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.