Peripheral arterial disease (PAD) is a common yet serious disease, affecting 8 to 12 million people in the United States, particularly those over age 50. PAD occurs when plaque buildup reduces blood flow through the arteries. It often happens in the legs and feet, but can also occur elsewhere in the body. If this buildup occurs in the carotid artery (a large artery in the neck), it can be a major contributor to stroke.
Causes and Risk Factors for Peripheral Artery Disease
Peripheral arteries deliver oxygen-rich blood to the tissues outside the heart. As you age, your arteries become stiffer and thicker. In addition, risk factors, such as smoking and high cholesterol, can damage the artery lining. This allows plaque (a buildup of fat and other materials) to form within the artery walls. The buildup of plaque narrows the space inside the artery and sometimes blocks blood flow.
Risk factors that increase your chances of developing the disease include:
- Age 50+ with diabetes
- Current or recent smoking
- High blood pressure
- High cholesterol or triglycerides
- High levels of homocysteine, an amino acid in your blood
- Weighing over 30 percent more than your ideal weight
Symptoms of PAD
PAD does not always cause symptoms. Common symptoms of chronic PAD include:
- Painful muscle cramping in the hips, thighs or calves.
- Pain/tiredness in the leg or hip muscles while walking, climbing stairs or exercising. Typically, this pain goes away with rest and returns when you walk again.
Common symptoms of acute PAD include leg pain that does not go away when you stop exercising, foot or toe wounds that won’t heal or heal very slowly, gangrene and a marked decrease in the temperature.
The American College of Cardiology and the American Heart Association recommend that patients over the age of 70, or those over the age of 50 with diabetes or who smoke, are at an increased risk and should be screened for PAD. It is easily diagnosed in non-invasive and painless ways:
- Ankle Brachial Index – determines blood flow by comparing ankle and arm blood pressures
- Doppler and duplex ultrasound imaging
Treating Peripheral Artery Disease at St. Joseph's Heart & Vascular Institute
If PAD is detected early, you can help manage your disease through lifestyle changes such as:
- Exercising regularly
- Losing weight
- Quitting smoking
Your physician may also recommend medication, such as:
- Cholesterol-lowering drugs (statins)
- Blood pressure-lowering medications
- Medications that reduce blood clotting to minimize the chances of blockages in your narrowed arteries
- Other medications that may be prescribed to improve the distance you can walk without discomfort or pain
In more severe cases, you may also require surgical treatments. The choice of treatment depends on the extent of blockages as well as other factors. Your vascular surgeon will help you determine the best option for your particular situation. Some surgical treatments you may explore include:
In extreme cases and as a last resort, your surgeon may recommend amputating your lower leg or foot. This procedure would only be performed when circulation is severely reduced and cannot be improved by any of the methods already discussed.
Additionally, lifestyle changes may help you manage your PAD, including:
- Managing diabetes by maintaining healthy blood sugar levels.
- Lowering high cholesterol
- Lowering high blood pressure
- Quitting smoking.
- Eating foods low in saturated fats and calories
- Maintaining your ideal body weight
- Exercising and walking regularly.
At St. Joseph's Heart & Vascular Institute, we offer a number of preventative health programs and tools for our patients.