Going With the Flow: Risk Factors and Treatment Options for Vascular Disease

In 1990, 39 percent of the all Americans lived to see the age of 65. Ten years later, that number more than doubled to 86 percent.

Americans are certainly living longer, and while this is regarded largely as the positive result of medical and scientific advancements, there is also a darker consequence to our ever-expanding life spans.

Most people who have vascular disease don't even know it.

"People are living much longer and they are living robust lives in their later years," said Dr. Craig Kent, the Greenberg-Starr Professor at Weill Cornell Medical College and chief of vascular surgery at NewYork-Presbyterian Hospital. "A result of that is a better chance of vascular disease."

Dr. Kent, along with Dr. Ageliki Vouyouka, an assistant professor of surgery at Weill Cornell and assistant attending vascular surgeon at NewYork-Presbyterian/Weill Cornell, discussed vascular disease in depth during their recent lecture "Going With the Flow: Risk Factors and Treatment Options for Vascular Disease," at Uris Auditorium. The lecture was part of the Medical College's spring Health and Wellness Seminar Series.

The damage caused by vascular disease can vary. The plaque that develops in arteries can lead to poor leg circulation, resulting in functional disability, and to another extreme, possible amputation of a limb.

Aneurysm and stroke are other, more deadly, possibilities. An aneurysm occurs when an artery becomes dilated and ruptures. It is a very common cause of death, accounting for about 30,000 fatalities a year, which is comparable to the annual death tolls of prostate and breast cancer.

Despite this, vascular disease remains an underdiagnosed disease. Most people who have it, Dr. Kent said, don't even know it.

Individuals over the age of 65 who smoke, have heart disease or a family history of vascular disease should be regularly screened.

This is especially true of women, Dr. Vouyouka said. Women, on average, live longer than men, and lacking estrogen in the postmenopausal phases of their lives, leave them more susceptible to developing vascular disease. And although the reasons aren't fully known — perhaps because women are underrepresented in most large vascular clinical trials — doctors have observed that arterial disease behaves differently in women.

What is known is that carotid surgery and stenting are effective treatments for vascular surgery. Also, individuals over the age of 65 who smoke, have heart disease or a family history of vascular disease should be regularly screened.

"Sometimes vascular disease doesn't give symptoms," Dr. Vouyouka said. "Most of the time you do a CAT scan for something else and you find an aneurysm. If patients with aortic aneurysms do develop symptoms, it might be too late."

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