You might not realize that narrowing of the blood vessels happens throughout the body. When it happens in the legs, feet, arms, brain, stomach, and kidneys, it can lead to gangrene, amputation, stroke, high blood pressure, and kidney failure. Peripheral artery disease (PAD) is more serious and pervasive than I thought.
For six Saturdays every February and March, 500 interested older adults trek to the campus to attend UC Davis Mini-Medical School to hear lectures from the medical school faculty on health and aging topics. Part 1 in a series of reports on this year’s lectures.
Dr. William C. Pevec, Professor Emeritus in vascular surgery at UC Davis School of Medicine, presented a lecture called “The Arteries of the Lower Extremity: How They Work, How They Fail, and How They are Fixed.”
“Peripheral artery disease (PAD) is a disease in which plaque builds up in the arteries that carry blood to your head, organs, and limbs. Plaque is made up of fat, cholesterol, calcium, fibrous tissue, and other substances in the blood.” – National Heart, Lung, and Blood Institute
The risk factors are the same issues that are cited for so many other health problems:
One in 20 Americans over 50 have PAD but it can occur in younger people. It seems that women have some premenopausal protection but catch up after age 70.
As the arteries get narrower, the body grows natural bypasses to get around the obstruction. Unfortunately, these detours cannot carry enough blood. Claudication, the mildest symptom, happens when there isn’t enough blood to meet increased demands of exercise. There is pain in hips, thighs, and calves when walking, it is reproducible, and resolves with rest, according to Dr. Pevec.
The next level of disease is a lack of adequate circulation when at rest. There can be constant, severe pain in the foot. It gets worse when the leg is elevated and that’s why some people have to sleep in chairs. The next step is end-stage tissue loss. The body needs good circulation to heal wounds and keep tissue alive.
What can you do about PAD?
It’s very important to get a diagnosis as soon as possible to avoid amputation and gangrene. Many people mistake claudication for muscle pain. Muscle cramps are not claudication, and this is different from neuropathy caused by diabetes.
Surgical interventions include angioplasty and stents, which can open the clogged arteries but not as easily as in the main arteries to the heart. These arteries are smaller and require more delicate surgery.
“Exercise can’t prevent atherosclerosis, but it helps increase your walking time when you already have claudication,” Dr. Pevec explained.
Since I’ve met many people who can’t walk anymore due to PAD, I know how it affects daily life. Unchecked, cardiovascular disease will not only kill you, but it can also make your life miserable before it does.
Click here to learn more about peripheral artery disease.