Peripheral Arterial Disease: Risk Factors and Treatment Options

Peripheral Arterial Disease (PAD), also known as Peripheral Vascular Disease (PVD), is a blockage of blood flow in the peripheral arteries that affects approximately 6.5 million people age 40 years and older in the United States.

Peripheral arteries, when healthy and unobstructed, allow blood to feed the legs with oxygen, glucose and other nutrients. But over time, fatty plaque can develop in these arteries and obstruct the flow of blood. This may cause leg pain while walking and even at rest and can put a person at risk for heart attack and stroke. PAD can also cause non-healing ulcers and, ultimately, gangrene. Patients are at a higher risk for limb loss over time.

“A person who suspects PAD should see a doctor if they have a non-healing wound,” says Mark Kumar, MD, a board-certified vascular surgeon with Valley Health Vascular Surgeons. “Some patients will have pain when walking, and the time of onset is very reproducible. They can also experience pain at night when not walking. Patients will frequently have decreased or no hair growth in their feet and legs. With PAD, their legs can appear pale when raised and purplish when hanging down.”

Who’s at Risk?

“Patients are frequently smokers,” says Dr. Kumar. “They frequently have a history of coronary artery disease. Individuals with diabetes are also more prone to get PAD.”

Major risk factors include:

• hypertension (high blood pressure)
• hyperlipidemia (high cholesterol)
• diabetes (One in three people over the age of 50 with diabetes will develop PAD, according to the Department of Health and Human Services)
• smoking
• kidney disease
• age above 60 years

Available Prevention and Treatment

PAD can be prevented by getting plenty of physical activity, not smoking, controlling high blood pressure and managing high blood cholesterol and diabetes.

According to the Centers for Disease Control and Prevention, PAD can be treated with:

• Medication: You might need to take aspirin or other similar antiplatelet medicines to prevent serious complications from PAD and associated atherosclerosis. You may also need to take cholesterol medication.
• Smoking cessation: Check with your doctor about a smoking cessation program.
• Surgery: Surgery might be needed to bypass blocked arteries.
• Exercise: A supervised exercise program is recommended for people with pain caused by limited blood flow to muscles. This can improve the ability to walk longer distances.

At Valley Health, multiple specialties are involved in PAD diagnosis and treatment, including vascular surgery, cardiology, podiatry, wound care/limb preservation, interventional radiology and cardiovascular rehabilitation.

For more information, please visit valleyhealthlink.com/heart.