Peripheral Arterial Disease: What Experts Recommend

Can you walk more? This might be the last question you want to hear when you have a disease of the blood vessels called peripheral artery disease, or PAD. Even walking short distances, as you probably know, can cause leg cramps.

But doctors say if you push yourself to move more often and walk farther, you’ll feel better. John Osborne, MD, PhD, a cardiologist in Dallas, says that including supervised rehabilitation therapy will give you the best results – and the pain will be worth it.

Rehabilitation focuses on “keeping pushing your walk until it hurts,” he says. “But, if you keep doing it, it will actually tend to help create additional collateral. [blood] vessels or bridging vessels around stranded vessels.

PAD occurs when plaque builds up in your peripheral arteries. These arteries carry blood from your heart to other parts of your body, such as your arms and legs.

The most common form of PAD affects your legs and feet. You may not have felt any symptoms – about 1 in 4 people experience none. If you do, you may have felt pain in your muscles or weakness when you walk or try another type of exercise.

Your doctor may recommend a procedure to open any of these blocked arteries or to remove the accumulated plaque. But there are other steps you can take to improve how you feel with PAD, cardiologists say. Treating high blood pressure and high cholesterol, eating healthier foods – and quitting all smoking habits for good – will help protect the small vessels in your arms or legs. The goal: to guard against wounds or the death of surrounding tissues, which can lead to amputation.

You may also be able to prevent plaque which can cause problems in your heart and elsewhere, says Sahil Parikh, MD, associate professor of medicine at Columbia University Vagelos College of Physicians and Surgeons in New York City.

“Everything we do is designed to improve symptoms [of PAD], but also to make people live longer, ”he says.

Here are the best tips from the experts.

Limit your risk factors

Many people with PAD have likely used tobacco at some point. “I didn’t ask them if they smoked,” Osborne said. “I ask them, ‘Do you still smoke? “”

Tobacco is a major risk factor because nicotine promotes the formation of plaque in the blood vessels. “I tell people, ‘I don’t care if you smoke it, sniff it, chew it,” “said Osborne.

Quitting smoking is a great start, even if you might not know where to start. The American Heart Association offers some tips on how to quit smoking, starting by setting a “Quit Day” (ideally within the next 7 days) when you will quit smoking completely.

Stay on top of your blood pressure, so it doesn’t drift too high, Parikh says. Exercising, reducing stress, and other lifestyle changes may be enough, he says. Otherwise, your doctor may prescribe medication.

If you have diabetes, you need to closely monitor your blood sugar, Parikh says. Plus, keep your cholesterol levels in a healthy range, whether it just requires diet changes or medication.

To improve your diet, the American Heart Association recommends reducing salt, saturated and trans fats, sugars, and red meat as much as possible. Instead, fill your plate with vegetables, fruits, low-fat dairy products, fish, chicken, nuts, and other healthy foods.

Push your business

Because PAD often has no symptoms at first, you’ve probably had the disease for a while without realizing it. Over time, less blood has flowed through the arteries in your legs, Osborne says. Without so much blood to supply your muscles, walking can be uncomfortable or even painful. It’s often the calves that hurt, but it can also be the thighs or other areas, he says.

“Usually what happens is people start to walk, their legs twitch, twitch, pain and pain,” says Osborne. “They stopped. The blood flow catches up. They feel better. And they walk again. And then this cycle repeats.

Not surprisingly, it can sometimes be difficult to embrace exercise. But research has shown that if you exercise under the supervision of someone, like a physical therapist, you are more likely to push yourself. As your pain subsides, you can exercise even more.

Medicare covers this approach, called supervised exercise therapy, for patients with PA. Evidence shows that it works better at slowing the worsening of PAD than trying to exercise on your own.

Your medication options

You may already be taking medications to treat risk factors, such as high blood pressure, says Marc Bonaca, MD, cardiologist and director of vascular research at the University of Colorado School of Medicine at Aurora. Your doctor may also prescribe other medicines to lower your risk of clots, he says.

One option is aspirin. Recently, the FDA approved another drug, rivaroxaban (Xarelto), specifically for people with PAD. Federal authorities recommend prescribing rivaroxaban and aspirin for people who have already had a procedure to remove a blockage in the legs. Both drugs help lower your risk of a heart attack or stroke more than taking aspirin alone.

Monitor and defend your health

Stay on top of your meds and watch out for sores or other changes in areas where you have PAD, Bonaca says. If the disease affects your feet, keep your toenails trimmed and your feet clean – and check your feet daily for any signs of skin damage, he says.

A small pebble in your shoe or a toenail problem can turn into a serious problem, Bonaca says. With less blood flow, the body has a harder time fighting infections. “Then the wound grows and the surrounding tissue may die, and that may require amputation,” he says.

Other suggestions: Avoid bare feet and wear comfortable shoes. And don’t treat corns, calluses, and ingrown toenails yourself.

While you live with PAD, stand up for yourself to get the best possible care, says Parikh. “PAD is an important life changing diagnosis. Not just because of the legs, but because of its implications for the rest of the body.

But he says if people take “the right medications and you put them on a walking program, they feel a lot better and they are probably better off.”

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