What You Need To Know About Peripheral Arterial Disease

What is Peripheral arterial disease/peripheral artery disease (PAD), or peripheral vascular disease (PVD)? In layman’s terms, this is a common condition where bodily arteries become narrow as a result of a build-up of fatty plaques (atherosclerosis) in the arteries.

The Different Causes for Peripheral Arterial Disease

Atherosclerosis is the condition wherein there is a build-up of fatty deposits called atheromatous plaques within the walls of major blood vessels, or what we call arteries. When this happens, and there is a gradual narrowing of their lumen diameters, blood flow and oxygen transport to tissue becomes limited and restricted over time. PAD is essentially caused by atherosclerosis of peripheral arteries. This oftentimes happens at major branch points.

As for atherosclerosis in the heart, this is a coronary artery disease. When this happens to a sufferer, the brain itself becomes affected. This is called cerebrovascular disease, oftentimes leading to stroke and vascular dementia. PAD refers to atherosclerosis of other parts of the body. The feet and legs can be affected by this.

It is estimated that PAD affects over 200 million people worldwide. It becomes even more prevalent with the older generation.

The Symptoms of Peripheral Arterial Disease

There will be no noticeable symptoms, especially for the majority of people suffering from PAD. It will be easy for them to mistakenly brush off what they feel during its earlier stages because the symptoms aren’t detectable. Over time, however, the affected areas, such as the legs, progressively worsens. The symptoms then become more apparent.

The most common symptom of PAD that becomes noticeable is known as intermittent claudication. This often comes with muscle pain or cramping when physical exertion is involved and the sufferer rests immediately. Moreover, the affected area may also have a lower temperature when compared to the rest of the body. A times, the patient may also notice some redness in that part of the body.

Other symptoms also include:

• Lack of growth of nails or hair in the affected area
• Pale or discolored skin
• Limb weakness and/or numbness
• Tingling sensation or what is otherwise called “pins and needles”
• Sores that do not heal fast also become more infected

When left untreated, PAD progressively worsens. If the patient refuses to get help, the condition leads to critical limb ischemia, or a  sudden drop in flow to the affected region. For others, gangrene, death or necrosis of tissue within that region, develops. This may be limited to the extremities such as toes, or to the larger areas of the leg. Sadly, tissue necrosis that is caused by critical limb ischemia cannot be cured. The affected area may even be required for amputation.

The Risk Factors for Peripheral Arterial Disease

Several habits could worsen or lead to PAD. Some of which are:

• Smoking – this is biggest risk factor. Smokers are ten times more likely to suffer from PAD
• Diabetes – diabetic patients have on average a two to four times fold increase
• High blood pressure – hypertension increases the risk by 2.5 to 4 percent more
• High blood cholesterol – dyslipidemia/hyperlipidemia increases the risk of atherosclerosis, which is the primary cause
• Sedentary lifestyle – lack of activity or exercise

There are also several other risk groups that have been identified such as:

• Family history of PAD or heart/cardiovascular diseases
• Certain ethnicities/ethnic origins such as African American individuals

The Treatment and Diagnosis for Peripheral Arterial Disease

First of all, examination and confirmatory testing must be made by a doctor. These tests include:

• Ankle-brachial index (ABI) test – this is used to compare the blood pressure in the affected region to the non-affected region (for instance, comparing the leg to the arm).
• Checking for weaker pulses in the area
• Listening to poor blood flow in the area
• Assessing the color of the affected region
• Examining area for sores and swelling
• Blood tests to assess blood cholesterol, fat and sugar levels

It is imperative that the patient seeks treatment before it progresses. Early intervention is key when it comes to minimizing the complications. Damaging consequences could altogether be avoided by becoming proactive.

What helps patients is to modify and lessen risk factors, adjust lifestyle habits, and seek treatments for atherosclerosis, diabetes, hypertension and dyslipidemia, and others.

The most common ways to minimize the risk is through the following:

• Quitting smoking.
• Increased physical activity and exercise such as doing something for 30 to 45 minutes, 3 or 4 times weekly. This needs  to be done consistently for at least 12 weeks to substantially improve claudication
• Making improvements in their diet to significantly reduce saturated fat/high cholesterol food intake. These combat hypercholesterolemia/obesity.
• Reducing high-salt and high-sugar foods to avoid hypertension and diabetes
• Managing hypercholesterolemia by taking statins to reduce cholesterol levels and antiplatelet drugs, such as aspirin, to reduce blood clot formation.

The others may even require surgery. Such intervention includes:

• Angioplasty – a surgery performed to open up narrow or blocked arteries through the insertion of an inflatable balloon to flatten the plaque. This is oftentimes followed by inserting a stent to minimize arterial narrowing in the long term.
• Bypass surgery – another functional blood vessel, or artificial vessel, is surgically placed to divert blood flow from the blocked artery to form a ‘bypass’ way around the blocked area.

The Summary

Peripheral arterial disease (or PAD) is the atherosclerosis (build-up of fatty plaques and narrowing of arteries) of peripheral arteries. This oftentimes happens in the different parts of the body. However, it is common to manifest itself in the leg.

Symptoms are usually visible in the latter stage. This is more oftentimes characterized by intermittent claudication, or what is otherwise known as pain upon physical exertion. Moreover, the affected area feels colder and has a lower pulse/blood pressure.

PAD needs to be addressed before necrosis (or tissue death) occurs. There is a variety of physical, pharmacological, and surgical interventions available for it. If nothing is done, the area can develop gangrene and may even require amputation.