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The FAQs on PAD
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Get a leg up on your artery health
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By Teri Walsh
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MediZine's Healthy Living Fourth Quarter 2007
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 | Alan T. Hirsch, M.D., is director of the Vascular Medicine Program at
the Minneapolis Heart Institute and professor of epidemiology and
community health at the University of
Minnesota School of Public Health. |
Peripheral arterial disease (PAD) can seriously impair your quality of life. Expert Alan T. Hirsch, M.D., tells us more.
PAD includes all disorders that alter the function of the arteries besides those of the heart. Most often, the term is applied to blockages in the arteries to the legs.
Patients and their primary-care doctors need to discuss any leg muscle fatigue or discomfort that occurs with exercise. Physicians who suspect a problem should order an ankle-brachial index test, or ABI. This detects blockages through blood pressure readings in the legs. The ABI should be done for all adults over age 70 and those over 50 with risk factors.
All arteries, whether they supply the brain, the heart or the legs, can be harmed by tobacco use, diabetes, high cholesterol and high blood pressure. When we’re young, we should avoid exposure to these and other risk factors. Even if damage occurs and arteries develop blockages, it’s important to limit further damage by avoiding these risks.
That this disease is not as important as coronary heart disease. PAD is more common than most other cardiovascular diseases and is associated with a very high short-term risk of heart attack, stroke, hospitalization and death. It remains surprisingly underdiagnosed and undertreated.
Some conditions and habits raise your chance of developing PAD. Your risk increases if you:
• Are over the age of 50.
• Smoke or used to smoke. Those who smoke or have a history of smoking have up to four times greater risk of developing PAD.
• Have diabetes. One in every three people over the age of 50 with diabetes is likely to have PAD.
• Have high blood pressure. Also called hypertension, high blood pressure raises the risk of developing plaque in the arteries.
• Have high blood cholesterol. Excess cholesterol and fat in your blood contribute to the formation of plaque in the arteries, reducing or blocking blood flow to your heart, brain, or limbs.
• Have a personal history of vascular disease, heart attack, or stroke. If you have heart disease, you have a one in three chance of also having PAD.
• Are African American. African Americans are more than twice as likely to have PAD as their white counterparts.
Excerpted from MedlinePlus: The Magazine, Summer 2008 issue, a publication of the National Institutes of Health and the friends of the National Library of Medicine. Information provided by the National Heart, Lung and Blood Institute.
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At least half the people with PAD don't exhibit any symptoms.
Those who do may have pain when walking, climbing stairs, or exercising. This pain may be relieved by resting. During exercise, your muscles need more blood flow to get more oxygen to the muscles. If there is a blockage in the blood vessels, the muscles won't get enough oxygen. Exercising will not make PAD worse and studies show that a regular exercise program can improve symptoms. When you rest, the muscles require less blood flow and the pain goes away.
Other Signs of PAD include:
• Pain, aching, and heaviness in the muscles
• Cramping in the legs, thighs, and calves
• A weak or absent pulse in the legs or feet
• Sores or wounds on toes, feet, or legs that heal slowly, poorly, or not at all
• Color changes in skin, paleness, or blueness
• Lower temperature in one leg compared to the other leg
• Poor nail growth and decreased hair growth on toes and legs
Excerpted from MedlinePlus: The Magazine, Summer 2008 issue, a publication of the National Institutes of Health and the friends of the National Library of Medicine.
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