Understanding Peripheral Arterial Disease (PAD)
Peripheral artery disease (PAD) is a circulatory condition in which the arteries that carry blood to the arms and legs become narrowed or blocked.
What You Should Know:
PAD is a common condition, affecting about 20% of people over the age of 65. It is often underdiagnosed and is more common in men than women and in people with other risk factors for heart disease. The condition results when arteries in the arms and legs become narrowed or blocked, reducing blood flow to the extremities. The most common symptoms of PAD include numbness, weakness, or pain. When walking or exercising, PAD sufferers may experience muscle pain or cramping in the hips, thighs, or calves. Symptoms are typically relieved by rest. Without treatment, PAD can progress and lead to severe cardiovascular complications.
Could PAD be Affecting Your Legs?
Take Our Free Online Assessment to Find Out
Peripheral artery disease can lead to leg pain and walking problems. If you are experiencing symptoms such as leg pain or weakness along with shortness of breath or chest pain, you could be at risk for PAD. Our easy-to-use online self-assessment tool helps determine if you are at risk for PAD and if you should schedule an ankle-brachial index (ABI) screening. An ABI screening is simple, non-invasive, and can provide important information about the presence and severity of PAD.
Causes & Risk Factors
of Peripheral Arterial Disease
The most common cause of peripheral arterial disease (PAD) is atherosclerosis, a process in which fatty deposits accumulate on the inner walls of arteries, forming plaques. Over time, these plaques can narrow and harden the arteries, restricting blood flow. Other causes and risk factors may include:
Smoking damages the lining of the arteries, making them more likely to develop plaque.
Diabetes can damage the blood vessels, making them more likely to develop plaque.
- High blood pressure
High blood pressure can damage the walls of the arteries, making them more likely to develop plaque.
- High cholesterol
High cholesterol can contribute to the buildup of plaque in the arteries.
Obesity can increase the strain on blood vessels and promote atherosclerosis.
As people age, the risk of developing PAD increases due to the gradual accumulation of plaque.
- Family history
Genetics play a role, and individuals with a family history of PAD are more prone to developing the condition.
Peripheral Arterial Disease
The symptoms of PAD can vary depending on the severity of the narrowing or blockage. Some people with PAD may have no symptoms at all. Others may experience pain, numbness, or weakness in the arms or legs, especially when they exercise. They may also have cold feet or hands. In severe cases, PAD can lead to ulcers, gangrene, and even amputation. Early detection and management are crucial to prevent complications and improve overall cardiovascular health.
- Leg pain or cramping during physical activity
- Numbness or weakness
- Coolness and discoloration
- Slow-healing wounds
- Erectile dysfunction
Testing & Diagnosis
Early detection and accurate diagnosis of Peripheral Arterial Disease (PAD) are essential for effective management and prevention of complications. The type of testing used to diagnose PAD will vary depending on the individual's symptoms and medical history. Sometimes, a combination of tests may be used to get a complete picture of the patient's condition. There are several tests that can be used to diagnose and evaluate PAD.
- Ankle-brachial index (ABI)
This test is typically the first test ordered to evaluate for PAD and the most important for establishing a diagnosis. The ABI compares the blood pressure in the ankle to the blood pressure in the arm. A healthy ABI is 0.9 or higher. An ABI of less than 0.9 may indicate PAD.
- Doppler ultrasound
This test uses sound waves to create images of the arteries. Doppler ultrasound can measure blood flow in the arteries and identify areas of narrowing or blockage.
- Computed tomography angiography (CTA)
This test uses X-rays to create detailed images of the arteries. CTA can be used to identify areas of narrowing or blockage and assess the severity of PAD.
- Magnetic resonance angiography (MRA)
This test uses magnets and radio waves to create detailed images of the arteries. MRA is an excellent alternative to CTA for people who cannot have X-rays.
- Invasive Angiography
This test involves placing a small catheter into an artery in the body and then injecting dye into the artery while using a large X-ray machine to obtain images of the artery. Angiography is the most invasive test for diagnosing PAD, but it can provide the most detailed images of the arteries.
Treatment Planning for
Peripheral Arterial Disease
Peripheral Arterial Disease (PAD) is a serious condition that is often treatable. With early diagnosis and treatment, people with PAD can live long and active lives. Once PAD is diagnosed, the doctor will work with the patient to develop a treatment plan. Treatment options for PAD include exercise, smoking cessation, other lifestyle changes, medications, and surgery.
Exercise is the initial treatment of choice for patients with claudication. Exercise is ideally performed under medical supervision (called “supervised exercise therapy”), but unsupervised exercise programs in which a patient follows an exercise prescription from a doctor are also highly effective. Exercise helps reduce symptoms, improve quality of life, delay disease progression, and improve overall health and well-being.
- Smoking cessation:
Smoking is one of the most significant causes of PAD. Smoking cessation is a cornerstone of PAD treatment for patients who have PAD and smoke.
- Treating Diabetes:
Diabetes is another major cause of PAD. In patients with PAD who also have diabetes, it is critical to the effective treatment of PAD.
- Other Lifestyle changes
Healthy lifestyle changes are crucial in managing PAD and improving overall cardiovascular health. In addition to recommendations regarding exercise and smoking cessation, your doctor may recommend a healthy diet, weight management, and blood pressure and cholesterol control.
Various medications may be prescribed to manage symptoms and underlying risk factors. These may include Aspirin, Statins, Cilostazol, and Vasodilators.
- Skin Care
Patients with PAD are at increased risk for skin breakdown and skin infections and may have trouble with healing when they have cuts. Your doctor may, therefore, recommend measures to help take care of your skin to reduce the risk of developing cuts, open wounds, and skin infections.
Angioplasty involves inserting a balloon into a narrowed or blocked artery and then inflating the balloon to widen the artery.
- Stent placement
A stent is a small mesh tube that can be inserted into a narrowed or blocked artery to keep it open.
- Bypass surgery
Bypass surgery involves creating a new pathway for blood to flow around a narrowed or blocked artery.