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Circulatory problems seem to have been in the news recently following realisation of the risks of thrombosis associated with flying.DVT (deep vein thrombosis) affects the veins you cannot see and can strike without warnng.However there are many other parts to the circulation.

Broadly speaking there are 4 elements to the circulation.The arteries carry blood containing oxygen around the body.,The veins carry blood back to the heart which has had oxygen removed by the tissues.In between the two systems is an ever finer network of small vessels comprising the microcirculaton.The final parts of the system are the great vessels,arteries and veins which act as the main motorways for blood travelling to the smaller arteries and back to the heart from the smaller veins.

This system is not simply a set of pipes like those in your bathroom or supplying the radiators.Each vessel can respond to the demands made by the body.In the cold or following acute blood loss the vessels in the skin and inside the body close down to conserve heat(alcohol opens them up again so it is not a good idea to give brandy to people who are shocked or cold).In the warm they open up to lose heat.When you exercise the heart pumps more rapidly and the vesssels open up to supply more blood and oxygen to the tissues.This is why exercise helps the heart; the coronary blood vessels supplying the heart open up when the heart muscle demands more oxygen.There is evidence that their resting diameter is greater too.If the heart never demands more oxygen the blood vessels remain narrow and hence are more easily blocked by atherosclerosis(the process which leaves a deposit on the inside of vessels rather like scale in a kettle)

I firmly believe that cigarette smoking is the single factor which causes most preventable damage to blood vessels especially arteries. Smoke contains not only nicotine but poisons such as cadmium which cause the blood vessels to contract.The most dramatic demonstration of this occurs in pregnant women who smoke.If the heart rate of the baby is monitored by an external tracing whilst the mother smokes a cigarette the same changes can occur in the baby's heart pattern as are seen if the baby were experiencing distress during labour.These changes occur because the circulation in the placenta(afterbirth) is uniquely sensitive to cigarette smoke.Buergers disease affects younger people who smoke and can result in the amputation of limbs at a young age. if you have a family history of this dont smoke.If you suffer from Raynauds syndrome(fingers go white in the cold) DONT SMOKE)

A number of other factors operate to damage the circulation.The great vessels gradually fur up with age (atherosclerosis).Don't be lulled into a false sense of security -changes of atherosclerosis have been found in people in their 20's without any risk factors.This change can be worse if cholesterol or triglyceride levels are high.

High blood pressure damages the vessels over the long term as the walls thicken and become rigid.They then lose their ability to open up to supply more blood when needed..

Diabetes causes accelerated damage to the circulation if you are daibetic or have a family history of this DONT SMOKE.

If you already have circulatory problems there are many ways in which you can be helped.Simple measures such as gentle exercise,avoiding too much alcohol and not smoking will help.Some people take a small dose of aspirin (I usually recommend the enteric coated as this is less likely to upset the stomach).There are other preparations such as Gingko biloba and Pycnogenol which appear to have beneficial effects on the circulation at least in the short term.Whether they will prove to be a long term solution remains to be seen.

If you want to check out how your circulation is holding up visit the website www.connectmedical.com There is a scoring system there which I have devised.It is not scientifically validated but based on my experience and prejudices for which I make no apology.!!