Understanding Peripheral Artery Disease (PAD): What You Need to Know

Peripheral Artery Disease (PAD) is a common but often overlooked condition that affects millions of people, particularly those over the age of 50. It occurs when the blood vessels outside the heart and brain begin to narrow, limiting blood flow to the limbs—most commonly the legs. Despite its prevalence, PAD is frequently underdiagnosed, and many individuals suffer in silence, unaware of the impact it has on their health. Understanding PAD is key to managing and preventing its progression.

Causes and Risk Factors

PAD is a circulatory problem where the arteries in the legs (or sometimes the arms) become narrowed or blocked due to plaque buildup. Plaque consists of fatty deposits, cholesterol and other substances that clog the arteries. As the blood vessels narrow, less blood and oxygen reach the muscles and tissues in the legs, leading to various symptoms and complications if left untreated.

While PAD is primarily a vascular issue, it can be an early indicator of more severe cardiovascular diseases, including heart attack or stroke. Early recognition and intervention are essential for preventing more serious outcomes.

PAD is most commonly caused by atherosclerosis, a condition where fatty deposits build up on the walls of arteries. This buildup restricts blood flow and causes the arteries to harden. The risk of developing PAD increases with certain lifestyle habits and health conditions. Some of the most common risk factors include:

• Age: PAD is more common in people over 50, with the risk increasing as we age.
• Smoking: Smoking is one of the leading causes of PAD, as it damages blood vessels and accelerates plaque buildup.
• Diabetes: High blood sugar levels can damage blood vessels and nerves, increasing the risk of PAD.
• High Blood Pressure and High Cholesterol: These conditions contribute to the narrowing of blood vessels.
• Family History: A family history of cardiovascular diseases increases your risk of developing PAD.

Symptoms of PAD

PAD can present itself in a variety of ways, but the most common symptom is claudication, which is leg pain or cramping during physical activity, such as walking or climbing stairs. This pain is often relieved with rest but may worsen over time if left untreated. Other symptoms of PAD may include:

• Numbness, weakness or heaviness in the legs
• Cold or pale skin on the legs or feet
• Slow-healing wounds or sores on the legs and feet
• A noticeable decrease in the size of leg muscles

It's important to note that some people with PAD may not experience noticeable symptoms, which is why early screening and diagnosis are crucial, especially for those with risk factors.

Diagnosis of PAD

If you have risk factors for PAD or experience symptoms, it’s important to see a healthcare provider. Diagnosis typically involves a physical exam, during which the doctor may check for weak pulses in your legs or feet. Additional diagnostic tests may include:

• Ankle-Brachial Index (ABI): A simple test that compares the blood pressure in your ankle to that in your arm to assess blood flow.
• Ultrasound: A non-invasive imaging test that helps visualize the blood flow in your arteries.
• Angiography: In more severe cases, a doctor may use this imaging technique to see the arteries more clearly.

Early detection of PAD can help prevent complications like limb amputation, heart attack or stroke.

Treatment Options

Treatment for PAD generally focuses on improving blood flow, managing risk factors and relieving symptoms. Here are some common treatment approaches:

• Lifestyle Changes: Adopting a healthy lifestyle is critical. Quitting smoking, increasing physical activity, and following a heart-healthy diet can help improve blood circulation and prevent further artery damage.
• Medications: Doctors may prescribe medications to manage risk factors, including blood thinners (to prevent clots), statins (to lower cholesterol) and medications to control blood pressure and blood sugar.
• Surgical and Procedural Interventions: For more severe cases, procedures like angioplasty (a balloon procedure to open narrowed arteries) or bypass surgery may be necessary to restore blood flow.
   

Prevention and Lifestyle Adjustments

While PAD can be managed, prevention is always the best approach. Here are some lifestyle changes that can help reduce the risk of developing PAD:

• Exercise Regularly: Walking or other low-impact activities can improve circulation and strengthen the muscles in your legs.
• Eat a Healthy Diet: Focus on a diet low in saturated fats, cholesterol and sodium, and high in fruits, vegetables, and whole grains.
• Manage Chronic Conditions: Keeping conditions like diabetes, high blood pressure and high cholesterol under control can significantly reduce your risk.
• Quit Smoking: Smoking accelerates the development of plaque in your arteries and greatly increases the risk of PAD and other cardiovascular diseases.
   

Living with PAD

While PAD is a serious condition, it can be managed effectively with the right treatments and lifestyle changes. If you are diagnosed with PAD, it’s important to stay on top of regular check-ups with your doctor, follow prescribed treatments and make the necessary lifestyle adjustments. With proper care, many people with PAD can lead active, healthy lives.

Peripheral Artery Disease is a manageable condition, but awareness is key. If you have risk factors for PAD or experience any of the symptoms mentioned, don’t hesitate to seek medical advice. Early diagnosis and treatment can help improve blood flow, relieve symptoms and reduce the risk of complications. 

Here at TMH Physician Partners, Services by Southern Medical Group – Vascular Surgery, Christopher Griggs, DO, Robert Heidepriem, MD and Shane McEntire, MD are three fellowship-trained surgeons who bring a wealth of experience and the latest techniques in treatment and care. If you or someone you know is at risk for or suffers from PAD, talk to your healthcare provider about a referral to our team, or visit TMH.ORG/Vascular for more information.   

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Christopher Griggs, DO