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Do You Have Peripheral Artery Disease (PAD)? Here’s What to Know

Your cardiovascular system plays an important role of moving blood with oxygen and nutrients to all parts of your body. With your heart as a pump, blood travels through thousands of miles of blood vessels – arteries, capillaries and veins. Blood is pumped from your heart, out into your body via a system of arteries and veins.

However, if that blood flow is blocked, or even slowed down, it can result in things like heart attack and stroke

Peripheral artery disease (PAD), a form of peripheral vascular disease, is a condition that affects the blood vessels that carry blood from the heart to your legs. PAD is primarily caused when fat and cholesterol form plaque in the arteries, called atherosclerosis, narrow the arteries and cause a partial or complete blockage.

“This plaque buildup can affect the arteries of the heart, brain, abdomen, arms and legs, however the legs are most commonly affected,” said Paul Riesenman, MD, an endovascular and vascular surgeon at Banner Health Clinic in Arizona.

Just like clogged pipes are bad for your plumbing, clogged arteries are bad for your heart. Here are five things to know to keep your heart healthy and pipes clean.

1. You may not have symptoms

With PAD, you may have a variety of symptoms, or you may not have any at all. “It’s estimated that there are three times as many patients with PAD who have no symptoms as opposed to those who do,” Dr. Riesenman said. “Some people may have this condition for several years and not even be aware of it.”

You can have PAD for years without having symptoms, while the plaque continues to enlarge and harden.

Typical symptoms of peripheral artery disease include:

  • Pain in legs when walking or exercising (claudication)
  • Numbness and tingling in your legs and feet
  • Foot or toe sores (wounds) that heal very slowly or not all
  • Skin that is cool to the touch
  • Hair loss on your legs

2. Advanced PAD can lead to amputation

At first, you may even confuse symptoms of PAD as normal aging pains or neuropathy, a symptom of diabetes. As a result, you may delay talking to your health care provider until symptoms become severe and require immediate medical attention.

“Untreated PAD can progress to an advanced stage called critical limb ischemia, a condition where blood flow is so blocked that tissues in your legs, ankles and feet don’t get enough oxygen and start to die,” Dr. Riesenman said. “Ulcers and gangrene can develop and, as a result, you may require an amputation.”

3. Your genetics and lifestyle habits may put you at risk for PAD

PAD is a common condition that affects nearly 12 million Americans. Though your family history (genetics) may play a role, PAD can be caused by a variety of factors:

  • Age: Typically affects people over the age of 50.
  • Other health conditions: Several common health conditions increase your risk, such as high blood pressure (hypertension), high cholesterol (hyperlipidemia), kidney disease and diabetes.
  • Tobacco use: Smokers or those who have a history of smoking are at greatest risk for developing PAD and are much more likely to die of cardiovascular complications, undergo leg amputations and have poor outcomes with medical treatment.
  • Obesity: Carrying excess weight can lead to high blood pressure and diabetes, which in turn can cause PAD.
  • Physical activity: Lack of exercise can increase your risk for PAD and other diseases.

“PAD is also a red flag for future heart and cardiovascular problems,” Dr. Riesenman said. “There is a strong association between coronary disease and PAD.”

4. There is a test for PAD

“To determine if you have PAD, your health care provider will perform a physical exam, both through examination of your limbs as well as performing a vascular exam to examine your arterial pulses,” Dr. Riesenman said.

Additionally, you may have an ankle brachial index (ABI test), which measures the difference between the blood pressure at the ankles compared to the arms, or arterial ultrasounds to look at the blood flow to your limbs.

More invasive tests, such as CT angiograms, MR angiograms and catheter-based angiograms are usually only used when your provider is planning a procedure to help with PAD.

If you have underlying conditions, such as diabetes or hypertension, or you are beginning to notice symptoms of PAD, you can also take a free PAD risk assessment to see if you should be screened for PAD.

5. PAD is treatable, in many ways

The severity of your case will determine the type of care and treatment that is right for you. The good news is that not all people diagnosed with PAD will need invasive procedures.

“The first line treatment often consists of smoking cessation, diet changes, a review and management of chronic medical conditions (like hypertension), exercise, as well as education on the signs and symptoms of PAD,” Dr. Riesenman said. “Medications may also be given to slow disease progression and possibly some regression.”

Medications typically prescribed to help with PAD include antiplatelet therapy, lipid lowering medication, glycemic control and hypertensive control.

If you don’t improve with medical management and are limited in physical activity, your provider may recommend minimally invasive procedures like angioplasty, stents and atherectomy or a conventional surgical bypass to eliminate the plaque and restore normal blood flow.

“For those with advanced PAD with symptoms of critical limb ischemia, this may require more aggressive interventions to prevent limb loss,” Dr. Riesenman said.

Reduce your risk for PAD

Unfortunately, you can’t control your genetics but there are five major things you can do to reduce your risk for PAD:

“Good control of chronic medical conditions such as hypertension, hyperlipidemia and diabetes can play a major role in this as well,” Dr. Riesenman said. If you would like to connect with a health care professional to learn more about diagnosing peripheral artery disease, reach out to Banner Health.

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