Understanding PAD

Peripheral Artery Disease (PAD) affects millions of people worldwide, yet many remain unaware of the condition until it becomes severe. That’s why raising awareness during Peripheral Artery Disease Awareness Month is so critical. This condition, which affects the arteries outside the heart, can lead to serious health issues if left untreated. 

What is Peripheral Artery Disease (PAD)?

Peripheral Artery Disease (PAD) is a common condition that occurs when narrowed arteries reduce blood flow to the limbs. This restricts blood flow to the muscles and tissues in the arms and or legs. PAD is primarily caused by atherosclerosis, the same condition that leads to heart attacks and strokes, and is closely linked to cardiovascular disease.‍

Symptoms of PAD:

  • Pain or cramping in the legs during walking or exercise, known as claudication
  • Numbness or weakness in the legs or feet
  • Coldness in one leg or foot
  • Sores or wounds on the legs or feet that heal slowly or not at all
  • Change in skin color on the legs, often becoming pale or bluish
  • Weak or no pulse in the legs or feet

Some people with PAD may not experience symptoms at all, which is why regular check-ups and screenings are essential, especially for those at higher risk.

Risk Factors for PAD

If you have certain health conditions or are in one of these categories, you have an increased risk for PAD. 

  • Smoking: One of the most significant risk factors for PAD. Smoking damages the arteries and accelerates plaque buildup.
  • Diabetes: High blood sugar can damage the arteries, leading to an increased risk of PAD.
  • High Blood Pressure: Elevated pressure damages the artery walls, making it easier for plaque to form.
  • High Cholesterol: LDL cholesterol contributes to plaque buildup in the arteries.
  • Age: PAD is more common in people over 50, but younger individuals can also be at risk, especially if they have other risk factors.
  • Family History: A family history of PAD, heart disease, or stroke increases your risk.
  • Obesity: A body mass index of over 30 should lead you to watch for this condition.

Complications of PAD and How They Can Be Prevented

If left untreated, PAD can lead to serious complications, including:

  • Critical Limb Ischemia (CLI): CLI is a severe form of PAD where blood flow to the limbs is so restricted that it causes pain even at rest, along with non-healing sores or ulcers. In extreme cases, it can lead to gangrene and amputation. Early diagnosis and treatment of PAD are key to preventing CLI. Quitting smoking, managing diabetes, and controlling blood pressure and cholesterol levels can help slow the progression of PAD.
  • Heart Attack and Stroke: PAD is closely linked to cardiovascular disease, and people with PAD are at higher risk for heart attacks and strokes due to the same atherosclerotic process that affects the arteries in the legs. Lifestyle changes such as regular exercise, a heart-healthy diet, and taking prescribed medications to control risk factors (blood pressure, cholesterol, and blood sugar) are crucial in reducing the risk of heart attack and stroke.
  • Non-Healing Wounds: Because PAD reduces blood flow to the legs and feet, even minor injuries can take longer to heal, increasing the risk of infection and complications. Proper foot care, especially for individuals with diabetes, is essential. Inspect your feet daily for cuts, sores, or blisters, and seek medical attention if you notice anything unusual. Wearing comfortable shoes and keeping the skin moisturized can help prevent injuries.

How Your Medical Team Can Help

Your healthcare team plays a crucial role in diagnosing, managing, and treating PAD. If you have risk factors or are experiencing symptoms, it’s essential to seek medical advice to prevent the condition from worsening.

Your doctor can diagnose PAD through a variety of methods, including:

  • Ankle-Brachial Index (ABI): A simple test that compares the blood pressure in your ankles to the blood pressure in your arms.
  • Ultrasound: This test can visualize blood flow and detect blockages in the arteries.
  • Angiography: A more detailed imaging test to see how blood flows through the arteries.
  • Magnetic Resonance Angiography: After injecting a special dye, this test makes detailed images of organs and other tissues in the body.
  • Treadmill exercise test: This allows a doctor to monitor blood flow with increased heart rate.
  • Photoplethysmography (PPG): A doctor places a tiny cuff around the toe and evaluates the blood flow near the skin.

Screening for PAD is particularly important for people over 50 with risk factors such as smoking, diabetes, or a family history of cardiovascular disease.

If you’re diagnosed with PAD, your healthcare provider will create a personalized treatment plan tailored to your condition and risk factors. This may include:

  • Medications: To control cholesterol, blood pressure, and blood sugar, and to prevent blood clots.
  • Lifestyle changes: Smoking cessation programs, nutritional counseling, and exercise regimens to improve circulation.
  • Supervised exercise programs: Walking and other exercises can help improve symptoms and increase your mobility.

In more severe cases of PAD, your doctor may recommend minimally invasive procedures to restore blood flow. These include:

  • Angioplasty: A balloon is inserted into the narrowed artery to widen it.
  • Stenting: A small metal tube (stent) is placed in the artery to keep it open.
  • Atherectomy: The removal of plaque from the arteries.

PAD is a chronic condition, so regular check-ups and monitoring are essential to ensure that your condition is stable and to adjust your treatment plan if necessary. Your healthcare team will work with you to manage your risk factors and help you maintain a healthy lifestyle.

Dr. Shahin Assadnia of the East Tennessee Vascular Center specializes in vascular medicine and wound care. He is eager to help patients diagnose and monitor their conditions so that they can experience an improvement in quality of life.

The Healthstar Physicians network offers primary care and specialty services across East Tennessee. Our medical team is part of your community and because of that we are Near You, For You.