Peripheral arterial disease
Peripheral arterial disease (PAD) is a common condition in which a build-up of fatty deposits in the arteries restricts the blood supply to leg muscles. It is also known as peripheral vascular disease. It frequency increases with age. It tends to be an under-diagnosed condition with many people suffering from symptoms of PAD not realising what it is and that it can be treated. About 1 in 5 men and 1 in 8 women aged 50 to 75 years have PAD. It increases with age.
The most common symptom of PAD is painful cramping in the legs brought on by walking. Cramps generally disappear after 5 to 10 minutes of resting. About two-thirds of people with PAD have no noticeable symptoms. PAD is not immediately life-threatening; PAD often indicates that the person is suffering from a more serious condition called atherosclerosis. This is a serious condition where the medium and large arteries become clogged up by fatty substances, such as cholesterol. If untreated, condition will get worse and can lead to serious clots, including coronary heart disease including angina, heart attack and stroke.
If the symptoms of PAD worsen, there is a risk of gangrene as blood flow is blocked to the lower leg due to poor circulation; the tissue of the lower leg can die which can lead to amputation.
Risk factors for PAD are the same as for other cardiovascular diseases and include smoking, diabetes, high blood pressure and high cholesterol levels. Smoking is considered the biggest single risk factor. The two most important lifestyle changes are to stop smoking if still smoking and to exercise daily.
The most common symptom of peripheral arterial disease (PAD) is painful cramping in leg muscles triggered by physical activity such as walking or climbing stairs. This is because as you walk, muscles in the legs (especially the calves) need more blood and oxygen, but this is blocked by the narrowed arteries. The pain and cramps usually occur in the calves, but sometimes the hips or thigh muscles are affected. If an artery higher up is narrowed, then pain in the thighs or buttocks can occur when walking.
Other symptoms of PAD may include numbness or weakness in the legs; hair loss on legs and feet; skin colour on the legs turning pale or bluish; shiny skin; brittle, slow-growing toenails; ulcers on the feet and legs which are slow to heal; shrinking of the muscles in the legs; not being able to feel a pulse in the legs or the pulse feeling much weaker than normal and erectile dysfunction
Some symptoms suggest that the supply of blood to the legs has become severely restricted and require urgent medical treatment. These include being unable to move the muscles in the affected leg; a burning or prickling sensation in the affected leg; toes suddenly turning blue and the skin on the toes or lower limbs becoming cold and numb, turning reddish and then black or beginning to swell and produce foul-smelling pus, causing severe pain.
Making lifestyle changes such as stopping smoking, exercising more and eating a healthy balanced diet is the first step to preventing and treating PAD. Medication may be required to address the underlying cause of PAD and reduce the risk of developing a more serious condition such as stroke. Surgery may be used as a last resort.
Medication may be used to treat the underlying causes of PAD while reducing the risk of developing another cardiovascular disease such as heart attack or stroke. Statins reduce the production of LDL (bad) cholesterol by the liver. Antihypertensives treat high blood pressure. Anti-platelet drugs thin the blood thus reducing the risk of clots. Aspirin is the most commonly used anti-platelet drug.
Surgery is reserved for severe cases. The two main types of surgery for PAD are angioplasty and bypass graft. Angioplasty is where a blocked or narrowed section of artery is widened by inflating a tiny balloon inside the vessel. A bypass graft is where blood vessels are taken from another part of the body and used to bypass the blockage in an artery.
What is BPro Cardio Screen Service?
Whelehans has a cardiovascular health check called BPro Cardio Screen. It measures the stiffness of your arteries to help identify risk of blockages and your risk of cardiovascular disease and circulation problems. It calculates a wave signal that indicates the elasticity of large, small, and peripheral artery walls as well as tests for stress, central blood pressure, heart rate, and more. It is now €35 (was €50); it only takes about 15 minutes to get checked. The next clinic is this week, Thursday April 26nd from 9am to 6pm at Whelehans Pearse St. Book by calling Whelehans at 04493 34591.
BPro Cardio Screen is not meant as a substitute for proper medical assessment with your doctor and should not replace prescription medication
Written and researched by Eamonn Brady (MPSI), Whelehans Pharmacy, 38 Pearse Street, Mullingar. Enquiries 04493 34591; www.whelehans.ie