September has been designated Peripheral Artery Disease (PAD) Awareness Month — do you know your artery health? It’s not a trivial question, as more than eight million Americans aged 40 years and older have this circulatory system disease, sometimes also known as peripheral arterial disease.
With PAD, the arteries carrying oxygenated blood to the body’s tissues become narrowed, decreasing blood flow to the extremities and starving the tissues and organs. The most common cause is atherosclerosis, where a sticky plaque made up of fat, cholesterol, protein, calcium, and cellular debris builds up on the vessels’ walls, though it may occur as a result of an injury that causes chronic blood vessel inflammation.
Heart Vascular & Leg Center, located in Bakersfield, California, specializes in treating vascular disease. Our expert team of vascular, radiological, and wound care specialists know that peripheral artery disease, left untreated, can lead to serious complications, including lower limb amputation. That’s why they stress awareness of vascular health and urge patients at risk to seek medical help to prevent problems before they happen. Here’s why you should know the health of your arteries.
PAD risk factors
The risk factors for peripheral artery disease are very similar to those for coronary (heart) artery disease since both conditions result from plaque buildup. They include:
- Getting older (especially after 65)
- Being overweight or obese (a BMI more than 30)
- Having high cholesterol and/or high blood pressure
- Smoking or using other tobacco products
- Having diabetes
- Having a family history
- Having chronic kidney disease
People who smoke and/or have diabetes run the greatest risk of developing PAD since both lead to reduced arterial blood flow.
Some people with PAD have no overt symptoms, making regular appointments with your vascular specialist crucial to catching the disease in its early stages when it’s more easily treated. Some people have characteristic leg pain when walking, called claudication in this instance; it can vary from mildly annoying to so debilitating you can’t walk.
Other signs and symptoms include:
- Leg cramps
- Leg weakness and/or numbness
- Cold skin on the lower leg or foot
- Ulcerated skin on legs or feet
- Reddish skin color (venous stasis dermatitis)
- Weak or lack of pulse in lower extremities
Individuals whose PAD results from atherosclerosis risk serious complications, including:
- Critical limb ischemia: open sores on feet or legs that don't heal, along with potential infection; can lead to tissue death and the possible need for amputation
- Stroke and heart attack: fatty deposits in arteries supplying blood to the brain and heart (e.g., carotid) can block flow and deprive organs of oxygen
Limb pain associated with PAD is also a serious complication, especially for diabetics. Studies indicate 11% of diabetics who don’t treat their PAD develop gangrene in their lower limbs, with 22% of those needing an amputation within one year.
PAD diagnosis and treatment
To determine if you have PAD, your Heart Vascular & Leg Center doctor takes a complete medical history, including making note of your risk factors. He next performs a physical exam, listening through a stethoscope for signs of poor blood flow, measuring your pulse at various points, and noting any ulcers or color changes on your legs and feet.
Then, he uses on-site diagnostic testing to confirm or eliminate a PAD diagnosis. Tests include measuring the ankle-brachial index (ABI), a quick, painless, non-invasive procedure that compares the blood pressure in your ankle to that in your arm; taking an ultrasound of your blood vessels to view structural changes; or performing an angiography (an X-ray with a special dye) to determine how blood is flowing through your peripheral arteries. The office also offers a CO2 (carbon dioxide) angiography for kidney disease patients who can’t receive the traditional dye.
Peripheral artery disease treatment has two primary goals:
- Manage pain and other symptoms so you can resume physical activities
- Stop the progression of atherosclerosis, with lifestyle changes, medication, or angioplasty to remove blockages
We encourage our patients to try to meet these goals first with lifestyle changes, especially in the early stages of PAD. The most important thing to do to reduce complications, if you smoke, is to quit. In addition, a low-fat diet and a regular, supervised exercise program can improve your symptoms dramatically. If lifestyle changes aren’t enough, we explore other options.
If you have any of the risk factors for PAD but haven’t yet seen a vascular specialist, September is a great time to do so. Give Heart Vascular & Leg Center a call at 661-230-9659 to set up a consultation with one of our physicians, or book online with us today.