Peripheral Arterial Disease

Atherosclerosis is the narrowing of the arteries in the body, which usually occurs when cholesterol and fat build up on the walls of the arteries. (Read about "Arteriosclerosis & Atherosclerosis") Most people are aware of the term because of its connection to coronary heart disease. (Read about "Coronary Heart Disease") That narrowing can result in heart attacks (Read about "Heart Attack") and stroke. (Read about "Stroke") It can also result in another disease that is called Peripheral Arterial Disease or PAD. This is basically the same thing, a narrowing of the arteries, but in this case, it happens in another part of the body, usually the legs. (Read about "Feet, Ankles and Legs")

Early signs

PAD can be totally silent, with no symptoms, but if you have heart disease there is a very strong chance you have PAD as well. The American Heart Association (AHA) says that a common symptom for PAD in its early stages is a cramping or fatigue in your legs or rump during walking or other activity that goes away when you stop. It's called intermittent claudication and is the result of your leg muscles not getting enough red blood and the oxygen it carries. If the flow of blood to the legs is reduced enough, there will be other signs such as a burning or aching of the feet while lying down, according to the Vascular Disease Foundation (VDF). It will go away when the legs are lowered and gravity helps with the blood flow. This differs from night leg cramps that are sharp pains that can be massaged out of the leg. (Read about "Feet, Ankles and Legs") Other signs according to VDF include a cooling of the skin in specific areas of the leg, color changes of the skin, and sores on the toe and foot that won't heal.

Complications

The main complication for people with PAD is that they probably also have coronary heart disease. People with PAD are 6 times as likely to die from heart disease as people without PAD. In advanced cases of PAD, the foot sores can refuse to heal because they aren't getting the blood supply needed for growth and repair. If not treated, this can lead to other complications and require amputation.

Risk factors

The risk factors for PAD are the same as they are for cardiovascular disease but they bear repeating. Number one on the list, according to VDF and AHA, is smoking. (Read about "Quit Smoking") Other risks include:

• Diabetes does damage to the vascular system and increases the risk of developing PAD greatly. (Read about "Diabetes")
• Age - As you age, your chances of getting PAD go up. While only 3 percent of the population between 40 and 59 suffer with PAD, 19 percent of those over age 70 do.
• Family history of heart disease (Read about "Family Health History")
• Hypertension or high blood pressure - Most PAD patients also have high blood pressure, which damages artery walls. (Read about "Hypertension: High Blood Pressure")
• High levels of an amino acid called homocysteine - Recent studies are showing a connection to PAD. (Read about "Homocysteine")

Risk factors for heart disease such as high cholesterol (Read about "Cholesterol") and a high fat diet are also linked to PAD. PAD appears to be non-sexist for the most part, but men do suffer from it slightly more often, according to VDF.

Testing and treatment

Testing for PAD once again takes a page from coronary heart disease. The same types of tests are given, according to AHA. Ultrasound, magnetic resonance imaging or MRI and x-ray angiography can all be used to map the arteries and see what they look like. (Read about "Ultrasound Imaging" "MRI - Magnetic Resonance Imaging" "X-rays") The ankle brachial index (ABI) is another test used to diagnose PAD. This test compares the blood pressure in your ankle to the blood pressure in your arm. If the blood pressure in the lower part of your leg is lower than the pressure in your arm, you may have PAD. A treadmill stress test will help eliminate other reasons for leg pain. (Read about "Stress Test")

Treatments include drugs that are known as anti-thrombotics says AHA. A thrombus is a blood clot that forms in the blood vessel. It is important to stop them before they form. Once they do, they can block the blood vessel entirely and cause severe problems or break loose, and that can be deadly. A loose blood clot is called an embolus and can move through the vascular system (Read about "Vascular System") and get stuck somewhere else, resulting in a stroke, heart attack or a pulmonary embolism. (Read about "Pulmonary Embolism")

Angioplasty can be performed to open up the blood vessel. (Read about "Angioplasty") In this procedure, a fine tube, or catheter, is threaded through an artery into the narrowed heart vessel. The catheter has a tiny balloon or other device at its tip, that is used to open or stretch the artery. This is done to improve blood flow, after which the tube is removed. A stent can also be inserted. That is basically a wire cage that holds the artery open. Surgery to bypass the diseased area or to remove the blockage is also possible.

It is interesting to note that the body also has its own adaptation. It's called collateral circulation. VDF says the body develops smaller arteries that allow the blood to flow around the blockage, which helps explain why some people with PAD do not have symptoms.

Lifestyle

Lifestyle changes are almost always recommended for PAD patients. The first of course is to quit smoking (Read about "Quit Smoking") and using other nicotine products. Nicotine causes the blood vessels to constrict, making the problem worse. Your doctor will also probably suggest diet changes to lower your cholesterol, cut down on the fat you ingest and increase your fiber intake. (Read about "Fiber and Health") Your doctor may also set you on an exercise program. If your are overweight (Read about "Obesity"), losing the extra pounds will help ease the burden on your legs. (Read about "Losing Weight")

Related Information:

    Heart Risks

    Aspirin

    Exercise and Your Heart

    Heart Disease and Women

    Women and Blood Pressure

    Fighting Weight Gain

    Body Mass Index

    Thrombophilia

    Deep Vein Thrombosis

    Glossary of Stroke Terms

    Glossary of Heart Terms