Peripheral Arterial Disease (PAD) is also known as atherosclerosis, poor circulation, or hardening of the arteries. PAD occurs when the arteries that carry blood from the heart to the head, organs, and limbs become clogged with a substance called plaque.
Over time, plaque can harden and narrow the arteries,causing blood clots to form. These blood clots can block arteries, causing pain, numbness, inflammation, and even permanent tissue damage. If severe enough, blocked blood flow can cause tissue death (also called gangrene.) In very serious cases, this can lead to leg amputation.
Progression of PAD
PAD progresses over time at variable rates in each individual depending on the area of circulation effected and one's health and family history. The signs and symptoms of PAD may not arise until later in life. For many, the outward indications will not appear until the artery has narrowed by 60 percent or more.
One method the body uses to adapt to the narrowed arteries is the development of smaller peripheral arteries that allow blood flow around the narrowed area. This process is known as collateral circulation and may help explain why many can have PAD without feeling any symptoms. When a piece of cholesterol, calcium or blood clot abruptly breaks from the lining of the artery or a narrowed artery blocks off completely, blood flow will be totally obstructed and the organ supplied by that artery will suffer damage. The organs in PAD most commonly affected and researched are the legs.
Symptoms of Peripheral Arterial Disease
For many, the first noticeable symptom of PAD is a painful cramping of leg muscles during walking called intermittent claudication. When a person rests, the cramping goes away. This leg pain can be severe enough to deter a person from normal walking. Some individuals will not feel cramping or pain but might feel a numbness, weakness or heaviness in the muscles.
In patients whose PAD is more severe, insufficient blood flow to the feet and legs may cause a burning/aching pain in the feet and toes while resting. The pain will occur particularly at night while lying flat.
Other symptoms include:
- Cooling of skin in specific areas of legs or feet
- Color changes in the skin and loss of hair
- Toe and foot sores that do not heal
Many people are affected by PAD yet they do not have symptoms. These individuals are at a high risk for suffering an early heart attack or stroke. Research has proven that the life expectancy for a person with PAD is greatly reduced. For example, the risk of dying from heart disease is six times higher for those with PAD compared to those without. Therefore, it is important to discuss the possibility of PAD with a health care professional if someone has several of the risk factors for PAD.
Treatment for Peripheral Arterial Disease (PAD)
Millions of people are affected by peripheral artery diseases. Many face severe health issues, such as not being able to walk without pain or even losing a leg.
PAD is a disease that increasingly affects people as they age, particularly those with diabetes and those who have ever smoked. PAD is often ignored as many people think the pain or aching is related to aging or arthritis.
Although there is no "cure" for PAD there are many ways to prevent the progression of the disease. Good health practices, a healthy diet, exercise, and not smoking will slow the progression of PAD. Medications can often reduce its symptoms. Control of risk factors (such as cholesterol, blood pressure, diabetes) and use of "anti-platelet" medications can lessen the effect of the most severe consequences of PAD.
Work with your doctor
If you have any of these symptoms or more than one of the risk factors for PAD, talk with your doctor. Ask for an examination to test for PAD and to measure its severity. The most common test for PAD measures the blood pressure at your ankles, which is then compared to an arm blood pressure. This test is called the "ABI" or ankle-brachial index. Don't ignore leg pains. Leg pains are not just a part of growing older!
We know... everyone tells you this. But smoking is clearly the biggest risk you can have with PAD. Smoking is one of the most important causes of PAD.
One of the best things you can do is walk. Walking has lots of benefits, even if you can't walk very far.
Many new medications that can help manage PAD by preventing the formation of blood clots and that can help you walk further without pain.
Again, work with your doctor, who can help you enjoy a diet that will not only help PAD, but will also reduce your risk of heart attack, stroke, and progression of PAD. You should follow a diet that will control your cholesterol and, if you have diabetes, your blood sugar.
Take All Prescribed Medications
It is very important to keep your blood pressure, cholesterol, and if you have diabetes, blood sugar levels within normal ranges. Your blood pressure should be less than 120/80 mmHg. Your blood cholesterol should be lowered so that the LDL cholesterol is less than 100 mg/dl.
Surgery or Angioplasty
For patients whose walking distances are so short that they cannot perform their jobs or enjoy their lives, there are many safe and effective methods of treating blockages in the arteries supplying blood to the leg. Such methods include angioplasty and endovascular therapy.
Source: Vascular Disease Foundation (VDF); Mayo Clinic, https://www.mayoclinic.org/diseases-conditions/peripheral-artery-disease/symptoms-causes/syc-20350557