All you need to know about peripheral artery disease

Peripheral artery disease (PAD) refers to blood vessel illnesses that occur outside of the heart and brain. A accumulation of fatty deposits in the arteries is the most common cause. Peripheral arterial disease (PAD) is also known as peripheral vascular disease (PVD) (which includes both arteries and veins).

PAD affects blood arteries, narrowing them and reducing blood flow to the arms, kidneys, stomach, and, most often, the legs.

Peripheral artery disease affects roughly 12-20 percent of Americans over the age of 60, impacting an estimated 8.5 million people in the United States.

A major risk factor for heart attack and stroke is peripheral artery disease. African-Americans are more likely than other racial groups to acquire PAD, and males are somewhat more likely than women to get PAD. Smokers are also more likely to develop peripheral vascular disease.

Physical exercise can significantly alleviate symptoms, despite the fact that the condition might have dangerous implications.

Causes 

peripheral artery disease
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Atherosclerosis is the most prevalent cause of PAD. Atherosclerosis is a condition in which fatty deposits build up inside the arteries over time.

Blood clots in the arteries, limb damage, and unique muscle and ligament structures are all less prevalent causes of peripheral artery disease.

Diabetes, smoking, obesity, high blood pressure, increasing age, high cholesterol, a family history of heart disease, and high levels of C-reactive protein or homocysteine are all risk factors for PAD.

Symptoms 

According to experts, around half of all people with PAD are unaware that they have it because many people have no symptoms. Symptoms to look out for include:

  • Sores or ulcers on the legs and feet that take a long time to heal (or never heal).
  • The skin on the legs becomes shiny or turns pale or bluish.
  • Difficulty in finding a pulse in the leg or foot.
  • Erectile dysfunction (impotence in men, problems achieving or sustaining an erection).
  • Intermittent claudication – the thigh or calf muscles may feel pain when walking or climbing stairs; some individuals complain of painful hips.
  • Leg weakness.
  • Hair loss on the feet and legs.
  • A foot or the lower leg may feel cold.
  • Numbness in the legs.
  • Brittle toenails.
  • Toenails grow slowly.

Diagnosis

PAD can be diagnosed in a variety of methods, but if the disease is suspected, the doctor will first examine the patient’s legs.

  • Ultrasound scan, angiography, and blood tests – may also be recommended to check levels of cholesterol, homocysteine, and C-reactive protein.
  • Computed tomographic angiography (CT) – another non-invasive test that images the arteries of a patient’s abdomen, pelvis, and legs. This test is particularly useful in patients with pacemakers or stents.
  • Magnetic Resonance Angiography (MRA) – gives similar information to that generated by a CT scan, but without the need for X-rays.
  • Ankle-brachial index – the most common test for PAD, it is a test that compares the blood pressure in the ankle with the blood pressure in the arm.
  • Angiography – Normally, this is only used in combination with vascular therapy treatments. An angiography is a procedure in which a contrast agent is injected into an artery and X-rays are obtained to show blood flow and highlight any obstructions.
  • Doppler and ultrasound (Duplex) imaging – a non-invasive method that visualizes the artery with sound waves and measures the blood flow in an artery to indicate the presence of a blockage.

PAD that goes undiagnosed or untreated can lead to painful symptoms, amputation of a limb, an increased risk of coronary artery disease, and carotid atherosclerosis (a narrowing of the arteries that supply blood to the brain).

Because people with PAD have a higher risk of heart attack and stroke, the American Heart Association recommends that people who are at risk talk to their doctor about it so that it may be diagnosed and treated early.

Treatment

The “2011 ACCF/AHA Focused Update of the Guideline for the Management of Patients With Peripheral Artery Disease (Updating the 2005 Guideline)” was created in collaboration with the American College of Cardiology Foundation and the American Heart Foundation (ACCF/AHA). The paper was published in the journal Circulation.

They suggest:

Regular physical activity – this is the most effective therapy, and a doctor will typically prescribe supervised exercise instruction. It’s possible that the patient will have to take things carefully at first. In just 4-8 weeks, simple walking regimens, leg exercises, and treadmill exercise programs can result in lessened symptoms.

Changes in diet and lifestyle — many people with PAD have high cholesterol levels. Lowering blood cholesterol levels can be achieved by eating a diet low in saturated fat, trans fat, and cholesterol, as well as lots of fruits and vegetables.

Quitting smoking – tobacco smoke raises the risk of PAD, heart attack, and stroke significantly. Smokers are four times as likely than nonsmokers to develop PAD. Stopping smoking can help PAD and other heart-related disorders progress more slowly.

Some medicines – to decrease cholesterol levels, the doctor may prescribe antihypertensive drugs and statins. Patients with intermittent claudication may benefit from clostazol and pentoxifylline.

Walking can be uncomfortable, therefore exercise for intermittent claudication must take that into mind. The exercise and relaxation periods are alternated throughout the program.

If the foregoing therapies are ineffective, the doctor may recommend angioplasty, which is the surgical unblocking or repair of a blood artery.

Prevention

PAD can be prevented or delayed by addressing the following risk factors:

  • Family history – inform your doctor if you or someone in your family has or has had peripheral artery disease.
  • Smoking – more than any other risk factor, smoking is linked to the development of heart disease. Regular smokers are four times as likely than nonsmokers to develop PAD. Consult a physician about programs and products that can assist you in quitting smoking.
  • Diet — stick to a low-fat, low-saturated-fat, low-trans-fat, low-cholesterol, and low-sodium diet. Fruits, vegetables, and low-fat dairy products should all be consumed in large quantities. Patients who are overweight or obese should work with a doctor to develop a sensible weight-loss strategy.

Conclusion

PAD raises the risk of heart attack and stroke, so it’s important to get it identified very away. Outlook is influenced by a variety of factors, however adopting the lifestyle recommendations above can considerably enhance your outlook.

Some cases of PAD can be treated with just a change in lifestyle and medicines.

Sources:

  • https://vascular.org/patient-resources/vascular-tests/duplex-ultrasound
  • https://www.nhlbi.nih.gov/files/docs/public/heart/pad_extfactsheet_aa_508.pdf
  • http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2733014/
  • https://www.medicalnewstoday.com/articles/188939
  • http://www.nhlbi.nih.gov/health/health-topics/topics/pad/diagnosis
  • http://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_pad.htm
  • http://content.onlinejacc.org/article.aspx?articleid=1146931
  • https://www.nhlbi.nih.gov/health/health-topics/topics/pad/causes