PAD, characterized by poor circulation, indicates increased risk for heart attack and stroke
By: Dan Palmquist, M.D.
It goes by a few different names and descriptions including muscle aches, poor circulation and hardening of the arteries; however the correct medical name all these terms refer to is peripheral artery disease, or PAD.
PAD, which affects 8 million Americans, is a narrowing of the arteries – usually in the legs and sometimes arms. This narrowing is most often caused by atherosclerosis, or a build-up of plaque along the walls of arteries. The plaque is made up of fats, cholesterol and other substances. Atherosclerosis is the same condition that causes heart attacks and strokes, so it is important to pay attention to PAD because even a mild case can signal the fact that atherosclerosis might be affecting other vital arteries in the body, including coronary arteries and carotid arteries.
When atherosclerosis narrows the long arteries of the legs, blood flow to the leg muscles is restricted. When the muscles are working – during exercise, walking or other movement – they require increased oxygen and blood flow. With PAD, blood flow is inadequate and this can cause muscle pain – called intermittent claudication. Claudication is typically triggered by exercise, and is relieved with rest.
The most common area affected by PAD is the calf, but depending on the arteries that are blocked, other areas may be affected including the thigh, foot, buttock and hip.
Many people with PAD experience no symptoms. When they do, however, symptoms can include: burning, numbness, aching or squeezing pain, wounds that heal slowly, legs that are cooler than the arms, weak or tired legs, shiny skin on the legs, loss of hair on the legs, decreased pulse in the feet, cold toes, difficulty walking or balancing and foot pain while at rest.
Risk factors for PAD include smoking, high cholesterol, high blood pressure, a family history of PAD, diabetes and age – risk increases with age.
You can reduce your risk and reduce PAD symptoms by keeping cholesterol and blood pressure at healthy levels. Do not smoke and avoid second-hand smoke. Eat a heart healthy diet rich in whole grains, fruits, vegetables and low fat protein. Drink plenty of water. Exercise regularly; studies show that regular walking lengthens the distance you can walk before the onset of leg pain. Maintain a healthy weight. If you have diabetes, keep your blood sugar in target range.
If you are diagnosed with PAD, pay special attention to the condition of your feet and legs. Treat any wound, cut or scrape right away. Poor blood flow can keep wounds from healing. Cover open sores with a nonstick bandage and contact your doctor as soon as you discover an open sore. Avoid shoes that are too tight or irritate your feet. Avoid socks that are tight or leave elastic-band marks on your legs. Keep your feet clean and moisturized to prevent cracking of the skin.
Sometimes lifestyle changes aren’t enough to keep PAD at bay. In these circumstances, your doctor may prescribe medication to treat PAD. Certain medications can decrease the symptoms of claudication. Others improve blood flow. Your doctor will work with you to find the best treatment specific to your situation.
For severe cases of PAD, angioplasty or bypass surgery can open narrowed arteries or reroute blood flow around them and restore blood flow. In rare instances, PAD can cause irreversible tissue damage that may be life threatening. When all other treatment options have been exhausted, a part of the leg or foot with the tissue damage may require amputation. People with diabetes are at increased risk for amputation.
Poor circulation is nothing to take lightly. PAD is dangerous, even when it is silent. It is proof that atherosclerosis is occurring throughout the body, which increases the risk of dying from heart attack or stroke. Making healthy changes and following your treatment plan to reverse the build-up of plaque in your arteries not only treats PAD but helps reduce the risk of heart attack or stroke as well.
Dr. Palmquist is a board certified family practice physician at Raiter Clinic in Cloquet.