PAD - causes, risk factors, diagnosis and treatment

Peripheral artery disease (PAD) is one of the most common diseases, although few have heard of it. Unfortunately, despite the many diagnostic methods available, it is usually diagnosed very late. In Poland, about 40,000 patients with peripheral arterial disease are hospitalized every year.. Many patients have to perform amputation of limbs due to impaired blood supply. Narrowing or blockage of large arteries that block blood flow can also cause other complications. As a result of unrecognized peripheral arterial disease and circulatory disorders, incl. to death from cardiovascular causes - the disease causes, among other things, stroke and heart attack.

How common is PAD?

The prevalence of peripheral vascular disease in the general population is 3–10%. In persons at risk, which includes patients over 70 years of age, the incidence of peripheral vascular disease is 14-29%. Many patients are not aware of the risks associated with PAD. The disease can be detected with simple tests such as angiography and ultrasound.

It’s worth knowing that Methods for diagnosing and preventing PAD are not complicated. To reduce the risk associated with peripheral vascular disease, lifestyle modification plays an important role, i.e. increased physical activity and avoidance of stimulants.

Estimated about 40 percent of patients with peripheral artery disease cause no symptoms. Intermittent claudication, among other things, is a characteristic symptom indicating PAD and requiring careful diagnosis.

Peripheral artery disease - basic information

Peripheral artery disease does not affect the coronary and cerebral arteries. Its development affects the functioning of the blood supplying arteries, i.e. lower limbs and kidneys. Older people are most at risk of developing PAD, but middle-aged people can also be affected. In this case, Lifestyle is important.

Causes of peripheral arterial disease

Peripheral artery disease is caused by the buildup of atherosclerotic plaques in the arteries (peripheral arteriosclerosis) that impair blood flow, resulting in inadequate blood supply to the lower extremities. Acute limb ischemia, which may be accompanied by coronary artery calcification, is one of the most commonly diagnosed peripheral arterial diseases. The disease process greatly increases the risk of heart attack and stroke.

Risk factors for developing PAD

Risk factors for developing peripheral artery disease include:

• middle age and old age

• smoking,

• overweight and obesity,

• passive lifestyle,

• chronic stress.

Risk factors for PAD also include diabetes, high cholesterol, and high blood pressure.

More often this disease develops in people with a genetic predisposition to the development of cardiovascular diseases.
However, by reducing risk factors, serious complications of PAD can be avoided. Stopping smoking, changing diet and increasing physical activity are the most important elements in the prevention and treatment of peripheral artery disease.

Symptoms of peripheral artery disease

Symptoms of the disease clearly indicate problems with blood circulation. These include:

• pain in the lower extremities when walking,

• weakness of the arms and lower extremities,

• calf cramps,

• pain in the lower extremities at rest.

It is worth paying attention to the appearance of the lower extremities and complaints associated with impaired blood supply, which may indicate peripheral arterial disease. The following should be of concern:

• wounds and ulcers that appear on the skin,

• hair loss,

• excessive freezing of the feet,

• change in skin color.

The above symptoms are typical for older people. They can indicate various diseases, for example, varicose veins of the lower extremities. They should not be underestimated, since untreated circulatory disorders lead to tissue necrosis and increase the risk of serious cardiovascular complications.

Other symptoms of peripheral artery disease include: headaches, dizziness, and visual disturbances, which are common in patients with atherosclerosis.

How is peripheral arterial disease diagnosed?

At the stage of diagnosing peripheral arteries, non-invasive methods are used, i.e. Ultrasound, magnetic resonance imaging and angiography. The doctor also checks the ankle-brachial index - it measures blood pressure in the ankle and both hands.

Treatment of peripheral arterial disease

Early diagnosed peripheral arterial disease is treated conservatively. With the ineffectiveness of conservative treatment, treatment with varying degrees of invasiveness is necessary. Treatment of peripheral arterial diseases is selected individually for each patient. Treatments used include minimally invasive stenting and balloon angioplasty, as well as typical open heart surgeries.

Sources:

• Krasinski Z. et al., “The position of Polish specialists in the conservative treatment of patients with lower limb artery disease”, Acta Angiol, 2019, vol. 25, no. 2

• Fawkes F, Gerald R et al. Comparison of global estimates of prevalence and risk factors for peripheral artery disease in 2000 and 2010; system review and analysis, The Lancet. 2013; 382 (9901): 1329–1340