Peripheral Arterial Disease -- Are You at Risk?

By Alan T. Hirsch, M.D.

When people hear the term "blocked artery," they often assume doctors are referring to a vessel near the heart. But, the same fat and plaque that obstructs arteries surrounding the heart can block the channels supplying blood to the arms and legs. This can result in a serious condition known as Peripheral Arterial Disease (PAD), which afflicts more than 8 million Americans.

PAD restricts blood flow to the limbs, but primarily affects the legs. It can cause leg muscle fatigue, cramping, and pain during walking and exercise. Other symptoms include leg numbness, cold legs and feet, and a change in the color of your legs. This discomfort is sometimes thought to be a sign of aging and written off as unimportant, but individuals with PAD have a serious disease that increases their risk of heart attack and stroke and can lead to amputation or death.

PAD may also be present in people who do not experience typical symptoms. In either case, if patients are not aware of the seriousness of the disease, they may not ask their doctor what can be done to prevent and treat the condition.

The best way to fight PAD is through awareness and early detection. You are at increased risk for PAD if you: are over 50; have diabetes; smoke or have ever smoked; have high cholesterol or blood pressure; or are African-American. These individuals should ask their doctor for a simple blood pressure test called the ankle-brachial index (ABI) to determine if they have clogged arteries to their legs.

There are effective treatment options for PAD that can lower the risk of heart attack and stroke, improve leg discomfort and prevent amputation. A healthy diet, exercise and medications to lower cholesterol levels and improve blood pressure and blood sugar numbers are often effective. Stopping smoking is essential for controlling symptoms and helping prolong life. For some individuals, leg artery angioplasty, a procedure that unclogs and repairs arteries, or leg bypass surgery can improve symptoms and prevent amputation.

While current care is helping millions of Americans with PAD, researchers from the University of Minnesota are searching for new and innovative treatments for the disease. Research performed at the University shows that PAD patients who jog on treadmills and perform arm exercises can significantly relieve leg symptoms and increase their walking distance. An expanding series of clinical trials are now investigating if human genes or stem cells can be useful in growing new leg arteries in people with severe PAD. University researchers are leading other studies that examine the relative value of exercise programs, stents and medications, or a combination of these treatments. Other researchers are evaluating how walking helps people with PAD and diabetes, or how PAD patients can quit smoking.

As the American population grows older, it is imperative that individuals who are at risk for PAD ask to be evaluated by their physician. With increased awareness, early diagnosis and treatment, both quality and length of life can be improved.

For more information on PAD, visit www.aboutpad.org or www.padcoalition.org.

Alan T. Hirsch, M.D., is a professor in the Division of Epidemiology and Community Health at the University of Minnesota School of Public Health and the chair of the Peripheral Arterial Disease Coalition.

This column is an educational service of the University of Minnesota. Advice presented should not take the place of an examination by a health-care professional. For more health-related information, go to http://www.healthtalk.umn.edu.