BY ELINOR NAUEN
You walk a block, then clutch your leg with what feels like a charley horse. You stop, and the pain does too. The discomfort may be a warning of a common yet serious condition called peripheral arterial disease (PAD).
In PAD, the same fatty material that can clog heart arteries builds up in the arteries of the legs, blocking blood flow. The risk for death from heart attack or stroke is six to seven times greater in people with PAD—equivalent to the risk of someone who’s had a heart attack or stroke. Without prompt treatment, one in four people with the condition will suffer a heart attack, stroke or amputation or die within five years.
PAD is most often recognized when it causes claudication—fatigue, cramps, tiredness or pain in the leg or buttock muscles that goes away when you stop walking. Less frequently, PAD can cause ulcers or slow-healing wounds on the feet or toes, or pain in the feet or toes that disturbs sleep. However, as many as half to two thirds of those with the condition have no symptoms.
As with coronary heart disease, key risk factors for PAD are having diabetes, smoking or having smoked, and being over age 50. “If you have no other risk factors, age alone will increase risk—and yet risk rapidly increases even in younger people who smoke or have diabetes,” says Alan T. Hirsch, M.D., professor of epidemiology at the University of Minnesota School of Public Health in Minneapolis. “We want people to recognize that if you are over 50 and have any other risk factor, you have a one in four chance of having PAD.”
Also at risk are African Americans and anyone with chronic kidney disease, high blood pressure, high blood cholesterol or a personal or family history of vascular disease, heart attack or stroke. An estimated 8 to 12 million people in this country have PAD.
If you have risk factors, talk to your doctor, whether or not you have symptoms. The PAD Coalition, a consortium of health organizations and government agencies, recommends that those at risk get a quick, painless, accurate and inexpensive diagnostic test called an ABI (ankle-brachial index).
The good news: PAD is both preventable and treatable. “PAD is a common and serious disease, which merits immediate and lifelong attention,” says Dr. Hirsch. “Become informed and take actions to protect your health.”
Arms for Legs
While exercise is helpful for people with PAD, walking—a typical workout for sufferers—can also be painful. Diane Treat-Jacobson, R.N., Ph.D., assistant professor at the University of Minnesota in Minneapolis, has done studies on the effects of exercise on people with PAD. She recently discovered that supervised training using aerobic arm exercise was as beneficial as treadmill walking in improving walking distance. Treat-Jacobson notes that while results are preliminary, arm exercise might be a pain-free option that can “help break the cycle of disability or enable patients to start exercising sooner after a surgical procedure.”
Writer: Elinor Nauen
©MediZine's Healthy Living, Second Quarter 2007
