Around 200 million people worldwide are at risk of a frequently disregarded and underestimated health issue: Peripheral Artery Disease (PAD). This disorder affects blood vessels by causing them to narrow and restrict blood flow to the limbs, which can lead to severe complications if not treated properly.
Despite affecting millions globally and an over 70% increase in its prevalence over the last two decades, PAD is frequently overlooked or misdiagnosed due to its early symptoms being mistaken for common ailments. In fact, at least 15 percent of the global population over 50 have undiagnosed PAD. As a result, millions of people are suffering from PAD without realizing it.
September is PAD Awareness Month, an opportunity to bring attention to this chronic condition and its preventable complications. Even if you haven’t personally experienced PAD, you likely know someone who has this disease or displays its symptoms.
In this blog, we will discuss crucial information about PAD, including its definition, risk factors, symptoms, testing, treatment options, the significance of early intervention and awareness, and how you can participate in PAD Awareness Month to aid in preventing misdiagnosis and neglect of this condition in the future.
WHAT IS PERIPHERAL ARTERY DISEASE (PAD)?
Peripheral Artery Disease (PAD) is a chronic condition that affects the circulatory system. It occurs when arteries undergo a process called atherosclerosis, where fatty deposits, cholesterol, and other substances build up on the inner walls of the arteries. This narrowing and hardening of the arteries reduce blood flow and oxygen supply to the limbs.
PAD can affect people of all ages and backgrounds, but some groups are at higher risk. Those over 50, especially those who smoke or have diabetes, are more likely to develop PAD. Studies suggest that men are slightly more susceptible than women, and the risk increases with age.
Certain ethnic and racial groups, such as African Americans and Hispanics, have a higher incidence of PAD compared to other populations. Lifestyle factors like lack of physical activity and diets high in unhealthy fats can also contribute to PAD, particularly in those who are already at risk.
If left untreated or undiagnosed, PAD can lead to significant health complications. What might begin as intermittent leg pain or discomfort during physical activity can progress to more severe pain, ulcers, the destruction of healthy tissue, and other cardiovascular diseases that increase your chances of a heart attack or stroke.
The American Heart Association reports that a third of individuals with a PAD diagnosis may pass away within five years, and 20% may suffer from a heart attack or stroke. However, it’s important to know that PAD is not always fatal.
By being aware of the condition, detecting it early, and seeking treatment from a trusted vascular expert, further decline can be prevented, and the quality of life for those impacted can be improved.
WHAT ARE THE SYMPTOMS OF PAD?
There are various ways in which Peripheral Artery Disease (PAD) can manifest. Certain individuals may exhibit a diverse range of symptoms that are often similar to other medical conditions, while others may not have any observable symptoms (asymptomatic) or only experience mild symptoms that are often disregarded.
For those with PAD, the symptoms they experience may vary, with some only experiencing one or a combination of symptoms while others remain asymptomatic. It is crucial to seek medical attention immediately if you encounter any of the following symptoms. Detecting and treating PAD early is vital in effectively managing it and preventing further complications.
Leg Pain and Discomfort
Many individuals with PAD may initially experience mild to moderate leg pain and discomfort, particularly in the calves, thighs, or buttocks, during physical activity. This discomfort is known as “claudication” and often improves with rest. People may mistakenly attribute these symptoms to aging or other causes, delaying seeking medical evaluation.
Pay attention to any unusual sensations in the legs and lower extremities, especially if you have risk factors such as age, smoking history, diabetes, or a sedentary lifestyle. If you notice any persistent leg pain or discomfort, it is crucial to seek prompt medical evaluation from a vascular specialist to rule out the possibility of PAD.
Pain at Rest
When Peripheral Artery Disease (PAD) progresses, the discomfort and pain in the legs can intensify and even occur during rest or when lying down. This condition is called “rest pain” and can seriously impact one’s quality of life, disrupting daily activities and sleep.
If you are experiencing pain while at rest, it may suggest that PAD has advanced to a more serious stage or could indicate the presence of another cardiovascular disease. In such cases, seeking medical attention from a vascular specialist as soon as possible is crucial.
Non-Healing Sores and Wounds
PAD can lead to reduced blood flow to the extremities, making it difficult for wounds on the legs and feet to heal properly. This can result in non-healing sores or ulcers, which may become infected if left untreated.
If you have non-healing sores and wounds, you should schedule an appointment with a vascular specialist as soon as possible.
Poor nail growth or discoloration of the nails can be an indicator of compromised blood flow due to PAD. Nail abnormalities are common in many other medical conditions, and alone might not be a reason to be concerned that you have PAD.
Still, if you notice persistent nail changes along with other symptoms such as leg pain, cramping, or difficulty walking, it is essential to seek medical evaluation to rule out the possibility of PAD.
Some individuals may notice variations in temperature between their extremities, with the affected limb feeling colder than the unaffected one. Temperature differences can be a potential indicator of compromised blood flow due to PAD.
Various factors, such as environmental conditions, can also cause temporary changes in skin temperature. Therefore, experiencing isolated temperature differences alone might not be conclusive evidence of PAD.
Nevertheless, if you consistently observe temperature variations along with other symptoms like leg pain, numbness, or difficulty walking, it is crucial to seek medical evaluation to investigate the possibility of PAD.
COMPLICATIONS LINKED TO PAD
PAD is a treatable condition, and early diagnosis and management can significantly reduce the risk of complications. Lifestyle modifications, medication, and other medical interventions can help improve blood flow, alleviate symptoms, and mitigate the risk of severe outcomes.
However, left untreated or undermanaged, PAD can lead to various complications, significantly impacting an individual’s health and well-being. Individuals may experience limitations in physical activity due to pain and discomfort, leading to reduced mobility and a diminished quality of life.
Some complications linked to PAD include:
Critical Limb Ischemia (CLI)
In severe cases of PAD, CLI can occur. CLI is severely blocked blood flow to one or multiple of your hands, legs, or feet and is a critical medical emergency that presents as severe pain, non-healing wounds, and tissue death. Timely intervention is crucial to prevent limb loss and improve outcomes.
Non-Healing Wounds and Ulcers
Reduced blood flow to the legs and feet due to PAD can lead to the development of chronic wounds and ulcers. These wounds may be slow to heal and are susceptible to infection, posing significant challenges for individuals with PAD.
Gangrene is a severe and potentially life-threatening complication of PAD, characterized by tissue death caused by a lack of blood supply. It can lead to a rapid deterioration of the affected area, necessitating urgent medical attention.
Reduced blood flow can weaken the body’s ability to fight infections effectively. Individuals with PAD are at higher risk of developing infections, which can further exacerbate the condition and complicate treatment.
In advanced stages of PAD, severe limb ischemia and non-healing wounds may necessitate the removal of affected limbs to prevent life-threatening complications. In fact, as of 2017, PAD is responsible for 80% of all amputations.
PAD is strongly linked to an increased risk of developing coronary artery disease and cerebrovascular disease. Coronary artery disease involves the narrowing of the arteries that supply blood to the heart muscle, which can lead to angina (chest pain) or a heart attack (myocardial infarction).
Similarly, cerebrovascular disease affects the blood vessels that supply the brain, increasing the risk of stroke. These complications can have severe consequences and may be life-threatening.
Emotional and Psychological Effects
Living with PAD and its potential complications can take a toll on an individual’s emotional well-being. Anxiety, depression, and stress may arise as a result of the condition’s impact on daily life and uncertainty about the future.
PAD RISK FACTORS
It is possible for someone that is healthy with no traditional risk factors to develop PAD, but this condition is typically influenced by several risk factors that can significantly increase an individual’s likelihood of developing the disease.
Here are the key contributors to a higher risk of PAD:
Cigarette smoking is one of the most potent risk factors for PAD. The harmful chemicals in tobacco can damage the blood vessels, leading to atherosclerosis—the buildup of fatty deposits within the arteries that restrict blood flow.
High Blood Pressure (Hypertension)
Persistent high blood pressure strains the arteries, making them more susceptible to damage and narrowing. Over time, this can increase the risk of PAD.
As mentioned above, atherosclerosis is a major risk factor for PAD. The accumulation of plaque in the arteries gradually reduces blood flow to the extremities, potentially leading to PAD.
Individuals with diabetes are at a heightened risk of PAD due to the impact of high blood sugar levels on blood vessels. Diabetes can cause further damage to blood vessel walls, accelerating the progression of atherosclerosis.
High Cholesterol (Hypercholesterolemia)
Elevated levels of cholesterol, especially LDL cholesterol (often referred to as “bad cholesterol”), can contribute to the formation of artery-clogging plaque, increasing the risk of PAD.
Age 50 or Older
Advancing age is a significant risk factor for PAD. As people age, their arteries may naturally become less flexible, making them more prone to atherosclerosis.
Race and Ethnicity
Certain racial and ethnic groups, such as African Americans and Hispanics, have a higher predisposition to PAD. Genetic factors and disparities in healthcare access and education may contribute to this increased risk.
Lack of Educational Awareness
A lack of awareness or limited access to information about PAD and its early testing can lead to delayed diagnosis and intervention. Educational initiatives and community outreach are crucial in improving early detection rates, making PAD Awareness Month even more important.
HOW TO LOWER YOUR RISK OF PAD
PAD is a serious condition, but the good news is that you have the power to lower your risk and protect your vascular health. By understanding the risk factors and implementing simple lifestyle changes, you can proactively address PAD and improve your overall well-being.
Here’s a list of easy ways to lower your risk of PAD:
Regular Check-Ups and Vascular Screenings
Proactive measures such as taking a vein quiz to determine your risk, regular check-ups and vascular screenings are pivotal in safeguarding your well-being. They can be a game-changer in lowering your risk of PAD. Vascular screenings, in particular, are a powerful tool to assess the health of your arteries, enabling early detection of potential issues before they escalate.
If you’re a smoker, kicking the habit is one of the most effective ways to reduce your risk of PAD. Smoking damages blood vessels and accelerates the buildup of fatty deposits that lead to PAD. Seek support from friends, family, or healthcare professionals to quit smoking for good.
Adopt a Heart-Healthy Diet
A balanced diet rich in fruits, vegetables, whole grains, and lean proteins can work wonders for your vascular health. Reduce saturated and trans fats, sodium, and processed foods in your diet. Opt for heart-healthy fats like those in nuts, avocados, and olive oil.
Stay Physically Active
Engaging in regular physical activity can significantly lower your risk of PAD. Aim for at least 30 minutes of moderate exercise most days of the week. Daily walks are an excellent way to prevent PAD. Activities like cycling, swimming, and yoga are also excellent choices to get your blood flowing.
Manage Chronic Conditions
Conditions like hypertension and diabetes can contribute to PAD. Work closely with your healthcare provider to manage these conditions effectively. Monitor your blood pressure and blood sugar regularly and follow your treatment plan diligently.
Maintain a Healthy Weight
Excess weight puts extra strain on your blood vessels, increasing the risk of PAD. Adopting a healthy lifestyle that includes a balanced diet and regular exercise can help you achieve and maintain a healthy weight.
Control Cholesterol Levels
Elevated levels of LDL cholesterol (“bad cholesterol”) can contribute to the formation of artery-clogging plaque. Incorporate heart-healthy foods and, if necessary, medications to manage your cholesterol levels.
Chronic stress can have a negative impact on your cardiovascular health. Find healthy ways to manage stress, such as meditation, yoga, spending time in nature, or engaging in hobbies you enjoy.
TESTING FOR PAD
One of the reasons why PAD is commonly underdiagnosed or misdiagnosed is that many individuals with the condition were never screened or examined to receive a proper diagnosis and treatment.
Vascular screenings and PAD tests are necessary to manage and diagnose this vascular ailment effectively. If timely intervention and appropriate management are provided, those affected by the condition can significantly enhance their quality of life and outcomes.
Various tests are available to diagnose PAD and assess its severity. Here are the common methods used for testing PAD:
Ankle-Brachial Index (ABI)
The Ankle-Brachial Index is a simple and non-invasive test that compares the blood pressure in the arms and ankles. By measuring the blood pressure at both locations using a blood pressure cuff and a Doppler ultrasound device, healthcare professionals can determine the ABI ratio. A lower ABI ratio indicates reduced blood flow in the legs, which may indicate PAD.
Regular vascular screenings, which may include the ABI test, are essential for identifying individuals at risk of PAD or those with early-stage disease before symptoms become evident.
Treadmill Exercise Test
Also known as the “treadmill test” or “treadmill walk,” this test involves walking on a treadmill while monitoring blood pressure and heart rate. Gradually increasing the treadmill’s speed and incline helps identify symptoms such as leg pain (claudication) and assess the severity of PAD.
Duplex ultrasound is a non-invasive test that combines traditional ultrasound with Doppler ultrasound to visualize the blood flow in the arteries and assess any obstructions or blockages. It provides valuable information about blood flow and helps diagnose PAD.
Angiography is an invasive procedure that uses contrast dye and X-rays to create detailed images of the blood vessels. It helps identify the location and extent of blockages or narrowing in the arteries, providing essential information for treatment planning.
Magnetic Resonance Angiography (MRA)
MRA is a non-invasive imaging technique that uses magnetic fields and radio waves to visualize blood vessels. It offers detailed images of the arteries, helping detect any abnormalities or blockages.
Computed Tomography Angiography (CTA)
CTA is a non-invasive imaging test that combines a CT scan with the use of contrast dye to create detailed pictures of the blood vessels. It is particularly useful for evaluating the arterial system in the legs and identifying any narrowing or blockages.
TREATMENT OF PAD
Treatments for peripheral artery disease can vary from minimally invasive to major surgery. The earlier PAD is diagnosed, the more likely minimally invasive procedures will be a viable option.
Angioplasty is a medical procedure that involves the insertion of a small balloon into an artery through a catheter, which is then inflated to widen the blood vessel and improve blood flow. This minimally invasive procedure is generally considered a safe and effective treatment option for patients with arterial blockages or narrowing and can often be performed on an outpatient basis with minimal recovery time required.
An atherectomy is a medical intervention that eliminates plaque buildup in arteries. It is a minimally invasive and safe procedure that does not require major incisions. A specialized tool equipped with either a laser or a grinding bit is used to effectively remove the plaque from the affected area. By removing the plaque, an atherectomy can restore proper blood flow to the affected region and prevent further complications due to clogged arteries.
Stenting is a medical procedure that involves the insertion of a tube made of either metal or plastic into a blood vessel. The primary objective of stenting is to prevent any blockage that may impede the normal flow of blood in the vein. The stent is a permanent fixture and remains in the vein once implanted.
This minimally invasive technique has proven to be a highly effective solution for patients with various vascular conditions, including PAD, ensuring continuous blood flow and reducing the risk of complications.
Bypass Graft Surgery
Bypass Graft Surgery is a complex surgical procedure that involves the removal of a healthy blood vessel and grafting it into a blocked vein to restore blood flow. This invasive surgery is typically reserved for cases where minimally invasive treatments have failed, or PAD has advanced to a critical stage.
WHY PAD AWARENESS IS IMPORTANT
Understanding PAD is crucial for maintaining good health and quality of life. PAD Awareness Month aims to increase awareness about this commonly overlooked condition and its potential impact on an individual’s well-being. By educating the public about PAD and its risk factors, we can improve access to vascular screenings and treatments.
Regular vascular screenings are especially important for high-risk populations to catch PAD early. Through promoting awareness, we hope to encourage individuals to undergo appropriate screenings and seek medical attention promptly if they experience any symptoms associated with PAD. Early detection and intervention can significantly reduce the risk of complications.
If you have not had a screening for PAD or are experiencing discomfort such as leg pain, cramping, or non-healing wounds, it is vital to seek medical attention promptly. Let’s work together to increase awareness about PAD and improve access to screenings and treatments.
Contact us online or give us a call at 615-269-9007 to schedule an appointment with our Board-Certified Surgeons. Our experienced medical team can provide a comprehensive assessment to identify and manage PAD effectively.
HOW TO OBSERVE NATIONAL PERIPHERAL ARTERY DISEASE AWARENESS MONTH
National Peripheral Artery Disease Awareness Month presents a valuable opportunity to make a positive impact and raise awareness about this treatable yet often overlooked condition.
The most crucial and impactful action you can take during National Peripheral Artery Disease Awareness Month is to get screened for PAD and encourage your friends and loved ones to do the same. Early detection is crucial in preventing complications and improving the prognosis for individuals affected by this vascular condition.
Additionally, you can support the fight against PAD by contributing to fundraising campaigns for organizations dedicated to this cause or use your social media to educate your followers about PAD and the importance of early detection and management.
By taking the initiative to get screened for PAD and raising awareness among others, you may not realize the impact you can have, but your actions play a crucial role in preventing complications and making a difference in the fight against this vascular disease.
PAD DIAGNOSIS AND TREATMENT IN MIDDLE TENNESSEE
Early diagnosis and awareness of PAD are crucial for optimal vascular health. At The Vein Centre, our experienced team of board-certified vein doctors specializes in diagnosing and treating vascular conditions, including PAD.
Don’t wait if you suspect PAD; schedule a vascular screening and consultation with our dedicated team to take charge of your vascular health and prevent complications. Your proactive approach can make a significant difference in your well-being.