Many Patients Unaware They Have This Type of Heart Disease
Peripheral arterial disease (PAD) affects an estimated 8 million Americans. PAD limits blood flow to the body’s extremities, kidneys and other organs and left untreated can lead to a heart attack or stroke.
PAD is caused when plaque builds up in arteries outside of the heart. High cholesterol, high blood pressure and smoking – three factors that cause plaque to build up in the coronary arteries – also cause plaque build-up in the peripheral arteries. Patients with diabetes or pre-diabetes are also at increased risk of developing PAD.
The legs are the most common part of the body affected by PAD. Patients may report painful cramping and numbness or pain while walking since the blood supply to the legs has decreased, or an overall feeling of heaviness or weakness in the legs. The blockage can lead to changes in skin color, dry, thin skin and, when advanced, the death of tissue and muscle, which would require the leg to be surgically removed. Fortunately, most cases are not that severe. Another risk with PAD is that left untreated, some of the plaque build-up may break off, creating a clot that could travel to the heart or brain, causing a heart attack or stroke.
Several tests identify PAD. The doctor may start by measuring the blood pressure in your arms and ankles see what differences there may be; a lower pressure in the legs may mean the blood supply to that area is weak. An MRI, ultrasound or CT scan can also be used to diagnose PAD. ThedaCare just launched an online screening tool at www.thedacare.org/heart to identify if you may have PAD or are at risk of developing PAD.
Patients can make several lifestyle changes to manage their PAD. If the patient smokes, I urge him or her to quit since smoking is a big risk factor for all cardiac diseases. (ThedaCare can provide patients with the resources they need to quit smoking.) After that, I look to create a weekly walking program for people with problems in their legs and work on lowering their cholesterol levels. Lifestyle changes, such as increased exercise and diet modifications (eat more fruits, vegetables, lean protein and whole grains) are discussed first. If those do not make a difference, then a statin may be prescribed. Diabetic patients should also keep their blood sugar in the target range.
For some patients, angioplasty may be the right choice to remove the plaque deposits or clots. Every patient is different, which is why we create a plan tailored to his or her unique needs.
Knowing your blood pressure and cholesterol levels – and keeping them in the normal range – along with keeping your blood sugars in the normal range if you are diabetic are a few ways you can decrease your chances of developing PAD.
Thomas Tamlyn, MD, is a cardiologist with ThedaCare Cardiovascular Care in Appleton.
