By Anne Wick
Peripheral artery disease, or PAD, is a circulation disorder caused by narrowing of the arteries in the feet and legs. It is associated with leg numbness, weakness or pain during activity and can cause significant disability.
When PAD is present, cardiovascular disease may be affecting the entire body, including the heart, brain or other major organs. It is also a major risk factor for lower extremity amputation.
People with PAD are six times more likely to experience a heart attack or stroke than others. Awareness and early identification of PAD can reduce the risk of a harmful or fatal cardiovascular event.
PAD is common. In fact, an estimated 12 million adults in the United States are living with it, including 20 percent of men and women over age 65. It is also a very expensive disease, with more than $21 million a year spent on PAD-related hospitalizations.
PAD can be detrimental to your quality of life. Impaired circulation in your legs and feet can cause discomfort and mobility problems, and severe PAD may lead to death.
Early diagnosis and treatment of PAD helps prevent disability, can slow or stop the progression of the disease, and can help you maintain your quality of life. It also lowers the risk of heart disease, heart attack and stroke.
Facts about PAD
PAD is commonly caused by atherosclerosis – hardening and narrowing of the blood vessels due to plaque buildup that obstructs blood flow and can cause clots. Plaque is made up of fat, cholesterol, calcium and other substances found in the blood.
Several factors increase the risk for developing PAD. Diabetes and smoking are the strongest risk factors. Other risks include hypertension, high cholesterol, kidney disease and a personal or family history of stroke, heart attack or vascular disease. Obesity, a sedentary lifestyle and age also increase the chances of developing PAD.
The signs and symptoms of PAD may be mistaken for aging, and some patients experience no symptoms, making early identification of the disease difficult. The most common symptom is pain or cramping in the feet, calves, thighs or buttocks that occurs with activity. Pain usually subsides with rest.
Signs of more advanced disease include:
Cramping pain that does not go away with rest
A noticeable decrease in the temperature of your foot or lower leg compared with the rest of your body
Toe or foot wounds that won’t heal or heal very slowly
Thin, shiny skin on your legs or feet
The absence of hair on the legs
Poor toenail growth
Bluish or pale feet or toes
If you experience any of the signs or symptoms of PAD and have one of the risk factors, ask your health care provider to evaluate you for vascular disease.
What to expect
During a vascular assessment, your health care provider will ask you about pain, sores and wounds, and examine your legs, feet and ankles. It may be helpful to have a blood pressure test called an ankle brachial index to evaluate your circulation. The test is non-invasive, inexpensive and very reliable.
You also may be asked to walk on a treadmill and have your blood pressure taken. If you are diagnosed with severe PAD, you may need additional tests such as a CT or MRI to evaluate your blood vessels more closely.
Treatments for PAD vary depending on the severity of the disease. Lifestyle modification is important to reduce your risk for disease progression and serious cardiovascular complications. Quitting smoking is the most important thing you can do for your health. A healthy diet and exercise are also critical.
Your provider may recommend a walking or a supervised exercise program to help alleviate your PAD symptoms. You may also be referred to a dietitian for weight loss assistance.
In addition, your provider may prescribe medication to help with pain or improve blood flow and circulation. If your PAD is severe, you may need a procedure to open up your blood vessels.
It’s important to follow up regularly with your provider for careful management of your blood pressure, cholesterol and blood sugar.
You may not know that you are at risk for heart and vascular disease. It’s important to talk to your primary care provider if you experience leg pain or cramping; discomfort or heaviness in the chest, jaw or arm; shortness of breath; dizziness; nausea; or similar symptoms.
Anne Wick is the vascular program coordinator and nurse practitioner at the UW Health Heart & Vascular Center at ProHealth Care in Waukesha. She performs examinations and works with specialists to provide services to heart and vascular patients. Visit ProHealthCare.org/Heart to learn more.
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For more than a century, ProHealth Care has been the health care leader in Waukesha County and surrounding areas, providing outstanding care across a full spectrum of services. The people of ProHealth Care strive to continuously improve the health and well-being of the community by combining skill, compassion and innovation. The ProHealth family includes ProHealth Waukesha Memorial Hospital, ProHealth Oconomowoc Memorial Hospital, ProHealth Rehabilitation Hospital of Wisconsin, ProHealth Medical Group, the UW Cancer Center at ProHealth Care, Moreland Surgery Center, ProHealth AngelsGrace Hospice, ProHealth Home Care, ProHealth West Wood Health & Fitness Center and ProHealth Regency Senior Communities. Learn more at ProHealthCare.org.