Peripheral artery disease (PAD) develops over time. And at first you might not realize what is going on. But there are things you can do to lower your chances of having PAD. The first step is to understand how it takes root, if you are at risk, and how it happens.
PAD occurs when certain arteries – usually in your legs – narrow due to the buildup of plaque. This prevents blood from flowing into your limbs the way it is supposed to.
Some people don’t experience symptoms, while others may ignore them if they are subtle at first. If you don’t identify it and get treatment, PAD can lead to gangrene – areas of dead tissue – and require amputation. And this same process of plaque build-up could take place in the blood vessels that supply the heart or brain, leading to a heart attack or stroke. Treating PAD can help prevent this from happening. This is why early detection is essential.
“The biggest problem we see are people who arrive late and late,” says Michael S. Conte, MD, professor and head of the vascular and endovascular surgery division at the University of California at San Francisco. .
“[They’re] wait too long, think it’s nothing, think it’s old age, think that this stain on their foot is going to go away and wait so long that we then have to do really complicated surgeries and procedures to save a leg ” , said Comte.
Know your risk
The three main risk factors for PAD are age, diabetes and smoking.
Age. It is quite rare to see this disease in people under the age of 50, unless they have a history of diabetes or smoking.
Diabetes. High blood sugar can prepare the artery walls for plaque buildup. Diabetes can also add more problems to the equation when paired with PAD. About 15% of people with diabetes have foot ulcers, and if you also have PAD, the risk of limb amputation is five to ten times higher.
Smoking. Smoking, which makes constriction and damage to your arteries worse, increases your risk of PAD by 400% and causes symptoms of PAD almost 10 years earlier.
PAD can also happen if you receive radiation to your neck or legs. Radiation therapy to treat tumors can cause arterial blockages down the line – 3 to 10 years or more later.
Other things that can increase your chances of getting a PAD include:
- Obesity (body mass index over 30)
- Arterial hypertension
- High cholesterol
- Peripheral artery disease, heart disease or stroke in your family history
- High levels of homocysteine
Men are more likely to have PAD than women, and earlier – about a decade earlier than women. PAD also disproportionately affects blacks and Native Americans, and this gap widens with age.
How fast is PAD growing?
PAD usually sets in over time, not suddenly. But it doesn’t always range from mild to moderate to very bad. How quickly this happens also varies from person to person and depends on factors such as where the blockage is and your overall health.
You can also have PAD without major symptoms at first. But over time you would.
“In terms of true peripheral artery disease, where there is significant impaired blood flow to the arteries in the legs, just about all of these people [who have it] have some sort of functional limitation, ”says cardiologist Aaron W. Aday, MD, assistant professor of medicine at Vanderbilt University Medical Center.
The most common symptom of PAD is pain or weakness in the legs, usually in the calf muscle, when you walk. It can be slightly uncomfortable or extremely painful, making it difficult for you to be active. A few minutes of rest usually relieves pain.
Other signs to watch out for include:
- Pain in the hips, thighs, or calf muscles after walking or climbing stairs
- Weak or numb legs
- Cold in one leg or foot compared to the other side
- Sores on the toes, feet, or legs that do not heal
- A change in the color of your legs
- Hair loss or slower hair growth on your feet and legs
- Slower nail growth
- Shiny skin on your legs
- No pulse or weak pulse in legs or feet
- Pain, such as aches and cramps, when using your arms for basic tasks
Why You May Not Realize You Have Peripheral Arterial Disease
It is still a bit of a mystery why some people may not experience the typical symptoms of PAD. But here are a few reasons why you might think you don’t have it, but you do.
It is too early to tell. As PAD unfolds over time, warning signs may not yet be evident. Many people with PAD do not have visible symptoms until the artery is narrowed by 60% or more.
You assume it’s aging or a joint problem. Symptoms that accompany orthopedic conditions, such as lumbar spine disease and spinal stenosis arthritis, are often similar to those of PAD. The same goes for problems with the nerves which, when pinched, can cause similar pain. It takes a doctor to figure out what is causing your pain.
Other diseases can mask signs of PAD. Another condition can prevent you from being active enough to experience symptoms. Or the pain of another health problem masks the pains of PAD.
The location of the blockage affects how you feel. The location and distance of your PAD can affect how you feel. The further away the blockage is in your limbs, the more likely it is that PAD will appear late and with a worse symptom, not at an earlier stage with more common red flags like leg pain.
How to manage your symptoms
If you have PAD, your doctor may prescribe medicines, such as antiplatelet medicines to prevent heart attacks and strokes and others for high blood pressure or high cholesterol, as part of your treatment. You’ll also want to make lifestyle changes to help relieve your symptoms and prevent PAD from getting worse:
Stop smoking. This includes avoiding second-hand smoke from others. Doing this can not only help relieve your symptoms, but also reduce your chances of having more problems.
Take walks often. It might seem counterintuitive if it’s painful to walk, but it’s the best exercise you can do to improve your PAD. In fact, the distance you can walk painlessly can show how effective your treatment is.
It may not be comfortable.
“The point is not to avoid pain,” says Aday. “It’s to get comfortable with that pain in your legs, push to the point of pain – if you need to rest, that’s fine – but then keep going.” The overall goal increases [your] functional capacity.
Walking can also help you control risk factors for PAD such as high cholesterol and high blood pressure.
Eat healthy foods. The same things that are good for your heart, brain, and whole body are also good for stopping PAD. Focus on foods high in fiber and avoid salt and saturated fat. This will help keep your blood pressure and cholesterol levels under control.
Check your feet and wash them daily. Look closely at each foot. If you see a sore or injury, see your doctor. This is important, especially if you have diabetes, as your body may have a harder time healing wounds and sores on the lower legs and feet. Less blood flow to these areas makes this recovery process even more difficult, making infection and even amputation more likely.
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