Peripheral Arterial Disease (PAD)

Peripheral Arterial Disease, also known as PAD, is a common vascular disease caused by a gradual buildup of fatty deposits where the arteries become hardened and narrowed. This condition is referred to as atherosclerosis, commonly known as poor circulation or hardening of the arteries. The atherosclerotic process injures cells lining the blood vessels (endothelial cells) and causes a build-up of fat, white blood cells, and muscle cells, known as plaque, in the vessel wall. This condition can occur in any artery in the body.

PAD gradually restricts blood flow to the legs and feet, which can cause muscle aches/pain and fatigue when walking. This pain is caused by the lack of oxygen getting to the muscles in your legs. PAD may lead to disability and decreased quality of life and, if severe, amputation. PAD is often a "silent" condition, producing no symptoms. As a result, PAD is under-diagnosed and under-treated. People who do experience symptoms, such as pain or cramping in the legs, often do not report them, believing they are a natural part of aging or due to another cause.

Guidelines and data emphasize the importance of standards of care and the need to identify and treat PAD. In fact, PAD needs to be treated as aggressively as if you have had a previous heart attack or stroke as it represents the same atherosclerotic process. If you have PAD, you are four to five times more likely to have a heart attack or stroke.

The standards of care or best treatment for PAD depend on a number of factors, including your overall health and the seriousness of the disease. In some cases, lifestyle changes are enough to halt the progression of PAD and manage the disease. Lifestyle changes include exercise, stopping smoking, and dietary changes. Sometimes, medications or procedures that open up the narrowed blood vessels are required to treat PAD. The most commonly prescribed medications include: an antiplatelet agent to make the blood less sticky and flow better, cholesterol-lowering medication, and maybe a blood-pressure lowering medication. If the person has diabetes, glucose levels need to be managed. Blood pressure, cholesterol levels, and blood glucose levels all need to be kept within normal values to meet the standards of care.

Initial management should consist of modifying the vascular risk factors and aggressive medical treatment in the expectation that this will extend life, reduce the risk of progression of PAD, and improve the patient's functional status. Only after the best medical treatment has been instituted and given sufficient time to take effect should endovascular or surgical intervention be considered by your physician.

The best medical treatment is beneficial even in patients who eventually need invasive treatment, as the safety, immediate success, and durability of intervention is greatly improved in patients who adhere to the best medical treatment. Talk to your doctor to find out if you have PAD and then follow up on treatment to Save your legs—Save your life!!