Peripheral Artery Disease: Facts you need to know

No matter where in your body clogged arteries may occur, they are a major health risk. An artery located in the chest that is blocked by plaque can dramatically raise your risk of a heart attack.  If the artery is located in your neck, a stroke can occur.

Peripheral artery disease or PAD is a type of peripheral vascular disease (PVD) which refers to diseases of blood vessels outside the heart and brain.  PAD is found in one in every 20 Americans over the age of 50 and is a condition that raises the risk for heart attack and stroke. Between 8 to12 million people in the United States have PAD. 

PAD is a type of organic disease caused by fatty buildups (atherosclerosis) in the inner walls of arteries.  These deposits end up blocking normal blood flow and a narrowing of the vessels that carry blood to the legs, arms, stomach, or kidneys.  This is just like clogged arteries leading to the heart or brain except that the arteries being clogged are in different areas of the body.

What are the symptoms?

One of the primary areas of plaque buildup in PAD is in the legs.  Plaque buildup in the legs does not always cause symptoms so many people with PAD can have it and not know it.  People who do experience symptoms, such as pain or cramping in the legs, often do not report them, believing they are a natural part of aging or due to another cause.  However, leg artery blockages represent a danger to your health that is equal or greater than blockages in arteries to your brain or heart – and can carry an equal or higher risk of heart attack, stroke, amputation, or death.

Common symptoms of poor leg circulation include:

·      Cramping

·      Fatigue

·      A heavy feeling in the legs

·      Pain or discomfort in the legs and buttocks during activity which usually goes away when the activity stops.  This is called “intermittent claudication.”

·      Sores or wounds on toes, feet or legs that heal slowly, poorly or not at all

·      Color changes in the skin of the feet, including paleness or blueness

·      A lower temperature in one leg compared to the other leg

·      Poor nail growth and decreased hair growth on toes and legs

Symptoms can also affect the kidney indicating poor kidney functioning which include: 

·      Sudden high blood pressure

·      Blood pressure that is hard or impossible to control with medications

·      Severe blockage could result in loss of kidney function or failure

Causes and risk factors of PAD

The cause of plaque buildup in the limbs is unknown in most people.  But there are some conditions and habits raising a person’s risk of developing PAD:

·      Over the age of 50

·      Smoker or used to smoke – people who smoke have up to four times greater risk of PAD

·      Diabetes – one in every three people over the age of 50 with diabetes is likely to have PAD

·      High blood pressure – this raises the risk of developing PAD

·      High blood cholesterol – Excess cholesterol and fat in the blood contributes to plaque formation in the arteries

·      Personal history of vascular disease, heart attack, or stroke – anyone who has heart disease has a one in three chance of also having PAD

·      African American – they are twice as likely to have PAD as Caucasians

Is PAD dangerous?

The short answer to this is yes.  The fatty deposits buildup in the inner lining of artery walls leading to restricted blood flow, mainly in arteries to the kidneys, stomach, arms, legs, and feet.  If PAD is left untreated, this can lead to gangrene and amputation of limbs and if the blockage occurs in a carotid artery, it can cause a stroke. 

Diagnosing PAD

A doctor during an exam will do a test called the ABI (ankle brachial index) which is a test used to predict the severity of PAD.  Other tests may also be done which include the following:

·      Doppler and duplex ultrasound imaging

·      Magnetic resonance angiogram (MRA)

·      CT angiogram

·      Regular (catheter-based) angiogram

Treating PAD

The goal for treating PAD is to reduce symptoms, improve quality of life and mobility, and to prevent a heart attack, stroke or amputation.  A person who is diagnosed with PAD will need to make lifestyle changes in addition to medications to aid in lowering high blood pressure, cholesterol and blood glucose levels.  In some cases, having a special procedure or surgery such as angioplasty and bypass graft can improve blood circulation to the legs and the ability to walk. 

Lifestyle changes will need to be life-long in order to prevent PAD from getting worse.  These changes include the following:

·      Quit smoking

·      Lower high blood pressure, cholesterol and blood glucose numbers

·      Follow a heathy eating plan – choose foods low in saturated fat and cholesterol.  Include more fruits, vegetables, whole grains, nuts and seeds.

·      Become physically active – make a commitment to aim for 30 minutes of moderate-intensity activity on most days of the week

·      Reach a healthy body weight