According to the Centers for Disease Control and Prevention, "Approximately 6.5 million people age 40 and older in the United States have peripheral artery disease PAD," a condition that narrows arteries that carries blood to different areas of the body. If left untreated, PAD can cause stroke, changes in skin color and "total loss of circulation to the legs and feet can cause gangrene and the loss of a limb," the American Heart Association states. Knowing the signs can be life-saving and Eat This, Not That! Health spoke with experts who share seven things to know about the disease.
PAD Can Often Go Undiagnosed
Eric Stahl, MD Non-Invasive Cardiologist at Staten Island University Hospital tells us, "PAD often goes undiagnosed because symptoms can be vague. It is important to follow up regularly with a clinician for evaluation. Diagnosis typically starts with an ankle-brachial index (ABI), which compares blood pressure measurement in the lower legs to arms. If abnormal, more tests may be needed to further characterize the degree of narrowing."
PAD is Common
Dr. Ian Del Conde-Pozzi, cardiologist and vascular medicine specialist at Baptist Health's Miami Cardiac & Vascular Institute says, "Peripheral arterial disease is very common throughout the world, especially as people age and in those with a history of diabetes or who have smoked. Leading a healthy lifestyle, such as the American Heart Association simple 7, is a good way to help prevent PAD."
What Causes PAD
Del Conde Pozzi explains, "PAD is caused by blockages in the arteries that supply blood to the legs. Those blockages are made up of cholesterol deposits, similar to those that cause heart attacks. Prevention of PAD is therefore the same for prevention of heart attacks."
Dr. Todd Villines, world-renowned clinical cardiologist and Chief Medical Officer of Elucid says, "We know that the primary cause of PAD is atherosclerosis, or the buildup of plaque in the arteries. According to the Cardiovascular Coalition, "This occurs when arterial inflammation, cholesterol, calcium and scar tissue build up, forming plaque that clogs the arteries and slows blood flow to the legs. The more plaque that builds up on the inside walls of the blood vessels carrying blood from the heart to legs and arms, the more the arteries lose flexibility and narrow, putting patients at greater risk."
Risk Factors
Dr. Stahl says, "The prevalence of PAD increases with age. Other risk factors that contribute to PAD include cigarette smoking, diabetes, high blood pressure, and high cholesterol. Smokers are three times more likely to develop PAD compared to non-smokers. Those with diabetes have nearly twice the chance of developing PAD compared to those without diabetes."
You Can Experience Leg Symptoms
Dr. Stahl shares, "PAD most commonly affects the lower extremities. Patients with PAD typically experience fatigue, pain, cramping, or discomfort in their legs, particularly when walking or exercising."
According to Del Conde Pozzi, "More advanced PAD usually manifests itself with leg symptoms. Most patients with significant PAD have leg symptoms when walking, such as leg tiredness or aching. Leg pain, as such, is less common. If you experience leg symptoms when walking, you should be checked for PAD."
Check Your Ankle Pulse
Del Conde Pozzi shares, "Significant PAD can often be ruled out with a careful, yet simple, physical exam. If you have strong pulses at the ankles, it is unlikely that you have significant PAD. It is important that you know this to make sure that your doctor checks your pulses."
Treatment for PAD
Del Conde Pozzi states, "The treatment for PAD has evolved significantly over the past 2 decades. In addition to medications that prevent the progression of PAD, patients can now be treated with minimally invasive catheter-based techniques that produce excellent results."
Dr. Stahl adds, "Smoking cessation and effective diabetes management are most essential for the prevention and treatment of PAD. Additionally, a heart healthy diet, such as the Mediterranean diet, and regular physical activity slow the progression of atherosclerosis and the development of PAD. Finally, if lifestyle modifications are insufficient, medications targeted at lowering cholesterol and blood pressure in combination with anti platelet agents are available."
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