What is PAD?
Peripheral arterial disease or PAD (sometimes called peripheral artery disease or peripheral vascular disease) is a condition, or set of conditions, caused by the blockage or narrowing of the body's large peripheral arteries. Lack of proper blood flow to the legs is very common in this condition. Many patients experience leg pain with walking (claudication), which occurs as a result of the lack of oxygen to the muscle tissue.
It’s estimated that one in 20 Americans over the age of 50 has PADand between 12 and 20 percent of Americans age 65 and older suffer from the disease though many are "silent" cases that don't have symptoms.
What are some symptoms of PAD?
PAD symptoms include:
- Cramping or tiredness in leg muscles while walking or exercising (claudication) which goes away at rest
- Pain in the legs or feet that wakes you up at night
- Numbness or loss of sensation in the affected limb
- Sores that heal slowly or fail to heal
- Differences between limbs in relation to color and/or warmth
- Decreased rate of hair and nail growth on the impacted limb
- Foot pain at rest
In some patients the vascular system may compensate for the reduced blood flow by forming alternative routes, called collateral vessels, which bypass the affected vasculature. In others, collateral vessels may not be sufficient, resulting in foot pain at rest and non-healing sores on the feet.
What causes PAD?
Atherosclerosis (a disease in which plaque or fatty deposits build up in your arteries, often called hardening of the arteries) causes PAD. Over time various factors cause the vein walls to become rigid and narrow. The risk factors that contribute to PAD include:
- High cholesterol or triglycerides
- Family history of vascular disease, such as PAD, aneurysm, heart attack or stroke
- Personal history of hypertension (high blood pressure), heart disease or other vascular disease
- High levels of homocysteine, an amino acid in your blood
- Weighing over 30 percent more than your ideal weight
- Over age 50 and male
- Inactive lifestyle
How is PAD diagnosed?
If PAD is suspected, your health care provider will perform a non-invasive test referred to as an ankle brachial pressure index (ABI). The ABI measures the difference between the systolic blood pressure in your arms and the systolic pressure in your ankles. Based on the result of this test, an ultrasound may be ordered to determine the extent of the blockage. Angiography, an x-ray dye procedure, or a Computed Tomography Angiography Scan (CTA) may also be used to more precisely define the exact location of the blockage if a procedure is indicated.
What are some treatments for PAD?
Depending on the severity of your peripheral arterial disease, we offer various treatments. PAD treatments focus primarily on lowering your risk factors combined with medical (non-surgical) therapies. If PAD reduces blood flow to such an extent that prevents a wound or sore from healing, or if pain occurs at rest, surgery may be needed. Learn more about PAD treatments.
What can I do to prevent peripheral arterial disease?
Because PAD most commonly results from atherosclerosis or hardening of the arteries, you can reduce your risk for developing the condition by following these guidelines:
- Don't smoke.
- If you have diabetes, see your health care provider regularly and follow all diet and medication instructions.
- Lower your blood pressure if it is high.
- Eat foods low in fat and cholesterol.
- Lose weight if you are overweight.
- Exercise regularly according to your health care provider's recommendations.
- Try to reduce stress in your life.
- A daily baby aspirin regimen, a cholesterol-lowering statin medication (e.g. Lipitor™, Zocor™, etc...), or an ACE inhibitor for blood pressure control may also recommended, if appropriate.
- Beta-blocker medications may be recommended.
- Cilostozol™, a medication specifically designed to treat claudication (leg pain) symptoms, may be recommended.
Why is PAD a wake-up call?
Peripheral arterial disease, or PAD, can be a red flag to more extensive problems such as heart disease.
We often think of clogged artery disease, or arteriosclerosis, as something that only happens in the heart. Yet for some people, the leg pain caused by PAD acts as an “early warning” that someone is at high risk for a heart attack or a stroke. So that leg pain can save your life if you seek treatment for PAD. Read a related news story about leg pain and PAD.
Make an Appointment
To make an appointment to discuss your need for a PAD treatment plan designed for your specific needs, contact us toll-free at 888-287-1082 or email us at CVCCallCtr@med.umich.edu.