What’s the prognosis for ‘microvascular disease’?

Via Peters

Dear Dr. Roach: I am an 80-year-old active male taking only thyroxine. I have no known health issues. In November 2021, I experienced a migraine with aura and have a slight vision loss in my right eye. After seeing an eye doctor, a retinal specialist and a primary care doctor, the only thing I am hearing is the term “microvascular disease.” This is based on the eye doctor’s examination. I am unable to find a satisfactory definition or prognosis anywhere I search. Any information you could provide would be appreciated.

— R.B.

Dear R.B.: The blood vessels in your body go from very large (the aorta, which takes the blood directly from the heart, is the largest) all the way down to the capillaries, the very smallest. Microvascular disease refers to poor flow in the smaller arteries, called the arterioles. These branch off from the larger arteries and ultimately provide blood to the capillaries.

All organs have small blood vessels, but the term microvascular disease is most often applied to the heart and brain. The most common causes include smoking, high blood pressure and diabetes, but high cholesterol and rheumatological diseases such as rheumatoid arthritis or systemic lupus are other causes. However, it’s not necessary to have any of these conditions, as the condition can affect apparently healthy older women and men.


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