There’s Trouble Afoot (Avoid This Common Health Misstep)

Far less well-known than Coronary Artery Disease (CAD), Peripheral Artery Disease (PAD) can still result in loss of life and limb (not in that order).

Or, as it was put in a new action plan that has been launched all so recently in Canada, in large part due to public awareness being so poor:

❝Peripheral artery disease (PAD) is defined as atherosclerosis that affects limb arteries remains a major cause of cardiovascular morbidity, limb loss, and premature mortality.

Despite its prevalence, PAD remains under-recognized, undertreated, and inconsistently prioritized within national chronic disease strategies.❞

Source: Canadian National Action Plan for Peripheral Artery Disease: A Joint Statement of the Canadian Society of Vascular Medicine and the Canadian Society of Vascular Surgery

Fortunately, there are already some ways to be on your guard:

What it is

Peripheral Artery Disease (PAD) is the same thing as Coronary Artery Disease (CAD), just, in the periphery—which by definition means “outside of the heart and brain”, but in practice, it starts with the extremities. And of the extremities, it tends to start with the feet and legs, for the simple reason that if someone’s circulation is sluggish, then because of gravity, that’s where’s going to get blocked first.

In both CAD and PAD, the usual root cause is atherosclerosis, that is to say, the build-up of fatty material inside the arteries, usually commensurate to LDL (“bad”) cholesterol, especially in men (high LDL is still a predictor of cardiovascular disease in women though, just more modestly so, at least pre-menopause or in cases of treated menopause whereby HRT has returned hormones to pre-menopause levels).

See also: Demystifying Cholesterol

And for that about sex differences: His & Hers: The Hidden Complexities of Statins and Cardiovascular Disease (CVD)

Why it is

This one’s straightforward, as it’s the same things as any kind of cardiovascular disease: high blood pressure, high cholesterol, older age, obesity, smoking, drinking, diabetes, and genetic factors (so, a risk factor is: family history of heart disease).

However, while those are the main causes and/or risk factors, it absolutely can still strike other people, so it’s as well to be watch out for…

What to look out for

Many people first notice signs and symptoms that turn out to be PAD when they experience pain or numbness in the foot or feet, and/or a discoloration of the feet (especially toes), and slow wound healing.

At that stage, chances are you will need to go urgently to a specialist, and surgery is a likely necessity. With a little luck, it’ll be a minimally-invasive surgery to unblock an artery; failing that, an amputation will be in order.

At that stage, under 50% will be alive 5 years from diagnosis:

Cardiovascular and all-cause mortality in patients with intermittent claudication and critical limb ischaemia

You probably want to avoid those. Good news is, you can, by catching it earlier!

What to look out for before that

The most common test for PAD is one you can do at home, but enlisting a nurse to do it for you will help ensure accurate readings. It’s called the Ankle-Brachial Index (ABI) test, and it involves comparing the blood pressure in your ankle with the blood pressure in your arm, and expressing them as a ratio.

Here’s how to do it (instructions and a video demonstration if you want it):

Do Try This At Home: ABI Test For Clogged Arteries

If you need a blood pressure monitor, by the way, here’s an example product on Amazon.

• A healthy ABI score is between 1.0 and 1.4; anything outside this range may indicate arterial problems.
• Low ABI scores (below 0.8) suggest plaque is likely obstructing blood flow
• High ABI scores (above 1.4) may indicate artery hardening

Do note also that yes, if you have plaque obstructing blood flow and hardened arteries, your scores may cancel out and give you a “healthy” score, despite your arteries being very much not healthy.

For this reason, this test can be used to raise the alarm, but not to give the “all clear”.

There are other tests that clinicians can do for you, but you can’t do at home unless you have an MRI machine, a CT scanner, an x-ray machine, a doppler-and-ultrasound machine, etc. We’ll not go into those in detail here, but do ask your doctor about them if you’re concerned.

What to do about it

In the mid-to-late stages of the disease, the options are medication and surgery, respectively, but your doctor will advise about those in that eventuality.

In the early stages of the disease, the first-line recommend treatment is exercise, of which, especially walking:

Lower Extremity Peripheral Artery Disease: Diagnosis and Treatment

Given that this more often happens when someone hasn’t been walking so much, it can be a walk-rest-walk approach at first (a treadmill on a low setting can be very useful for this):

See also: Exercise Comparison Head-to-Head: Treadmill vs Road

If walking outside isn’t an option and you don’t have a treadmill, then you can also try: The Best Home Exercise To Improve Circulation In Your Legs

Take care!