Peripheral Artery Disease (PAD): Symptoms, Causes & Prevention

[Total: 0    Average: 0/5]

Peripheral Artery Disease (PAD), also called as peripheral vascular disease (PVD) is the abnormal narrowing of arteries in the leg. It is a common circulatory problem where the narrowing of the arteries will reduce the blood flow to the limbs. If you develop [1]  PAD, your legs will receive the required amount of blood causing your legs to be in constant pain while walking.

peripheral artery disease image

The condition also causes skin ulcers, a colour change in your skin and abnormal nail and hair growth in the affected area. PAD can also be an indicator of an [2]  accumulation of fat deposits in the arteries, a condition termed as atherosclerosis. It can reduce the blood flow to your brain, heart and leg.

PAD is considered to be the central risk factor causing stroke and heart attack. Studies have pointed out that men are more likely to develop the condition than women. Also, it is commonly found in regular [3]  smokers.

Symptoms Of Peripheral Artery Disease

In most cases, individuals suffering from the condition does not develop any signs, apart from leg pain while walking which usually disappears after a few minutes of rest. This condition is medically termed as [4]  intermittent claudication. The leg pain can vary, ranging from mild to severe and affects both the legs, with more pain concentrated on a single leg.

The symptoms of PAD include

  • painful cramping in one or both of your hips, thighs or calf muscles after walking or climbing stairs,
  • weakness and [5]  numbness in your legs, 
  • coldness in your lower leg or foot, especially when compared with the other side,
  • ulcers and open sores on your toes, feet or legs that won’t heal,
  • a change in the colour of your legs, mostly blue or pale, 
  • hair loss or [6]  slow hair growth on the feet and legs, 
  • slower growth of toenails,
  • shiny skin on the legs,
  • weak pulse or no pulse in the legs or feet, and
  • erectile dysfunction in [7]  men.

The symptoms of PAD usually elevates over time, slowly. If the symptoms are developing at a fast pace, it could be an indication of a severe problem which will require immediate medical attention.

Causes Of Peripheral Artery Disease

Studies have revealed that atherosclerosis is the most common reason behind the condition. Atherosclerosis [8]  causes your artery walls to be filled with fatty deposits, thereby blocking and reducing the blood flow. The plaques called as atheroma, made of water substances and cholesterol will build upon the artery walls of your legs. By affecting the blood supplying arteries, the condition limits the blood supply into your limbs.

The other factors causing the condition are

  • blood vessel inflammation [9] ,
  • limb injuries,
  • unusual anatomy of ligaments or muscles, and
  • radiation exposure [10] .

Risk Factors Of Peripheral Artery Disease

There are various aspects that can elevate your chances of developing the condition and it [11]  include

  • smoking,
  • high blood pressure,
  • diabetes (type 1 and type 2),
  • high cholesterol,
  • obesity, 
  • a family history of heart disease, stroke or peripheral artery disease, 
  • ageing, especially after 50 years of age, and
  • high levels of homocysteine(protein component that helps build and maintain tissue).

The highest risk factor is smoking as it reduces the [12]  blood flow, and men tend to develop the condition quickly than women.

Complications Of Peripheral Artery Disease

It has to be noted that the condition is not life-threatening, but atherosclerosis (the process that develops PAD) can lead to serious [13]  problems. If left untreated, atherosclerosis can become potentially fatal. The complications pertaining to PAD are as follows.

1. Critical limb ischaemia (CLI)

This condition develops when the blood flow to your legs become [14]  severely limited. CLI is extremely severe in nature and can become challenging to be treated. CLI can develop the following symptoms;

  • Loss of leg [15]  muscle mass. 
  • Severe burning pain in legs and feet that do not recede even after resting. 
  • Wounds, ulcers and an open sore on feet and legs that do not heal. 
  • Skin turning pale, smooth and [16]  dry. 
  • Injuries and infections causing a condition called as [17]  gangrene, where the skin on toes or lower limbs becomes cold and numb or begins to swell and produce foul-smelling pus, causing severe pain. The condition can even result in amputating the affected limb.

2. Coronary heart disease (CHD)

The build-up of plaques in the arteries in the leg can affect other parts of your body too. It can affect the arteries that supply to the brain and [18]  heart. Therefore, PAD can result in the development of other forms of cardiovascular diseases such as

  • stroke,
  • coronary heart [19]  diseases,
  • angina, and
  • heart attack.

Diagnosis Of Peripheral Artery Disease

If you think that you may be suffering from PAD, go to a doctor immediately. In order to diagnose the disease, the doctor will conduct a [20]  number of tests.

1. Ankle-brachial index (ABI)

One of the common tests used to diagnose the [21]  condition, ABI will be carried out by comparing the blood pressure in your arm with that of the blood pressure in your ankle. This may require you to walk on a treadmill, where the doctor will take readings before and after exercising, so as to analyse and examine the severity of the arteries.

2. Physical exam

The doctor will be able to find signs and symptoms of the condition such as a weak or absent pulse and whooshing sounds over the [22]  arteries. The doctor will also check the poor wound healing and low blood pressure in the affected area.

3. Angiography

Under this test, the doctor will use a dye which will be injected into your arteries so as to analyse the blood flow through the arteries. Using X-ray imaging, [23]  magnetic resonance angiography (MRA) or computerized tomography angiography (CTA), the doctor will be able to trace the blood flow. Catheter angiography is also used but is a more invasive procedure.

4. Ultrasound

Techniques such as Doppler ultrasound will be used to [24]  evaluate the blood flow, where the doctor will be able to identify and examine any blocked or narrowed arteries.

5. Blood tests

A blood sample of yours will be used to measure triglycerides and cholesterol levels to check if you have diabetes or not.

Treatment For Peripheral Artery Disease

The intention of doctoring the condition is firstly, to manage the painful symptoms that restrict one’s daily physical activities. And to end the elevation of [25]  atherosclerosis in your body, so as to reduce the risk of developing stroke or heart attacks.

In the early course of PAD, you can divert the condition by adopting changes in your lifestyle such as quitting the smoking habit if you are a smoker. In case of severe signs and symptoms, there is a need to get medical treatment. Your doctor may prescribe you with a set of medications to help lower the cholesterol, blood pressure, pain and the other symptoms. The medications will [26]  include

  • high blood pressure medications,
  • cholesterol lowering medications,
  • medications to prevent blood clots,
  • medication to control blood sugar, and
  • symptom-relief medications that will help get relief from the agonizing symptoms of PAD.

However, in some cases where the condition has become severe, surgeries and [27] therapies will be required. The doctor will ask you to undergo procedures such as angioplasty, bypass surgery or thrombolytic therapy.

Prevention Of Peripheral Artery Disease

By maintaining a healthy lifestyle, you will be able to hinder the onset [28]  of the condition. The best preventive methods are as follows:

  • Quit smoking, as it can damage your arteries and is a central cause towards the development of PAD.
  • Exercise on a regular basis, as it helps condition your muscles towards the effective use of oxygen.
  • If you are suffering from diabetes, make sure to maintain your blood sugar in control. 
  • Follow a healthy diet, avoid foods that have high saturated fat content. 
  • Maintain your (healthy) weight.

View Article References

  1. [1] Fowkes, F. G. R., Rudan, D., Rudan, I., Aboyans, V., Denenberg, J. O., McDermott, M. M., … & Criqui, M. H. (2013). Comparison of global estimates of prevalence and risk factors for peripheral artery disease in 2000 and 2010: a systematic review and analysis. The Lancet, 382(9901), 1329-1340.
  2. [2] Diehm, C., Allenberg, J. R., Pittrow, D., Mahn, M., Tepohl, G., Haberl, R. L., … & Trampisch, H. J. (2009). Mortality and vascular morbidity in older adults with asymptomatic versus symptomatic peripheral artery disease. Circulation, 120(21), 2053-2061.
  3. [3] Price, J., Mowbray, P. I., Lee, A. J., Rumley, A., Lowe, G. D. O., & Fowkes, F. G. R. (1999). Relationship between smoking and cardiovascular risk factors in the development of peripheral Artery disease and coronary artery disease; Edinburgh Artery Study: Edinburgh Artery Study. European heart journal, 20(5), 344-353.
  4. [4] Murabito, J. M., D’Agostino, R. B., Silbershatz, H., & Wilson, P. W. (1997). Intermittent claudication: a risk profile from the Framingham Heart Study. Circulation, 96(1), 44-49.
  5. [5] McDermott, M. M., Greenland, P., Liu, K., Guralnik, J. M., Criqui, M. H., Dolan, N. C., … & Sharma, L. (2001). Leg symptoms in peripheral Artery disease: associated clinical characteristics and functional impairment. Jama, 286(13), 1599-1606.
  6. [6] Marso, S. P., & Hiatt, W. R. (2006). Peripheral Artery disease in patients with diabetes. Journal of the American College of cardiology, 47(5), 921-929.
  7. [7] American Diabetes Association. (2003). Peripheral Artery disease in people with diabetes. Diabetes care, 26(12), 3333-3341.
  8. [8] Hirsch, A. T., Criqui, M. H., Treat-Jacobson, D., Regensteiner, J. G., Creager, M. A., Olin, J. W., … & McDermott, M. M. (2001). Peripheral Artery disease detection, awareness, and treatment in primary care. Jama, 286(11), 1317-1324.
  9. [9] Hiatt, W. R. (2001). Medical treatment of peripheral Artery disease and claudication. New England Journal of Medicine, 344(21), 1608-1621.
  10. [10] Ouriel, K. (2001). Peripheral Artery disease. The lancet, 358(9289), 1257-1264.
  11. [11] Selvin, E., & Erlinger, T. P. (2004). Prevalence of and risk factors for peripheral Artery disease in the United States: results from the National Health and Nutrition Examination Survey, 1999–2000. Circulation, 110(6), 738-743.
  12. [12] Fowkes, F. G. R., Housley, E., Cawood, E. H. H., Macintyre, C. C. A., Ruckley, C. V., & Prescott, R. J. (1991). Edinburgh Artery Study: prevalence of asymptomatic and symptomatic peripheral Artery disease in the general population. International journal of epidemiology, 20(2), 384-392.
  13. [13] Norman, P. E., Eikelboom, J. W., & Hankey, G. J. (2004). Peripheral Artery disease: prognostic significance and prevention of atherothrombotic complications. Medical Journal of Australia, 181(3), 150-154.
  14. [14] Nasr, M. K., McCarthy, R. J., Hardman, J., Chalmers, A., & Horrocks, M. (2002). The increasing role of percutaneous transluminal angioplasty in the primary management of critical limb ischaemia. European journal of vascular and endovascular surgery, 23(5), 398-403.
  15. [15] Wolcott, R. D., & Rhoads, D. D. (2008). A study of biofilm-based wound management in subjects with critical limb ischaemia. Journal of wound care, 17(4), 145-155.
  16. [16] Sigvant, B., Wiberg-Hedman, K., Bergqvist, D., Rolandsson, O., Andersson, B., Persson, E., & Wahlberg, E. (2007). A population-based study of peripheral Artery disease prevalence with special focus on critical limb ischemia and sex differences. Journal of vascular surgery, 45(6), 1185-1191.
  17. [17] Paty, R., & Smith, A. D. (1992). Gangrene and Fournier’s gangrene. The Urologic clinics of North America, 19(1), 149-162.
  18. [18] Wilson, P. W., D’Agostino, R. B., Levy, D., Belanger, A. M., Silbershatz, H., & Kannel, W. B. (1998). Prediction of coronary heart disease using risk factor categories. Circulation, 97(18), 1837-1847.
  19. [19] Grundy, S. M., Benjamin, I. J., Burke, G. L., Chait, A., Eckel, R. H., Howard, B. V., … & Sowers, J. R. (1999). Diabetes and cardiovascular disease: a statement for healthcare professionals from the American Heart Association. Circulation, 100(10), 1134-1146.
  20. [20] Koyama, H. (2016). Diagnosis of peripheral Artery disease. Nihon rinsho. Japanese journal of clinical medicine, 74, 328-332.
  21. [21] Ankle Brachial Index Collaboration. (2008). Ankle brachial index combined with Framingham Risk Score to predict cardiovascular events and mortality: a meta-analysis. JAMA: the journal of the American Medical Association, 300(2), 197.
  22. [22] Reis, E. D., & Morrissey, N. Diagnosis of Peripheral Artery Disease. Changes, 1, 2.
  23. [23] Anderson, J. L., Adams, C. D., Antman, E. M., Bridges, C. R., Califf, R. M., Casey, D. E., … & Lincoff, A. M. (2007). ACC/AHA 2007 guidelines for the management of patients with unstable angina/non–ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines for the Management of Patients With Unstable Angina/Non–ST-Elevation Myocardial Infarction) developed in collaboration with the American College of Emergency Physicians, the Society for Cardiovascular Angiography and Interventions, and …. Journal of the American College of Cardiology, 50(7), e1-e157
  24. [24] Meijer, W. T., Hoes, A. W., Rutgers, D., Bots, M. L., Hofman, A., & Grobbee, D. E. (1998). Peripheral Artery disease in the elderly: the Rotterdam Study. Arteriosclerosis, thrombosis, and vascular biology, 18(2), 185-192.
  25. [25] Norgren, L., Hiatt, W. R., Dormandy, J. A., Nehler, M. R., Harris, K. A., & Fowkes, F. G. R. (2007). Inter-society consensus for the management of peripheral Artery disease (TASC II). Journal of vascular surgery, 45(1), S5-S67.
  26. [26] Hankey, G. J., Norman, P. E., & Eikelboom, J. W. (2006). Medical treatment of peripheral Artery disease. Jama, 295(5), 547-553.
  27. [27] Rowe, V. L., Lee, W., Weaver, F. A., & Etzioni, D. (2009). Patterns of treatment for peripheral Artery disease in the United States: 1996-2005. Journal of Vascular Surgery, 49(4), 910-917.
  28. [28] Belch, J., MacCuish, A., Campbell, I., Cobbe, S., Taylor, R., Prescott, R., … & Macfarlane, P. (2008). The prevention of progression of Artery disease and diabetes (POPADAD) trial: factorial randomised placebo controlled trial of aspirin and antioxidants in patients with diabetes and asymptomatic peripheral Artery disease. Bmj, 337, a1840.

This story has not been edited by Topic Hunt (with the possible exception of the headline) and has been generated from a syndicated feed. (BoldSky)

Leave a Reply

Leave a Reply

Your email address will not be published. Required fields are marked *