During American Heart Month each February, heart attack and stroke prevention rightly take center stage because cardiovascular disease is the nation’s leading cause of death for men and women. However, another circulatory problem affects one in twenty Americans over 50, yet most have never heard of it: peripheral artery disease.
Some people blame aging for muscle cramps in the legs when walking, climbing stairs or exercising. Most likely, the cause is peripheral artery disease (PAD), a common circulatory problem in which narrowed arteries reduce blood flow to the limbs.
Untreated, PAD can lead to increased pain in the leg, and with an injury or infection of the foot or leg, this can cause a progression to gangrene. Another reason why PAD is significant is that it may indicate more widespread accumulation of fatty deposits in your arteries (atherosclerosis), which may be associated with reduced blood flow to your heart or brain. So, ignoring PAD may be associated with increased risk of heart attack and stroke.
The most common symptom of PAD is leg pain after activity, which may range from mild to extreme, and it usually disappears after a few minutes of rest. Other symptoms of PAD include: leg numbness or weakness, foot wounds that are difficult to heal, coldness in one lower leg or foot compared to the other leg, or a different appearance from one leg to the other.
If you have these symptoms, make an appointment to see your physician for a quick, inexpensive test. Your physician will compare the blood pressure in your ankle with the blood pressure in your arm. If this suggests that blood circulation in your leg is restricted, an ultrasound or angiography may be done to help evaluate blood flow through your vessels.
Many people with PAD don’t experience symptoms, however. Ask your physician about a PAD screening if you are:
• Over age 70,
• Over age 50 and have a history of diabetes or smoking,
• Under age 50 but have diabetes and other risk factors, which include obesity, smoking, high blood pressure, high cholesterol, or a strong family history of heart disease.
Lifestyle changes are the first choice of treatment for PAD. Most importantly, stop smoking, which will improve blood circulation throughout your body. Eat a healthy diet, and maintain a healthy weight. Control your blood pressure, cholesterol, and blood sugar levels. Take good care of your feet. Your physician will probably recommend an exercise plan that gradually increases the amount of walking you can do.
Some people with PAD might require medication to ease symptoms or to reduce the risk of forming blood clots. For a small group of patients, minimally invasive surgery might be needed to restore blood flow.
The first goal of PAD treatment is to manage leg pain so you can resume physical activities and have a better quality of life. The second objective is equally important: to stop the progression of atherosclerosis throughout your body to reduce your risk of heart attack, stroke or amputation. Early treatment of PAD can restore your mobility, reduce your risk of heart disease, and possibly save your life.
Michael Wood, MD, FACS, FACC, FACCP, is an award-winning cardiothoracic and vascular surgeon with twenty years’ experience performing coronary bypass surgeries, heart valve repair and replacement, complex aortic aneurysm repair, endoscopic surgery, vascular surgery, thoracic surgery and thorascopic surgery. Prior to joining Huguley Medical Associates, Dr. Wood was an assistant professor of surgery at Loma Linda University School of Medicine in Loma Linda, California and an attending cardiothoracic surgeon at two hospitals in southern California. For appointments or more information, he may be reached at 817-293-5547.