Cardiovascular disease (CVD) is a serious problem in the United States, affecting an estimated 81 million Americans, according to the American Heart Association. CVD is a broad group of diseases involving the heart and blood vessels and is caused by atherosclerosis. Atherosclerosis is a condition in which fatty substances are deposited on the walls of arteries, reducing or blocking blood flow. There are many types of cardiovascular disease, such as coronary artery disease or peripheral arterial disease, which affect specific parts of the body.
Identification
Abbreviated PAD, peripheral arterial disease is a type of vascular disease that affects the lower extremities of the body. The disease is characterized by restricted blood flow to the legs that results in pain and other complications. It affects approximately 8 million Americans, but only about 25 percent are undergoing medical treatment, according to the American Heart Association.
Symptoms
Leg pain is the most common symptom of PAD. The pain generally occurs while walking, a condition called intermittent claudication. Pain severity varies widely among individuals and most often occurs in the region of the clogged artery. Additional symptoms related to restricted blood flow include numbness, coldness or sores in the lower extremities, color change of the legs or feet, and hair loss in the lower limbs.
Causes and Risk Factors
Atherosclerosis is the primary cause of peripheral arterial disease, but many conditions and lifestyle behaviors increase the risk of developing fatty deposits on vessel walls. Smoking, diabetes and obesity are all risk factors along with high cholesterol and blood pressure. Increasing age is a risk factor as more time allows more buildup to occur, depending on certain lifestyle and genetic factors. Sometimes, certain infections, blood clots and injuries to the legs can cause peripheral arterial disease. It is important to note that atherosclerosis and associated diseases are often preventable with healthy lifestyle choices.
Treatment
Many therapies exist to manage the symptoms of PAD and to stop the progression of atherosclerosis. Lifestyle changes are extremely important and include smoking cessation, weight loss, increases in physical activity and a healthy diet. Medications are often prescribed to lower cholesterol and blood pressure, control blood sugar levels, and to prevent blood clots or increase blood flow to the limbs. Several surgeries exist to open up clogged arteries or to circumnavigate them altogether, such as an angioplasty or graft bypass surgery.
Diagnosis
A complete medical history and physical examination along with blood and imaging tests is the general process in diagnosing peripheral arterial disease. The most common test is the ABI (ankle-brachial index) test, which compares the blood pressures of the ankle region to the arm, generally while walking on a treadmill. Imaging techniques such as an angiography or ultrasound evaluate blood flow to determine if narrowed arteries are present. Blood tests evaluate levels of homocysteine and C-reactive protein, which are commonly elevated in PAD.
