World No Tobacco Day: How tobacco fuels Peripheral Vascular Disease



Published May 31, 2024


By Andiswa Mdunge

Tobacco, while legal and widely consumed, claims more lives each year than many realise, acting as a silent killer in the shadows of public health crises.

In South Africa alone, tobacco-related diseases are responsible for over 42,000 deaths annually, accounting for nearly 8% of all deaths. Globally, the situation is even more dire, with tobacco killing more than 8 million people each year, according to the World Health Organisation (WHO).

Renowned Durban Vascular Surgeon Dr Vinesh Padayachy has seen first-hand the the damage tobacco causes on the human body through his fight against a critical yet often overlooked health issue—Peripheral Vascular Disease (PVD).

As we approach World No Tobacco Day on May 31, Dr Padayachy discusses the stark implications of smoking on vascular health, highlighting the urgent need for public awareness and lifestyle change.

PVD primarily impacts blood vessels outside the heart and brain, leading to narrowing, blockage, or spasms.

“This condition mostly affects the legs and is a significant public health concern, increasing the risk of heart attack, stroke, and limb amputation,” explains Dr Padayachy.

The disease’s link to severe cardiovascular conditions makes it an essential topic for discussion, especially in the context of preventable risk factors like smoking.

“Smoking is a critical risk factor for the development of PVD,” Dr Padayachy points out.

The toxins in cigarettes damage the arterial walls, promoting the build-up of atherosclerotic plaques. Nicotine and other chemicals exacerbate this effect, leading to harder, more constricted arteries and worsening blood flow.

The symptoms of PVD often manifest subtly—leg pain when walking, numbness, or persistent sores.

Dr Padayachy stresses the importance of early detection, “It allows for earlier intervention, which can prevent the progression of the disease, potentially averting severe outcomes like limb loss.”

When it comes to treatment, options vary based on the disease’s severity but include stenting, angioplasty, atherectomy, and bypass surgeries.

“These treatments are effective in restoring blood flow and improving symptoms,” says Dr Padayachy.

However, the choice of treatment depends greatly on the patient’s overall health and specific circumstances of the disease.

Despite the effectiveness of these interventions, challenges remain, particularly among patients with extensive atherosclerosis or those who continue unhealthy lifestyles. “Managing patients with multiple blocked arteries or those who continue to smoke poses significant difficulties,” he admits.

To prevent PVD, Dr Padayachy recommends quitting smoking, maintaining a healthy diet, regular exercise, and managing other health metrics like diabetes and cholesterol. Regular medical check-ups are also crucial.

The implications of advanced PVD are dire, impacting the quality of life through pain, mobility issues, and even leading to amputation.

“Emotional and psychological support is essential for managing the lifestyle changes required by such a diagnosis,” he said.

On the frontier of medical science, new treatments and innovations offer hope.

“Drug-coated balloons and stents and promising gene therapies aimed at improving blood vessel growth are some of the advancements that could soon transform treatment paradigms,” Dr Padayachy notes with optimism.

His message to smokers is unequivocal, especially poignant as World No Tobacco Day looms.

“Quitting smoking is the single most important step you can take to improve your vascular health and overall wellbeing. It significantly reduces your risk of developing PVD and other severe health conditions.”

As Dr Padayachy continues his work at the Lenmed Ethekwini Hospital and Heart Centre, his insights serve as a crucial reminder of the risks posed by smoking and the importance of vascular health. This World No Tobacco Day, let his words be a call to action—not just for smokers but for everyone concerned with leading a healthier, fuller life.