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September was peripheral artery disease (PAD) awareness month, but it’s never too late to talk about this often silent, but serious condition. Nearly 6.5 million people in the United States forty and older have PAD, which causes reduced blood flow to the arteries in the legs. Because many people who have the disease don’t experience symptoms, it’s important to understand how it develops so you can manage any potential risks and know when to seek treatment.
What is PAD?
Peripheral artery disease is a chronic condition caused by atherosclerosis, which occurs when a buildup of fatty deposits lead to narrowed or hardened blood vessels. Blood vessels (arteries) carry blood to your organs and limbs, so atherosclerosis can severely limit or block blood flow. Although gradual, this process can result in serious complications, such as stroke, limb loss, or heart attack.
When atherosclerosis develops in the legs, it’s typically called peripheral artery disease (PAD) or peripheral vascular disease (PVD). Because many people with the disease don’t have symptoms, it can sometimes go undetected. For others who do experience symptoms, leg pain and chronic wounds can begin to negatively impact an individual’s mobility and quality of life.
Who is at risk of developing PAD?
Atherosclerosis and peripheral artery disease are caused by smoking and other chronic medical conditions that affect the blood vessels, such as:
- Elevated cholesterol
- High blood pressure
- Diabetes
In addition, your risk increases with age. While less than five percent of men and women have the condition at age 50, nearly 20 percent of men and women in their 80s have PAD.
What are the signs of PAD?
Many people with PAD don’t experience symptoms. However, others may experience disabling cramping or pain in the leg muscles when walking or climbing stairs. This pain is called claudication, and it’s reproducible, meaning the pain occurs after walking the same distance and goes away with rest.
More advanced cases of PAD may also lead to pain in the feet or toes while resting, especially if the legs are elevated. In addition, an open wound or ulcer on the foot that won’t heal can be a sign of PAD, warranting immediate medical attention.
Diagnosing and treating PAD.
The most common way we detect signs of peripheral artery disease is through a physical exam conducted in your physician’s office. There are several things that can increase our suspicions for limited blood flow, such as a decreased pulse in the lower extremities, a lack of hair growth on the legs, or cold feet.
Your doctor may also perform additional, non-invasive tests to gather more information. These may include:
- Ankle brachial index (ABI), which uses a blood pressure cuff to measure and compare the blood pressure in your foot and arm
- Arterial duplex (ultrasound), an imaging test that uses soundwaves to identify if and where blood flow may be restricted
Just because you have poor blood flow doesn’t mean we need to immediately begin medical or surgical interventions. That’s why it’s important to seek care from a specialist who is familiar with the disease process and the specifics of your unique condition.
How is PAD treated?
Although there is no cure for PAD, there are several ways we can treat PAD symptoms and slow down its progression. However, it’s not a one-size-fits all approach for everyone. Your treatment should be tailored to manage your personal risk factors and may vary based on your age, disease severity, symptoms, and related health conditions.
Treatments may include one or more of the following:
Lifestyle modifications
For many people with PAD, healthy lifestyle changes alone can be an effective way to eliminate symptoms and prevent the disease from worsening. This includes prioritizing a healthy diet, supervised exercise therapy (SET), and quitting smoking. In fact, even decreasing the amount of cigarettes you smoke can make a significant difference. All of these habits can contribute to a healthier heart and improved blood flow, thereby improving your symptoms. Our specialists offer a variety of services to help you manage and monitor your progress, so you won’t have to do it alone.
Medications
Some patients benefit from medications that help to control other chronic conditions, such as blood pressure, elevated cholesterol, and diabetes.
Surgery
For severe cases of PAD where blood vessels are significantly restricted, we may perform a surgical procedure to restore blood flow. Surgical options range from minimally invasive procedures that involve placing a balloon and/or stent to open up the blockage to bypass surgery that requires your surgeon to use your own vein or a prosthetic graft to reroute blood flow.
Your partner in risk management for PAD.
If you’re at risk of developing PAD, talk to your doctor about how to manage your risk factors and whether or not you may benefit from being screened. And if you have symptoms, seek care right away from a specialist. At MedStar Health, we work with a multidisciplinary team of experts in different fields to personalize care for patients with PAD and other arterial diseases. This ensures we can provide treatment that will most effectively address your symptoms using the most advanced techniques available so you can live a healthier, longer life.
