Diseases of blood vessels

In many western countries, arterial disease (principally atherosclerosis) is the most important cause of mortality and morbidity. Ischaemic heart disease, stroke and peripheral vascular disease together rival cancer as the leading causes of death. These diseases are on the decline in some Western countries; however, in others and in the developing world there is a rapid increase in incidence in heart disease and stroke. Rapid increases in obesity and in diabetes are major factors. In this review, the distribution and complications of atherosclerosis are outlined. The impact of aging on the arterial tree is considerable and the clinical effects of age-related arteriosclerosis are explained. Aneurysms are classified and the pathogenetic mechanisms in arterial dissection are summarized. There is a synopsis of the many types of vasculitis and the roles of infection and immune mechanisms are considered. There is a short account of pulmonary thrombo-embolism and diseases of veins and lymphatics including varices. Finally, vascular malformations, and the many benign and malignant vascular tumours are mentioned.