Peripheral artery disease: Symptoms, treatments, and causes (original) (raw)

Peripheral artery disease (PAD) is a disease of the blood vessels outside the heart and brain. PAD often occurs due to a buildup of fatty deposits in the arteries.

PAD is also known as peripheral arterial disease or peripheral vascular disease (which includes both arteries and veins). PAD affects the blood vessels causing them to narrow, therefore restricting the blood flow to the arms, kidneys, stomach, and most commonly, the legs.

Peripheral artery disease is a major risk factor for heart attack and stroke.

Although the condition can have serious consequences, physical activity can substantially improve symptoms.

This article discusses the symptoms of PAD, what causes it, and how to treat it.

PAD affects more than 8 million people over the age of 40 in the United States, according to the National Heart, Lung, and Blood Institute (NHLBI).

The Centers for Disease Control and Prevention (CDC) notes that up to 4 in 10 people with PAD do not experience leg pain or other symptoms. For those who do experience symptoms, they may include:

• hair loss or decreased hair growth on the legs
• decreased toenail growth
• claudication, the thigh, calf muscles, or hips may feel pain when walking or climbing stairs
• numbness or weakness in the legs
• one foot may feel colder than the other
• sores or ulcers on the legs and feet that heal slowly or do not heal at all
• skin on the legs becomes shiny or turns pale or bluish
• difficulty in finding a pulse in the leg or foot.
• erectile dysfunction

The most common cause of PAD is atherosclerosis. Atherosclerosis is a gradual process in which fatty material builds up inside the arteries.

Less common causes of peripheral artery disease are blood clots in the arteries, injury to the limbs, and unusual anatomy of the muscles and ligaments.

Risk factors that contribute to PAD include:

• diabetes
• smoking
• obesity
• high blood pressure
• increasing age, most people in the U.S. with PAD are 65 or older
• high cholesterol
• family history of heart disease

There are several ways healthcare professionals can diagnose PAD. This may begin with the healthcare professional examining the individual’s legs.

They may also order certain tests to verify the diagnosis.

• Ankle-brachial index: the most common test for PAD, it compares the blood pressure in the ankle with the blood pressure in the arm
• Blood tests: to check levels of cholesterol
• Doppler and ultrasound (Duplex) imaging: a noninvasive method that visualizes the artery with sound waves and measures the blood flow in an artery to indicate the presence of a blockage
• CT Scans: another noninvasive test that images the arteries of the abdomen, pelvis, and legs. This test is particularly useful in people with pacemakers or stents.
• Magnetic Resonance Angiography (MRA): similar information to that is generated by a CT scan, but without the need for X-rays
• Angiography: a contrast agent injected into the arteries helps to show the blood vessels during X-rays

Undiagnosed or untreated PAD can be dangerous. It can lead to painful symptoms, loss of a leg, increased risk of coronary artery disease, and carotid atherosclerosis (a narrowing of the arteries that supply blood to the brain).

Because people with PAD have an increased risk of heart attack and stroke, the American Heart Association (AHA) encourages people at risk to discuss PAD with their healthcare professional to ensure early diagnosis and treatment.

Treatment for PAD generally involves lifestyle changes and possibly medications or surgery.

Exercise

Regular physical activity and specific exercises are often the first-line treatment for PAD. These exercise programs are generally supervised by a healthcare professional and include bouts of walking followed by rest.

Diet changes and adjustments

Many individuals with PAD have elevated cholesterol levels. A diet low in saturated fat, trans fat, and cholesterol, as well as plenty of fruit and vegetables, can help lower blood cholesterol levels. The NHBLI recommends the DASH eating plan to help people improve heart health through their diet.

Smoking cessation

Tobacco smoke greatly increases the risk of PAD, heart attack, and stroke, according to the AHA. Stopping smoking can help to slow the progression of PAD and other heart-related diseases.

Medications

A healthcare professional may prescribe medications to help manage various aspects of PAD. These may include:

• antiplatelet medications, such as aspirin or clopidogrel, to help prevent blood clots
• medications to lower cholesterol, such as statins
• high blood pressure medications, such as angiotensin-converting enzyme (ACE) inhibitors or angiotensin-receptor blockers
• anti-coagulants, such as warfarin or rivaroxaban

Surgery

If other treatments are not effective, a healthcare professional may recommend surgical options to treat PAD.

Angioplasty can help to unblock arteries or open narrowed arteries.

In order to heal wounds, treat severe pain, save a damaged leg or foot, or if angioplasty is not likely to work, a doctor may use bypass surgery instead.

The following are answers to some questions people frequently ask about peripheral artery disease.

What is the life expectancy of someone with peripheral artery disease?

Research from 2017 found the 5-year survival rate of peripheral artery disease (PAD) to be 79.2%, and the 10-year survival rate to be 60.5%.

Predictors of the life expectancy of people with PAD included age, diabetes, and the presence of chronic kidney disease (CKD).

What is considered the first symptom of peripheral arterial disease?

According to the CDC, the most classic symptom of PAD is pain in the legs during physical activity. The pain generally gets better with rest. However, they also note that up to 4 in 10 people with PAD do not experience leg pain.

What is the best treatment for peripheral artery disease?

The first-line treatment for all people with PAD is generally some type of exercise program. This is often supervised by a healthcare professional and involves bouts of walking followed by rest.

PAD is a condition that affects the blood vessels outside the heart and brain. It involves restricted blood flow to the legs, arms, and organs, like the kidneys.

If left untreated, PAD can lead to the loss of a limb and an increased risk of coronary artery disease.

PAD can be treated with lifestyle changes, such as exercise, diet, and smoking cessation.