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Lymphatic dysfunction or disturbances in hydrostatic or osmotic forces can all disrupt this equilibrium. The most common clinical result is the increased interstitial fluid known as edema (see Table 14-4, Some Peripheral Causes of Edema, p. 464).

H Changes With Aging_

Aging itself brings relatively few clinically important changes to the peripheral vascular system. Although arterial and venous disorders, especially atherosclerosis, do afflict older people more frequently, they probably cannot be considered part of the aging process. Age lengthens the arteries, makes them tortuous, and typically stiffens their walls, but these changes develop with or without atherosclerosis and therefore lack diagnostic specificity. Loss of arterial pulsations is not a part of normal aging, however, and demands careful evaluation. Skin may get thin and dry with age, nails may grow more slowly, and hair on the legs often becomes scant. Because these changes are common, they are not specific for arterial insufficiency, although they are classically associated with it.

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