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Angiopathy

Angiopathy (from the Greek: "ἀγγεῖον" angeion for vessel and "πάθος" pathos for suffering) is an umbrella term for diseases of the blood vessels (arteries, veins and capillaries). It describes changes or damage to the vessel walls that can lead to various functional limitations in the affected vessels.

Types of angiopathies

1. Microangiopathy

   • Affects mainly the small blood vessels such as arterioles, venules and capillaries.
   • Common examples are changes due to diabetes mellitus, so-called diabetic microangiopathies. High blood pressure (hypertension) can also damage the smallest vessels.
   • Symptoms are often only apparent at a late stage, for example in the case of damage to the retinal vessels (diabetic retinopathy), the kidney vessels (diabetic nephropathy) or the nerves (diabetic neuropathy).

2. Macroangiopathy

   • Affects mainly the larger blood vessels such as medium-sized and large arteries and veins.
   • Here too, diabetes mellitus is a common cause of premature vascular changes, which can lead to arteriosclerosis (vascular calcification), for example.
   • Macroangiopathy can manifest itself in the form of circulatory disorders in the legs (peripheral arterial occlusive disease) or in the coronary arteries (coronary heart disease).

Causes and risk factors

• Chronic diseases such as diabetes mellitus and high blood pressure (hypertension) are strong risk factors.
• Elevated blood lipids (cholesterol and triglycerides) can contribute to arteriosclerosis and thus promote angiopathy.
• Smoking promotes vascular changes and damage.
• Unhealthy eating habits and lack of exercise lead to obesity and can also damage the blood vessels.
• Genetic factors can influence the occurrence of angiopathy.

Symptoms

The symptoms vary depending on the vessels and organs affected:

• Legs: pain when walking, feeling cold, delayed wound healing, circulatory disorders.
• Heart: angina pectoris, heart attack (due to narrowing or blockage of the coronary arteries).
• Brain: Stroke (due to circulatory disorders in the cerebral arteries).
• Kidneys: Renal dysfunction up to and including renal failure.
• Eyes: Deterioration of vision, blindness (e.g. in diabetic retinopathy).

Diagnosis

• Blood tests (e.g. measurement of blood sugar and blood lipids).
• Imaging procedures such as ultrasound (Doppler sonography), angiography (imaging of the vessels with contrast agents) or MRI/CT angiography.
• Specific examinations for organ damage (e.g. ophthalmologist's examination of the fundus of the eye).

Treatment and prevention

1. Reduce risk factors
   • Normalization of blood sugar levels in diabetics
   • Adjustment of blood pressure in hypertension
   • Management of elevated blood lipid levels
   • Stop smoking
2. Adjust lifestyle
   • Balanced, healthy diet
   • Regular exercise
   • Weight reduction if overweight
3. Drug therapy: antihypertensives, lipid-lowering drugs, anticoagulants or antidiabetics (depending on the cause)
4. Surgical interventions: In advanced cases, interventions such as bypass surgery, stent implantation or other vascular surgery may be necessary.

Summary

Angiopathy is a collective term for changes or diseases of the blood vessels, which can have different health consequences depending on the type of vessel (small or large). Underlying diseases such as diabetes mellitus or high blood pressure are often at the forefront. Early diagnosis and control of risk factors are crucial in order to avoid or minimize consequential damage to organs.