which is going to be the heart itself. † [00:03:35]
[00:03:38] The reason I bring this up is because, as I mentioned, many individuals come to me and say that they experience these types of problems, chronic venous insufficiency. It is also a very prevalent issue and condition in this country. And we have to recognize that common treatments that most people will seek out from their primary doctor oftentimes doesn’t lead to too much symptomatic relief. It certainly puts you at a greater risk of having a potential side effect to the medications that they are prescribing. But we do want to always say, well, what’s the underlying root cause and how do we make improvements on this? As I mentioned, intermittent claudication, this is usually the most common reason as to why people present to their doctor’s office. When you have what appears to be muscle pain when you’re active. And then you sit down and then it starts to resolve itself. This is known as the intermittent claudication. This is commonly associated, as I mentioned, with peripheral artery disease. Now, when you have the pooling of blood and fluids in the lower extremities down near the ankle, this is going to be more associated with chronic venous insufficiencies. So, we’re getting kind of a pooling out or a leakage out of the vascular system, and we get that fluid that’s building up. In either case as I mentioned, we’re dealing with a breakdown of the integrity of the lining of those vessels or arteries. And we’re also having to always draw this back to why is it that the heart itself is struggling to get proper flow out to those extremities? So, when you’re dealing with this, we always want to make sure if you have high blood pressure, that the blood pressure itself is well regulated. You want to make sure that you were doing the right things in terms of your dietary intake of good, healthy antioxidants. Having foods that are high in omega threes to help lower inflammation around those vessels and arteries, this will certainly help. And then we can look at different nutrients. † [00:05:50]
[00:05:51] We have many different varieties of products that are available that have been shown in clinical research trials to be incredibly beneficial when it comes to enhancing circulatory function. We can look at the Veins Hx formulation just as being one of those products that we offer, and we have such success with this particular formulation. And this is a herbal blended formulation. So, it has different nutrients in it that have been clinically studied and shown to be very effective in the repair mechanism of the vascular system. So, it has horse chestnut extract, there is citrus bile flavonoids in this, Vitamin C, because we know that’s very important for the collagen that lines those vessels. It has gotu kola extract, there’s horsetail extract along with Bilberry Extract. So, the powerful anthocyanins that come along with those fruit extracts are all contained in the Veins Hx. So, it really helps to support proper blood flow and overall circulatory function. I have found great success utilizing this product in folks who are dealing with chronic venous insufficiency, folks who are dealing with hemorrhoids. Even if you have an acute injury, say, for example you sprain your ankle, this is a really great way to help that healing process along and we can look at the scientific research on how it is that horse chestnut, for example, has been studied in the setting of chronic venous insufficiency. Over ten years ago they published a really interesting find on a meta-analysis of looking at multiple clinical research trials that showed the efficacy as well as the safety, most importantly, the safety, because we know that the prescribed medications come with side effects. † [00:07:49]
[00:07:50] So we always want to look at if we’re using these different herbal extracts. Number one, is it going to work? Number two, is it safe? And yes, this is what this study zeroed in on, is looking at these randomized controlled trials and showing the effectiveness of horse chestnut as well as the safety of the use of horse chestnut when it comes to chronic venous insufficiency with improvement not only on the circulatory function itself, but with leg pain that is associated with chronic venous insufficiency and clearly with peripheral artery disease. That’s where that intermittent claudication comes back into play. So, for folks who are dealing with either one of those conditions, whether it be chronic venous insufficiency, or peripheral artery disease, The Veins Hx is an excellent choice because we know just through all of the clinical research done on this, that the overall improvement is quite astonishing, and that horse chestnut is considered to be a highly effective way for the treatment of chronic venous insufficiency. We can see how it’s been studied in other countries and actually utilized in other countries as a treatment modality for these different circulatory conditions. So that’s one example of a formulation that can definitely be turned to for those who are dealing with any type of circulatory problem. We can look right at those proanthocyanins coming from grape seed extract, coming from resveratrol, so if circulatory issues are a concern for you, this would always be advantageous to add in something like the Resveratrol Hx or the Resveratrol Max, which is going to not only give you the trans-resveratrol. But also, the grape seed extract in both of those formulations. You can do grape seed extract just by itself, this is another option that you can certainly do. Looking at other reasons why someone may be dealing with these circulatory issues, we can always go back to, ‘Are we getting enough magnesium?’ We know that magnesium is so important for the way in which our blood vessels can relax, and we have to have good relaxation of those vessels in order to have adequate blood flow and oxygenation through those vessels and arteries. So hence, if we are not supplementing with magnesium on a daily basis and we know that our diets are oftentimes incredibly lacking in adequate magnesium exposure. It would be highly advisable to make sure that you are including in magnesium to your daily supplementation routine. † [00:10:40]
[00:10:41] We have another formulation called Circusupport. This is another flavonoid, herbal supplement blend that really zeroes in once again on supporting the integrity of the vascular system. And this is a wonderful blend of Butcher’s Broom extract, has dioscimin extract, there’s hesperidin in this. All of which have been studied in the setting of chronic venous insufficiency in the setting of peripheral artery disease. Dioscimin in particular has been studied quite extensively when it comes to varicose veins and spider veins. So, we can look at formulations such as Circusupport, we can look at the formulation such as the Veins Hx, and recognize that these different products would be incredibly beneficial for those who are really looking to step up their circulatory support game. Now, when it comes to which product would be most supportive to your specific needs, this is one you would want to speak with one of our nutritionists and zero in on your particular issues. You know, are you finding that you have a lot of those muscle aches? Are you finding that you end up with swelling in the lower legs at the end of the day? Do you wake up in the middle of the night because you have muscle cramps? You know, these are the things that we need to know because it may modify what we advise you to take and when to take those nutrients. And keep in mind, too, something like restless leg syndrome, we always have to look at underlying issue with low iron status in the body. So, it may be advantageous to even include in the iron plus formulation to address those concerns. But when it comes to our circulation this is something that we definitely don’t want to overlook. We want to make sure that we maintain good cardiac as well as cerebral circulation, because we want to be able to age gracefully. And believe it or not, the way that your blood is moving about your body is incredibly important to that. And to have success with that, we want to make sure that we have those right nutrients on board. There are certainly many more formulations within our product line that can zero in on this. But it was a topic that I wanted to discuss because it’s been something that’s come up quite often in the past couple of weeks where I’ve had people ask me about this. So, I thought I would zero in on the Veins Hx, the Circusupport as well as that grape seed extract. So, I want to thank you so much for tuning in to the InViteⓇ Health Podcast. Remember, you can find all of our episodes for free wherever you listen to podcasts or by visiting, invitehealth.com/ podcast. Do make sure that you subscribe, you leave us a review. You can follow us on Facebook, Twitter, and Instagram at Invite Health and we will see you next time for another episode of the InViteⓇ Health Podcast. † [00:10:41]