Crestor is an original drug for the treatment of hypercholesterinemia . The drug is manufactured by Astra Zeneca in the UK. The drug is made in multiple dosages – 5, 10, 20, 40 mg. The most commonly prescribed tablets are Crestor 10 mg and Crestor 20 mg. The drug as the active substance contains Rosuvastatin . The drug according to the classification of statins belongs to the third generation of drugs and has a synthetic origin buy crestor online.  

•    Drug properties
•    When do doctors prescribe a drug?
•    High Cholesterol Nutrition Rules
•    Statin rules
•    In what cases the drug is prohibited to use?
•    Use during pregnancy and lactation
•    Unwanted reactions
•    Analogs of Krestor

Drug properties

Rosuvastatin , which is part of the Crestor Tablets , exhibits a number of pharmacological properties characteristic of most statins :

1. Lowers total cholesterol.
2. Reduces trigiceridov level.
3. It lowers low-density lipoprotein cholesterol.
4. Increases high density lipoprotein content.
5. Increases the level of apoliprotein A-1.

The change of indicators occurs on the seventh day of the use of the Crestor tablets . After three weeks of therapy with Crestor, the effect reaches a maximum.

When do doctors prescribe a drug?

The indications for prescribing Crestor are the following diseases and conditions:

•    with atherosclerosis to slow the progression of the disease;
•    increased cholesterol mixed origin with the ineffectiveness of diet and other methods;
•    genetically determined hypercholesterinemia;
•    primary type of increasing cholesterol.

High Cholesterol Nutrition Rules

Before using Crestor , as a rule, prescribe a hypocosterine diet. The diet requires compliance with some measures:

•    To exclude or sharply limit fatty foods – butter, lard, fatty meats and fish, chicken eggs (up to three pieces per week), smoked meats, canned food, “fast food”.

•    Low-fat dairy products such as cottage cheese, kefir, yogurts, milk, whey, white chicken meat, rabbit meat, turkey, veal, low-fat beef are shown as protein foods.
•    Dietary food should be cooked by boiling, stewing or baking. The cooking method should exclude frying, smoking, cooking on the grill. When cooking, avoid using oils and fats.
•    The diet should contain a large amount of vegetables and fruits, which should be consumed every day fresh or boiled – juices, salads, stews, casseroles, steam cakes, souffles, jellies and so on. Vegetables and fruits contain a large amount of fiber, which helps to remove excess fat from the body.
•    Calorie intake with high cholesterol should not exceed 2,700 calories per day.
•    You should also follow the drinking regime. Nutritionists recommend a day to drink up to two liters of water, in the absence of contraindications (renal dysfunction, hypertension, and others).

In addition to compliance with food recommendations during the treatment with the drug Crestor, it is necessary to give up alcohol and smoking. Because bad habits also affect cholesterol levels.

Statin rules

A drug prescribed by a doctor can be taken at any time of the day without associating it with a meal. Instructions for use Crestor contains information with the recommendation to take the pill whole, without chewing, with a small amount of water. The dose of the drug is chosen gradually, starting with the drug Crestor 5 mg. Then the dosage may be increased to 10, 20 or 40 mg. Is it possible to divide a Crestor tablet in half, if the prescribed dose does not correspond to the amount of the active substance in one tablet? Since the dosage form is film coated and has no risks, dividing the tablet is not desirable. Take Crestor should be entirely.

After the initial appointment of Crestor, after about three to four weeks, it is necessary to monitor the response to statin therapy .

If the effect of treatment is insufficient, the dosage is increased to 10 mg per day. At the same time it is necessary to control the work of the liver and kidneys. If the functions of these vital organs are impaired, the metabolism and elimination of Rosuvastatin may be disturbed , as a result of which the concentration of the drug will differ significantly from the expected one.

In what cases the drug is prohibited to use?

Instructions for use of the drug contains warnings regarding diseases in which Crestor can not be prescribed:

For tablets containing Rosuvastatin 5, 10, and 20 mg, contraindications are:

•    intolerance to Rosuvastatin or an auxiliary component contained in the dosage form (tablet);
•    acute liver disease;
•    an increase in the level of liver enzymes of unknown origin by no less than three times;
•    predisposition to myotoxic lesions;
•    children and adolescents under the age of 18;
•    the period of carrying a child and breastfeeding;

•    women of childbearing age who do not use reliable methods of protection from conceiving a child;
•    some disorders of carbohydrate metabolism;
•    period of therapy with cyclosporine .

For tablets containing Rosugastatin 40 mg in the composition:

•    intolerance to the active or auxiliary substances contained in the dosage form;
•    children and teenagers under the age of 18;
•    acute liver disease;
•    of unclear genesis an increase in hepatic enzymes by more than three times;
•    alcohol abuse;
•    the presence of diseases of the muscular system in the patient himself or his immediate family;
•    the period of carrying the child and breastfeeding;
•    women of reproductive age, sexually active without using reliable methods of contraception;
•    some metabolic disorders;
•    the period of treatment with cyclosporine ;
•    moderate renal failure;
•    thyroid diseases – hypothyroidism;
•    the use of drugs belonging to the group of fibrates ;
•    belonging to the Mongoloid race.

Use during pregnancy and lactation

Crestor , regardless of its dosage, is contraindicated for women carrying a child. Drugs containing Rosuvastatin are contraindicated in pregnancy because cholesterol is important for the normal development of the fetus. In this regard, it is believed that the effect of the drug on cholesterol levels in a pregnant woman adversely affects the development of the fetus. During lactation it is also contraindicated to drink drugs containing rozuvastatin . This is due to the lack of data on the ability of a substance to be excreted in breast milk.

If the pregnancy has occurred while being treated with a statin , you must stop taking Crestor . For women who are planning a pregnancy in the near future, Rosuvastatin therapyis not used. A woman taking a drug containing Rosuvastatin , doctors recommend the use of reliable methods of protection from pregnancy. This is extremely important because it can lead to an undesirable outcome of pregnancy or harm to the health of the future baby. Unfortunately, today there are no statins allowed for use during pregnancy.

Unwanted reactions

Crestor appointed from high cholesterol is taken by long courses. Sometimes, the drug is prescribed for life. With an incorrectly selected dose or non-compliance with the recommendations of the doctor, the possible development of adverse reactions:

•    headache, irritability, dizziness, weakness;

•    dyspeptic disorders such as diarrhea, nausea, heartburn, flatulence;
•    muscle aches, rhabdomyolysis , myopathic processes;
•    non-insulin-dependent diabetes mellitus;
•    the appearance of protein and blood in urine analysis;
•    immune reactions in the form of allergies, which can manifest as a skin rash with itching, hives, swelling of tissues and larynx, anaphylactic processes;
•    a significant increase in laboratory parameters of liver enzymes;
•    joint pain;
•    memory impairment;
•    polyneuropathy .

As a rule, adverse reactions are dose-dependent , and after adjustment of therapy they pass on their own. The exceptions are allergic reactions and the development of myopathy, which require urgent discontinuation of the drug. Therefore, before the appointment of Crestor, the doctor should warn the patient about the need to stop taking the drug and urgently seek medical help in case of signs of allergy and myopathy.

Analogs of Krestor

All medicines that have the international non-proprietary name (INN) – Rosuvastatin are substitutes for the drug . Differences in these drugs can only be in the content of excipients. Analogues of the drug Crestor are such drugs as Rosuvastatin SZ, Rosukard , Rosart , Roxera , Rosuvastatin-Vial , Rosufast , Ro-statin and other drugs. What is better to choose? Which drug to choose? Analogs of Krestor are produced by different countries-producers, have different costs, and also – may differ by packaging of dosage forms, that is, contain different number of tablets in a package.

Crestor is an original drug, and all its analogues are reproduced copies, or generics.

According to some people who took Rosuvastatin for a long time , Crestor, in comparison with its analogues, is less likely to cause adverse reactions. In addition, the drug is well tolerated, it shows fairly quick results. As a rule, even the smallest dosage means effectively reduce cholesterol levels and allow you to maintain it at the desired level. What is the reason? After all, the active substance in the tablets of Crestor and its analogues is absolutely identical, and the bioavailability of the drugs, apparently, is different. Most likely the fact is that tablets from different manufacturers have a different composition of excipients. Despite the fact that excipients are considered to be indifferent , that is, unable to influence the “behavior” of the drug in the body, they, nevertheless, affect the rate of absorption of the drug, its distribution and excretion.

The use of drugs related to statins , alone is extremely contraindicated. Because, only a specialist with the help of special tests will establish the initial cholesterol level and correctly select the “starting” dose of the drug. In addition, the doctor will take into account all associated diseases of the patient and assess the risk of adverse reactions. Statinscan interact with a large number of drugs belonging to other pharmacological groups. When appointing Crestor, be sure to inform the doctor about all medications taken. This measure is necessary in order to avoid dangerous drug interactions that can lead to serious health problems.

Why is daily exercise and massage necessary for atherosclerotic vascular lesions on the legs?

Physical therapy, massage and self-massage are an important part of the integrated treatment of almost all diseases. However, there are such pathologies, for example, vascular atherosclerosis, where these types of auxiliary functional therapy come to the fore and become almost the main ways to combat the disease. Exercises in atherosclerosis of the lower extremities are the same methods of pathogenetic therapy as other types of treatment prescribed by the attending physician. And for their proper conduct, consultations with a medical physical culture physician and a massage therapist can be scheduled.

Why do we need exercise therapy for atherosclerosis and to whom such treatment is contraindicated? Types of massage for atherosclerotic vascular lesions on the legs. The ideal complex for people with the initial stage of atherosclerosis of the lower extremities.

The risk of developing atherosclerosis of the lower extremities, including obliterating atherosclerosis and endarteritis, is especially great for people who “work sitting”, violating the principles of healthy eating, abusing smoking and not paying due attention to diverse physical exertion during their free time. Such a lifestyle, sooner or later, will surely end with atherosclerotic or other changes in the structure of the vascular walls of arteries and veins in the legs.

If the rate of cholesterol in men after 30 years, and in women after 40, is exceeded, and the figures went abroad to 6.55 mmol / l, urgent treatment should be started: quit smoking, go on an anti-cholesterol diet, daily exercise complex, sign up for massage therapist and conduct self-massage of the feet. Only in this way can further development of pathologies be avoided, which can lead to amputation of extremities or death.

Why do we need exercise therapy for atherosclerosis and to whom such treatment is contraindicated?

Gymnastics with atherosclerosis is one of the most effective ways to lower cholesterol in the blood, significantly improve metabolic processes and peripheral circulation in the lower limbs. It helps to restore vascular reactions, increase physical endurance of the muscles, as well as, and very importantly, develop collaterals that will promote full circulation.

In drawing up the individual complex exercise therapy, the following parameters should be considered:

• Exercises should begin with the work of large muscles of the legs, and end with small ones;
• each subsequent exercise must begin from a different starting position – standing-sitting on a floor-standing-lying-standing-sitting-sitting on a chair-lying-standing, and so on;
• Exercises with long-term static muscles of the lower limbs are prohibited.
• Be sure to include exercises for the gluteus muscle group;
• increase the load – the number of incoming exercises and their repetitions, you need to gradually;
• in the event of pain in the legs, the complex of exercise therapy should be reviewed and its components reduced.

In the selection of exercises for complex exercise therapy in atherosclerosis of the vessels of the lower extremities, it is necessary to take into account the general state of health, as well as the presence of lesions of blood vessels of other organs. For example, in atherosclerosis of the cerebral arteries, sharp turns and tilts of the head, as well as quick and sharp tilts of the body, are prohibited.

However, it is forbidden to perform leg exercises for patients with acute vascular thrombosis, migrating thrombophlebitis and gangrene.However, for such diseases there are their own special exercise therapy complexes, which consist of breathing exercises and exercises aimed at maintaining the muscle tone of the body, shoulder girdle and neck.

In moderate to severe forms of atherosclerosis of the lower extremities, meditative practices in static positions and swimming in cool water are strictly prohibited.

Types of massage for atherosclerotic vascular lesions on the legs

Most people suffering from atherosclerosis of the blood vessels in their legs do not perceive massage as a way to treat this pathology.And in vain. Massage in atherosclerosis of the lower extremities has a huge positive effect on the circulatory and lymphatic systems:

 expands the capillary network in the area of ​​the massaged part of the body;

 improves lymph and blood supply in areas adjacent to massaged;

 accelerates venous and lymphatic outflow, excretion and elimination of nitrogenous wastes;

increases the motor-tonic function of the vessels.

In case of atherosclerosis of the lower extremities, the complex of general therapeutic massage necessarily includes a reflex massage of the segments of the lower back and the sacrum, a syncardial massage and study of points on the feet.

Do not ignore self-massage techniques, which should be performed according to the following scheme:

optimal position – sitting on a chair, substituting a stand under the foot so that the angle between the thigh and shin is about 145 degrees;

the sequence of study areas – thigh, toes, foot, lower leg;

a sequence of massage techniques – stroking, rubbing, kneading, tapping, shaking;

massage movements are performed at a slow or average pace, simultaneously or alternately with both hands;

the direction of movements during the massage of the thigh – from the knee to the inguinal lymph nodes, while massaging the lower leg – from the ankle to the knee;

It is forbidden to massage the popliteal area and strongly press on the upper third of the inner surface of the thigh;

 at the end of the massage, you should perform movements with the toes, circular movements in the ankle joints and flexion-extension in the knees.

All types of massage are shown only at the early and middle stages of atherosclerosis. Massage procedures on the lower limbs are prohibited in violation of the integrity of the skin, acute vascular inflammation, severe atherosclerosis with trophic disorders, thrombophlebitis, thrombosis, angiitis , severe endarteritis obliterans, gangrene.

Medical fact. An experienced massage therapist, with the help of a massage course, can cause changes in the patient’s blood composition – to increase the level of red blood cells and hemoglobin.

The ideal complex for people with the initial stage of atherosclerosis of the lower extremities

With elevated cholesterol, which affects the blood vessels of the legs, it is enough to comply with the daily complex, approved by specialists of physical therapy and received positive feedback from patients. It consists of the following activities:

 1 – In the morning after sleep – 15-minute light gymnastic exercises with an emphasis on exercises for the lower extremities – squats, lunges, swinging, light jumping, and 3-5 minutes running on the spot.

2 – After taking a morning shower – self-massage of the legs.

3 – If possible, do not use the elevator, but walk the stairs, not only up but also down.

4 – At work – every 40-50 minutes to do physical exercises — minute pauses, during which, for example, stand up and sit down several times in a row, do deep squats, perform rotational movements in the ankle joints and alternate pulling of the knee to the chest while sitting or standing.

5 – At lunchtime before eating – if conditions do not allow to perform at least a small set of physical exercises for the legs, then you must take a walking 15-20 minute walk.

6 – Before dinner – perform an individual complex exercise therapy for muscles and joints of the legs.

7 – After dinner – walk for at least 45-60 minutes. While walking, you should change the pace. You can stop if there is severe pain in the legs.

8 – After the evening shower before bedtime – self-massage of the reflex zones of the feet.

Walking at a fast pace and without stopping best of all contribute to weight loss and stable normalization of body weight. But it is worth remembering that the active, irreversible burning of excess fat reserves begins after the 40th minute of continuous foot load.

Research has proven that walking after the 60th minute does not bring such an effect, and the grams dropped at this time quickly return.

And in conclusion, it should be added that any massage and gymnastic exercises will not bring the desired therapeutic effect if you continue to smoke and do not comply with the anti-cholesterol diet.

Atherosclerosis of the leg vessels: occurrence, treatment, prognosis

Atherosclerosis of the vessels of the lower extremities is one of the most serious and dangerous diseases of the leg arteries. It is characterized by the fact that due to the blockage of blood vessels by atherosclerotic plaques or blood clots, there is a partial or complete cessation of blood flow in the lower extremities.

In atherosclerosis, a narrowing (stenosis) or complete overlap (occlusion) of the lumen of the vessels that deliver blood to the lower extremities occurs, which prevents normal blood flow to the tissues. When stenosis of the arteries is more than 70%, the speed indicators and the nature of the blood flow change significantly, insufficient blood supply of cells and tissues with oxygen and nutrients occurs, and they cease to function normally.

The defeat of the arteries leads to pain in the legs. In case of progression of the disease, as well as in case of insufficient or improper treatment, trophic ulcers or even necrosis of the extremities (gangrene) may appear. Fortunately, this happens quite rarely.

Atherosclerosis obliterans of the lower limb arteries is a very common disease of the blood vessels of the legs. The largest number of cases is detected in the age group over 60 years old – 5–7%, at the age of 50–60 years – 2-3%, 40–50 years – 1%. But atherosclerosis can also be diagnosed in younger people – in 0.3% of them, people between the ages of 30 and 40 fall ill. It is noteworthy that men suffer from atherosclerosis 8 times more often than women.

Fact: Smokers of men over 50 years of age are at the greatest risk of getting obliterating atherosclerosis.

The main causes of atherosclerosis

The main cause of atherosclerosis is smoking. The nicotine contained in tobacco causes the arteries to spasm , thereby preventing blood from moving through the vessels and increasing the risk of blood clots in them.

Additional factors provoking atherosclerosis of the arteries of the lower extremities and leading to an earlier occurrence and severe course of the disease:

• elevated cholesterol levels with frequent use of foods rich in animal fats;
• high blood pressure;
• excess weight;
• genetic predisposition;
• diabetes;
• lack of sufficient physical activity;
• frequent stress.

Symptoms of atherosclerosis of the leg vessels

The main symptom to be paid attention to is pain in the legs. Most often, pain occurs when walking in the calf muscles and thigh muscles. When moving the muscles of the lower extremities increases the need for arterial blood, which delivers oxygen to the tissues. During physical activity, the narrowed arteries cannot fully satisfy the need of tissues for arterial blood, which causes oxygen starvation in them, and it manifests itself in the form of intense pain. At the onset of the disease, the pain passes quickly enough when the exercise stops, but then returns again when moving. There is a so-called syndrome of intermittent claudication, which is one of the main clinical signs of atherosclerosis obliterans of the lower limb arteries. The pains in the muscles of the thighs are called pains of the type of high intermittent claudication, and pain in the calves of the legs – pains of the type of low intermittent claudication.

In old age, such pain is easily confused with painful sensations in the joints inherent in arthrosis and other diseases of the joints. Arthrosis is characterized not by muscular, but joint pain, which has the greatest intensity at the beginning of the movement, and then somewhat weakens when the patient “paces”.

In addition to pain in the muscles of the legs during walking, obliterating atherosclerosis of lower limb arteries can cause the following symptoms in patients (one of them or several at once):

1 – Chilliness and numbness in the feet, aggravated when climbing stairs, walking or other loads.

2 – Temperature differences between the lower limbs (the leg affected by atherosclerosis of the vessels is usually slightly cooler than the healthy one).

3 – Pain in the leg with no physical exertion.

4 – In the area of ​​the foot or lower third of the leg, non-healing wounds or sores appear.

 5 – Dark parts appear on the toes and feet.

6 – Another symptom of atherosclerosis may be the disappearance of the pulse on the arteries of the lower extremities – behind the inner ankle, in the popliteal fossa, on the thigh.

Stages of the disease

According to the existing classification of arterial vascular insufficiency of the legs, the above symptoms can be divided into 4 stages of the development of the disease.

Stage I – pain in the legs, which appear only after great physical exertion, for example, walking over long distances.

Stage IIa – pain when walking for relatively short distances (250–1000 m).

Stage IIb – the distance to painless walking decreases to 50–250 m.

Stage III (critical ischemia) – pain in the legs occurs when walking for a distance of less than 50 m. At this stage, pain in the muscles of the lower extremities may begin even if the patient is at rest, especially this manifests itself at night. To ease the pain, patients tend to lower their legs from the bed.

Stage IV – trophic ulcers occur at this stage. As a rule, areas of blackening of the skin (necrosis) appear on the fingers or heel areas. In the future, it can lead to gangrene.

In order not to bring obliterating atherosclerosis to the extreme stage, it is important to diagnose it in time and to carry out treatment in a medical institution.

Treatment of atherosclerosis of lower limb arteries

This disease requires an individually tailored treatment regimen for each individual patient. Treatment of atherosclerosis of the lower extremities depends on the stage of the disease, its duration, the level of damage to the blood arteries. In addition, in the diagnosis and preparation of the clinical picture, the presence of concomitant diseases in the patient is also taken into account.

If atherosclerosis obliterans is detected at the initial stage, it may be sufficient to eliminate the risk factors to improve the condition. In this case, help:

1 – Mandatory cessation of smoking and other bad habits.

2 – Keeping the diet low in animal fat and lowering cholesterol in the blood.

3 – With overweight or obesity – weight correction .

4 – Maintaining normal blood pressure at a level of not more than 140/90 mm Hg. Art.

5 – Regular physical activity (walking, swimming pool, exercise bike, etc.).

6 – For patients with diabetes mellitus – control blood sugar levels.

In atherosclerosis of vessels, the use of the following products is strictly prohibited: butter, margarine, lard, margarine, fatty meats, sausages, pies, by-products, dairy products with high fat content, fried potatoes, ice cream, mayonnaise, flour baking.

Important: Sedentary lifestyle makes blood vessels less elastic and accelerates the progression of the disease. 

At other stages for the treatment of atherosclerosis of the vessels of the lower extremities, the following methods are used:

• Conservative;
• Endovascular (minimally invasive)
• Operational.

Conservative treatment

It can also be used at the initial stage of the disease, as well as in cases where the patient’s condition does not allow the use of other methods (for complications with comorbidities). Conservative treatment involves the use of drugs, physiotherapy and includes pneumopressure , dosed walking and physical therapy.

Medication, completely restoring normal blood circulation in the blocked artery and curing atherosclerosis, unfortunately, does not exist yet. Drug treatment can only give support and affect the small vessels through which blood goes around the blocked part of the artery. Drug treatment is aimed at expanding these “workarounds” and compensating for insufficient blood circulation.

Special medications are used to relieve spasm from the small arterial vessels, dilute the blood and protect the artery walls from further damage, some of which need to be drunk and others should be taken constantly.

In addition to medicines, patients are prescribed pneumopressure therapy – massage of the soft tissues of the legs with the help of special equipment. With the help of alternating low and high pressure in the cuff, worn on the limb, peripheral arteries expand, blood flow to the skin, muscles and subcutaneous tissue is increased and blood vessels are stimulated.

Endovascular treatment

The most common methods of treatment for atherosclerosis of the leg vessels are endovascular methods – arterial stenting , balloon dilatation , angioplasty . They allow you to restore normal blood circulation through the vessel without surgery.

Conduct such procedures in the X-ray , on special equipment. At the end, they put a pressure bandage on the patient’s foot, and he should be kept in bed for 12–18 hours.

Surgery

If occluded arteries in the legs are too long for endovascular techniques, one of the following types of surgery is used to restore blood circulation in the legs:

1 – Prosthetics of the artery area with an artificial vessel ( alloprosthesis );

2 – Shunting – restoration of blood flow by redirecting the movement of blood through an artificial vessel (shunt). A segment of the saphenous vein of the patient himself can be used as a shunt;

3 – Thrombendarterectomy – removal of an atherosclerotic plaque from the affected artery.

Surgical techniques can be combined or supplemented with other types of operations. If the operation is performed at the IVth stage of the disease, when dead zones have already appeared, the surgical removal of these sites and the closure of trophic ulcers with a skin graft are performed.

If obliterating atherosclerosis has passed to the extreme stage, when the patient has developed gangrene of the lower extremities, and it is no longer possible to restore blood flow, an amputation of the leg is performed. Sometimes it becomes the only way to save a patient’s life.

How to avoid the disease?

• Prevention of atherosclerosis includes in the first place:
• To give up smoking.
• Proper nutrition, cholesterol-free diet. 
• Physical exercise.

These are three whales that will reduce the risk of atherosclerosis of the vessels of the lower extremities. It is not necessary to exhaust yourself with physical exercise, you can just take daily walks and do gymnastics for the legs. In addition, as a prophylactic agent helps special acupressure and recipes of traditional medicine.

Read more about the comprehensive prevention of atherosclerosis, read here. 

The main signs of atherosclerosis of the lower extremities

The feeling of heaviness in the legs may indicate atherosclerosis of the vessels of the lower extremities, which affects older people over 40 years old, mostly men. It is impossible to finally get rid of this disease, but with timely treatment and monitoring of the state of the blood vessels, the blood circulation is restored.

Disease description

Atherosclerosis of the lower extremity vessels (ASNK) is included in the group of diseases called “ arteriopathy ”, developing against the background of ischemia, a decrease in blood circulation. 

ANC is a pathology characterized by a decrease in blood flow due to narrowing (stenosis) of blood vessels, and in severe cases, tight vein blockage (occlusion). If the accumulation of cholesterol deposits on the walls of the arteries develops actively, then it is a question of obliterating atherosclerosis. 

This disease should not be confused with endarteritis, in which the blood supply to the small arteries is disturbed as a result of their inflammation and subsequent spasms. Endarteritis develops faster than atherosclerosis, and occurs mainly in young men.

The mechanism of atherosclerosis

The pathological process takes place in large and medium-sized arteries against the background of a violation of the metabolism of lipids (fats) and complex proteins (lipoproteins), which negatively affects the permeability and elasticity of the vessels. 

Initially, slight damage to the internal walls of the arteries contributes to the deposition of an almost imperceptible fatty spot. This phenomenon can be observed along the artery and almost do not interfere with the blood supply. The process is called non-stenotic atherosclerosis and happens at the initial stage of pathology. 

Over time, the stain strengthens and grows with the help of connective fibers, turning into a “young” plaque of a loose consistency, which can dissolve and disappear, or, conversely, rupture due to friability and interfere with blood flow. Atherosclerotic plaque gradually thickens, grows in size and lives due to the health of the vascular wall. In this case, the vessel may suddenly become occlusive (occluded). Even more affected is the steno-occlusive vessel, in which obstruction is observed against the background of a narrowing of the diameter, including cholesterol deposits on the walls. 

The plaque ripens to complete threat to the body, turning into a thrombus, which continues to narrow the lumen in the vessel. The development of the disease at a late stage is called stenotic atherosclerosis.

The disease may be complicated by the occurrence of gradually increasing necrotic areas, which leads to a deterioration of health. Pathology develops on the background of metabolic disorders, reduced muscle tone and is called diffuse atherosclerosis.

Constant failure of blood vessels to adversely affect the condition of the skin, muscles, bones and joints of the legs, makes movement difficult. In complex cases, trophic ulcers and gangrene of limb areas are observed . 

Stage of the disease

There are four stages of atherosclerosis of the legs:

• first: pain in the legs appears only after passing more than 1 km of the way, the leg section with the affected artery is not supplied with blood, therefore it is cold to the touch;
• second: the ability to walk without pain is reduced to a distance of 250 m;
• third: the length of the painless movement is 50 m, some patients are plagued by pain in a fixed state;
• fourth: the skin on the legs at the sites of vascular lesion becomes dark, covered with trophic ulcers. The situation may be complicated by arterial thrombosis, when a blood clot seals the vessel. The limb begins to grow cold and pale. At the same time the emergency help of the vascular surgeon is necessary .

If the treatment of atherosclerosis of the leg vessels is not carried out even at the last stage, then as a result the patient will have no choice but to amputation.

The reasons

The main factors that accelerate the development of atherosclerosis are bad habits (including food and behavioral), the presence of chronic diseases, heredity, age, constant tension of the nervous system. Detailed causes of the disease include the following: 

• smoking. The statistics asserts that the main contingent of patients with atherosclerosis has been abusing nicotine for a large number of years;
• alcohol. Ethanol contained in alcoholic beverages in a disorderly state constricts and dilates blood vessels, which leads to wear and risk of vascular diseases;
• overweight. Extra kilograms create an additional load on the leg veins, creating pressure in them that is pathologically affecting the integrity of the vessel walls;
• high-calorie food. Food rich in animal fats contributes to the deposition of harmful cholesterol in the vessels and the formation of atherosclerotic plaques;
• diabetes, diseases of the joints, endocrine abnormalities, high blood pressure violate the body’s metabolism and create an imbalance in the blood that thin the walls of blood vessels and clogs the bloodstream cholesterol;
• heredity. Pathology is already laid in the body, so you need as closely as possible to monitor the vessels, avoid provoking factors;
• age. Over the years, a person does not become younger, metabolic processes slow down, which becomes a fertile ground for disruptions in the body;
• passive lifestyle. Such an attitude to health reduces general immunity, affects the main organ systems, which include the circulatory system;
• nerve loads leading to angiospasm (vasoconstriction), which causes impaired blood supply and metabolism.

Symptoms of the disease

Signs of atherosclerosis of the lower extremities should be paid close attention, as the disease proceeds almost imperceptibly, and the very first pronounced symptoms indicate that the pathological process is in full swing.

On average, signs of the disease can manifest themselves in men by the age of 45, and in women – at the onset of menopause.

It is possible to determine ASNK in advance by the characteristic symptoms. The first changes: fatigue and pain with slight physical exertion (walking, climbing stairs, fast pace or short-term running). Over time, the pain covers not only the legs, but also the fingers and feet, does not let go at rest.   

One of the obligatory signs of vascular atherosclerosis is intermittent claudication (usually in one leg) – regular pain and loss of sensitivity of the patient’s leg (anemia that occurs when there is a shortage of blood supply), which inevitably causes a person to stop while walking to wait out the seizure. Pain sensations are concentrated in the muscles of the leg, thigh area. Ischemia of the lower extremities causes neuritis – inflammation of the nerve roots, the symptoms of which is pain along the entire length of the lower extremity.

Due to the malnutrition of the cells on the surface of the leg, hair falls out irreversibly, nails grow poorly and exfoliate, wounds and abrasions heal with difficulty. Against the background of diabetes, atherosclerosis quickly takes the form of an obliterating disease.

If the pathology has gone far, then it can spread to both legs, but unevenly. The affected limbs have pale and relatively cold skin. Moreover, sore feet freeze even in summer.

At the most serious stages, cyanosis is observed (an unnaturally burgundy or dark red skin color), which is observed when a vein is blocked. With this phenomenon, if it is not treated, gangrene develops on the skin of the affected extremity, during which cells in the region of the leg, fingers, and feet die . The leg swells, becomes covered with trophic ulcers. Disappears or weakens the pulse under the knee and at the thigh, atrophy (reduction) of muscles occurs. 

In chronic atherosclerosis, insufficient blood supply is compensated by the formation of collaterals – new small vessels for the passage of blood. The more reserves the body has to develop this alternative to inactive vessels, the less even the most advanced atherosclerosis is manifested. In this case, a favorable prognosis is the preservation of small arteries healthy for collateral blood flow.

Diagnostics

To examine the vessels of the lower extremities, it is necessary to carry out diagnostics, which has proven methods, which include:

• Mr angiography (magnetic resonance), which allows you to check in detail the patency and location of the main arteries. This modern highly effective technique is carried out without the introduction of contrast agents, that is, without penetrating into the body;
• MSCT angiography is a multispiral computed tomography that sequentially collects information about each layer of the vessel. The three-dimensional image makes it possible to see in all details the thickness and quality of the walls, the narrowing of the vessels in each section. For greater clarity, a contrast agent is injected through the vein;
• calculation of the ankle- shoulder index in order to identify markers (pathological substances) for the risk of stroke and heart attack, for which pressure is measured simultaneously by volume sphygmography;
• duplex scanning (ultrasound scan) – ultrasound in combination with Doppler, which recognizes external signs and internal abnormalities. The following values ​​are determined: the direction and speed of blood movement, the size of the lumen in blood vessels and intravascular pressure;
• biochemical blood test for the degree of concentration of harmful cholesterol.

The study using the described techniques applies not only to the vessels of the legs, but also to the aorta , the main vessel in the body, whose branches feed all organs, including the peripheral tissues of the lower extremities. When diagnosing, patient complaints are taken into account. For example, atherosclerosis of the aorta of the lower extremities is accompanied, in addition to the characteristic symptoms for the affected vessels, with chaotic pains in the navel. 

An experienced specialist will distinguish atherosclerosis of the lower extremities from thromboangiitis – diseases with damage to all layers of the artery walls and the presence of hardened blood clots, which predominantly affect men younger than middle age.   

Treatment

There are several ways to treat atherosclerosis of the lower extremities: conservative (medical therapy and physiotherapy procedures), surgical (including minimally invasive, that is, with gentle penetration into the tissues of the body).

The principles of treatment are based on an integrated approach to the recovery of the patient. After the surgery, a special drug therapy is prescribed, fixing the result. In parallel, as in the case of drug treatment, you should follow a diet, control weight and bad habits, wear comfortable shoes. It is also necessary to pay serious attention to the associated systemic diseases. 

In drawing up the treatment regimen for a patient, the following are taken into account: the duration of symptoms, stage, degree of arteries, the presence of diseases in history.

Drug method

Treatment of leg vessels involves maintaining blood supply and suppressing trophic changes in the skin. To do this, use drugs: 

• preventing the formation of blood clots;
• reduce cholesterol;
• regenerating vascular walls;
• reduce blood clotting;
• relieving pain and cramps;
• dilating vessels.

Also, antibiotics are prescribed in the form of ointments for trophic ulcers: dimexide , levomekol , delaskine . To improve the body’s metabolism and strengthen the patient’s immunity, the doctor prescribes vitamin remedies.

Physiotherapy

Physiotherapy is used in conjunction with drug treatment. The doctor selects the patient procedures that will help in a particular case. The following methods are considered the most effective:   

• Interference therapy (effects on diseased arteries together with direct and alternating current);
• electrophoresis (administration of drugs using electric current);
• magnetic therapy (use of electromagnetic waves);
• UHF (use of ultra-high frequency magnetic field);
• massotherapy.

In the initial stages of the disease, the doctor prescribes a therapeutic foot massage by rubbing a special ointment. The procedure is aimed at reducing pain and is performed by a specialist. To improve the blood supply, physical exercises are prescribed, which the patient is able to perform at home. 

If the doctor deems it necessary, then he additionally prescribes treatment with homeopathic preparations made by the method of dilution of the active substance. Hirudotherapy can also be prescribed – treatment with leeches, which, sucking blood, inject healing enzymes into the affected areas. Through this process, blood clotting is reduced, blood clots in the vessels soften. 

Surgical methods

When the vessels cannot be restored, surgical intervention is applied. Such surgical methods are widespread as:

• shunting – replacement of an unsuitable part of the artery by a shunt (prosthesis);
• balloon angioplasty – expansion of the vessel using a microscopic balloon;
• stenting – the introduction of a stent in the artery that controls the diameter of the bloodstream;
• endarterectomy – removal of a portion of a diseased vessel with a plaque.

If the limb is not treatable, then it is amputated to save the life of the patient. After rehabilitation, procedures are carried out for the preparation and installation of the prosthesis. Irreversible processes in atherosclerosis of the lower extremities occur in the latter stages, when the neglected form does not give an optimistic choice to medicine and it is necessary to apply extreme measures.

As for the disease as a whole, its prognosis depends on the attitude of the patient to his health and compliance with the doctor’s instructions. When complaints of pain in the legs appear , it is necessary, without delaying “later”, to contact a vascular surgeon.   

The consequences of atherosclerosis are extremely dangerous – it is gangrene (death of the tissues of a living organism) and acute ischemia, which develops in the presence of a blood clot. When a person goes to the clinic in a timely manner, his quality of life is at a decent level in the treatment.

Diet

To support the process of treating atherosclerosis of the lower extremities, it is necessary to change the diet in which there should be: lean meat or poultry (better than turkey), fish (preferably fat); fresh fruits, berries and vegetables, dairy products, boiled eggs, omelets (egg casseroles), olive and sunflower oil, cereals, bran, wholemeal bread, beans, peas, nuts (almonds, walnuts), green tea.     

It is necessary to limit or exclude: offal (liver, kidneys, brains), sausage, lard, fatty meat, store-based sauces and mayonnaise, fried potatoes, confectionery, baked pastries.

Folk methods

Treatment of ASKN with the help of traditional medicine recipes is used as an adjunct to drug therapy. There are many recipes to which the body responds effectively, but before choosing non-traditional products, you should consult with your doctor about the appropriateness of their use.

To clean the vessels of the lower extremities by the following folk remedies:

• an infusion of horse chestnut, hops, and safflower-shaped bighead;
• decoction of chamomile flowers, rezedy, plantain, St. John’s wort, sage as applications;
• a mixture of olive and sea buckthorn oils for grinding;
• infusion of dill seeds;
• alcohol tincture from the root of Deviacela and 20% tincture of propolis;
• decoction of the bark of mountain ash;
• decoction of rose hips, hawthorn, elderberry flowers, immortelle, medicinal initial letter.

Poor vascular patency will change for the better after completing the course of one of the recipes chosen by the doctor. In this case, as already mentioned, the main treatment is not canceled.

Prevention

During treatment and after it, patients are advised to take preventive measures that will create favorable conditions for the body to recover. To this end, you need to follow a diet, focusing on juices, berry and herbal infusions, fresh and dry fruits. 

If the patient suffers from diabetes, then for the prevention of atherosclerosis of the legs it is necessary to control the level of sugar in the blood. In order to achieve a sustainable result in the treatment of ASNK, it is necessary to say a firm “no” to bad habits (especially smoking).

Regular physical activity (walking and cycling, swimming, feasible therapeutic exercises), blood pressure control – these measures also help to prevent failures in the blood supply to the vessels of the lower extremities.

The first pains in the legs, darkening of the skin are serious reasons for the examination. Timely measures will save the legs from atherosclerosis and its serious consequences.