Peripheral arterial disease: a manifestation of evolutionary dislocation and feed-forward dysfunction.
Peripheral arterial disease in the legs represents a subset of atherosclerosis that manifests a particularly sinister profile. A predominance of sympathetic activity in the periphery favors the development of neurogenic atherosclerosis. Atherosclerosis may then produce flow derangements and decreased physical activity that serves to escalate sympathetic bias in a vicious cycle. Restoration of normal flow in peripheral arterial disease may not only produce local benefit due to improved perfusion, but also represent a gateway to correcting many systemic conditions that may at first glance appear unrelated but share a common etiology of autonomic dysfunction, such as gout, acute coronary syndromes, stroke, sleep apnea, arrhythmias, depression, erectile dysfunction, inflammation, hypercoagulability, sleep disorders, bowel dysfunction, renal failure, and aging.
Simpson
John D
JD
Palo Alto Institute, 470 University Avenue, Palo Alto, CA 94301, United States.
Doux
John D
JD
Lee
Patrick Y
PY
Yun
Anthony J
AJ
D050197:Atherosclerosis / Q000145:classification / Q000209:etiology* / Q000503:physiopathology; D005075:Biological Evolution; D015444:Exercise; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply; D008955:Models, Cardiovascular; D016491:Peripheral Vascular Diseases / Q000209:etiology* / Q000503:physiopathology; D012039:Regional Blood Flow; D013564:Sympathetic Nervous System / Q000503:physiopathology