Could you be at risk for peripheral artery disease?

Peripheral artery disease (PAD) is a common circulatory problem with hard-to-spot symptoms. Many people with PAD don't have symptoms or mistake their symptoms for something else. Up to 10% of the Americans have PAD, but 40% of those individuals experience no symptoms at all.

If left untreated, PAD can cause tissue damage or limb loss and increase your risk for a stroke or heart attack. That’s why it’s important to get checked if you’re at risk for PAD and notice any symptoms.

Know Your PAD Risk Factors

Brett Aplin, MD, a vascular surgeon with ProMedica Physicians Jobst Vascular, explains, “PAD is a condition that has a lot of risk factors. Medical conditions like diabetes, high blood pressure and high cholesterol can cause buildup of plaque or blockages in the arteries. When you walk, that can lead to difficulty in getting blood to the leg muscles. This may result in leg cramping in the thighs or calves, or in more advanced cases, rest pain in the feet.”

The pain or cramping PAD causes is unique in that it is reproducible. In other words, it happens regularly, and usually around the same walking distance.

Anyone can develop PAD. Men, people with diabetes, people with heart disease, and those with a family history of PAD, vascular and/or heart disease are at a higher risk. People who smoke are two to six times more likely to develop PAD.

Use these questions to assess your risk:

• Do you have pain in your legs (calf, thigh, or buttocks) when you walk?
• Do your feet always feel cold?
• Does one foot feel colder than the other?
• Have you experienced any color changes (extremely white, blue or red) in your legs or feet?
• Have you noticed that a wound on your foot/toe/lower leg takes a long time to heal?
• Do you have or take medication for diabetes?
• Do you smoke?
• Do you have or take medication for high blood pressure?
• Do you have high cholesterol or take medication to help control it?
• Do you have hair loss below the knees?

If you answered yes to any of these questions, you may be at risk for PAD.

How Vascular Specialists Diagnose PAD

Vascular specialists and surgeons treat diseases of the circulatory system outside of the heart and brain. This includes the arteries and veins that carry blood throughout the body. When a person has PAD, it’s because a fatty buildup, called plaque, clings to their artery walls. This reduces blood flow to the legs.

To diagnose PAD, a physician will begin with a thorough examination that includes your medical history. They will also record any potential symptoms of peripheral artery disease. A pulse test, done feeling your pulse in different areas of the body, can help them assess blood flow. 

A physician may perform other tests to determine the health and functioning of your blood vessels. These include:

• Ankle-brachial index (ABI) to compare the blood pressure in the ankle with the blood pressure in the arm.
• Angiogram, which is an X-ray of the arteries and veins to detect blockage or narrowing. Your doctor will use a thin tube and insert it into an artery in the leg and inject a contrast dye. This makes your arteries and veins visible on the X-ray.
• Doppler ultrasound to create images of blood vessels. Your doctor will use the ultrasound to measure and assess the flow of blood.

When performing these tests, a vascular specialist is looking for signs of PAD as well as other vascular conditions and diseases.

Treatments for PAD

PAD is a lifelong condition, which means that treatment is also lifelong. Dr. Aplin says, “We develop longstanding relationships with our vascular surgery patients. We work with them to reduce their symptoms, improve their circulation and improve quality of life.”

Modifying risk factors is often the best starting point for treatment. Cholesterol-lowering medicine and reducing heart disease risk can help improve PAD. Exercise is also vital, as it improves circulation and reduces risk of vascular disease.

“Our body has the ability to develop pathways around blockages and improve blood flow to the legs, which could help improve symptoms,” says Dr. Aplin.

If conservative treatments do not work, your physician may recommend vascular surgery to restore blood flow. If untreated, PAD can cause serious and life-threatening issues such as heart attack and stroke. Know your risk factors and be on the lookout for potential symptoms. Early treatment can make a difference in treatment options and long-term health.

Brett Aplin, MD
Dr. Aplin is a vascular surgeon with ProMedica Jobst Vascular. View his profile.