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What Is Peripheral Artery Disease?

Peripheral artery disease (PAD) affects at least 8 million Americans, many of whom have no symptoms and are unaware that they are affected.  In many cases, women with PAD have greater difficulty walking than similarly affected men.  PAD is characterized by leg pain or cramping while walking.  Some patients have a sense of heaviness in the calf muscles.  It is caused by narrowing of the leg arteries by fatty plaques which impair blood flow to the legs and feet.  PAD is also known as "intermittent claudication" because symptoms usually resolve with rest, then resume with continued walking.  When the blockages are severe, however, pain persists even at rest. 

PAD is more significant than the leg pain and cramping it causes.  Patients with PAD have a similarly increased risk of heart attack and stroke as those with blockages in their coronary arteries.   The two conditions have other similarities as well.  In most patients, symptoms begin after age 50 and become increasingly noticeable after age 65.   Patients with PAD are also likely to have atherosclerosis in other blood vessels as well.  Like atherosclerosis, PAD also significantly increases your risk of death.  Unlike atherosclerosis, PAD also carries a significantly increased risk of amputation.

The risk factors for PAD are also similar to those for heart disease:  smoking, diabetes, high cholesterol, high blood pressure and a family history of heart disease or PAD.  The diagnosis is suggested by history and symptoms, but confirmed by certain tests including a Doppler measurement of peripheral blood pressure called the ankle-brakial index (ABI) and a magnetic resonance angiography (MRA).  After making the appropriate lifestyle adjustments (stop smoking!), the best treatment for PAD is often exercise, especially a repetitive walking/resting program.  Medical treatment is also commonly prescribed.  If these fail, there are minimally invasive catheterization procedures including angioplasty and stents that may help.  Exciting research is focusing on angiogenic proteins or stem cell therapy to stimulate new blood vessel growth.

Created: 9/29/2003  -  Donnica Moore, M.D.

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