Macrovascular

Macrovascular refers to the large blood vessels of the circulatory system, primarily the arteries and veins with luminal diameters large enough to be distinguished from the microcirculation. In clinical contexts, macrovascular disease denotes pathology of these large vessels, most commonly due to atherosclerosis, and is distinguished from microvascular disease that affects arterioles, capillaries, and venules. Macrovascular disease is a major contributor to cardiovascular and cerebrovascular morbidity and mortality.

Macrovascular diseases include coronary artery disease, carotid artery disease, peripheral arterial disease, and stroke arising from large-vessel atherosclerosis. Risk factors overlap with those for atherosclerosis in general and include age, hypertension, dyslipidemia, diabetes mellitus, smoking, obesity, and family history. In diabetes, macrovascular complications refer specifically to large-vessel disease, while microvascular complications encompass retinopathy, nephropathy, and neuropathy.

Diagnosis relies on clinical assessment supplemented by imaging and functional studies: coronary disease is evaluated with electrocardiography, stress testing, and coronary angiography; carotid and peripheral arterial disease are assessed with duplex ultrasonography, CT angiography, or MR angiography, and invasive angiography when necessary. Management emphasizes risk-factor modification, antiplatelet therapy where appropriate, lipid control with statins, blood pressure management, smoking cessation, and lifestyle changes; revascularization through percutaneous or surgical means may be indicated for advanced disease. Prevention and early intervention reduce cardiovascular events and improve outcomes related to macrovascular disease.