Peripheral Arterial Disease (PAD)
What is Peripheral Arterial Disease (PAD)?
Peripheral Arterial Disease, or PAD, is a cardiovascular disease that results in a decrease in blood flow to the lower limbs, most often the legs and feet. PAD is caused as a result of atherosclerosis, which occurs due to a buildup of plaque in arteries walls that supply blood to various limbs and organs in the body.
A buildup of these fatty deposits of plaque resulting from high levels of cholesterol, diabetes, high blood pressure, and smoking leads to the thinning of vessels and blockages that prevent the adequate flow of blood to the extremities. Poor circulation occurs as a result of PAD.
Patients with peripheral arterial disease, along with diabetes, are at a greater risk of developing foot ulcers that do not heal. If left untreated, this often results in amputation. In fact, these non-trauma related foot complications are the leading causes of leg and foot amputations in the US.
What Are the Causes of PAD?
While atherosclerosis is the major cause of PAD, there are other factors that can make a patient predisposed to developing this disease. The risk of developing peripheral arterial disease increases with age—according to the CDC, 6.5 million US adults aged 40 and over have PAD. Approximately 10% of adults between the age of 70-79 have PAD. The occurrence more than doubles to 25% for those over the age of 80.
Peripheral arterial disease can also occur due to the following risk factors:
- high cholesterol and blood pressure
- lifestyle choices, lack of physical activity
- diet high in saturated fats
- race—African Americans and Latinos are more likely to develop PAD
- chronic kidney disease
- certain metabolic diseases
- vitamin D deficiency
Symptoms of Peripheral Arterial Disease in Your Feet
For 4 in 10 patients with PAD, little to no symptoms may be experienced. This is why early diagnosis and regular checkups with your podiatrist are essential to managing PAD and preventing the symptoms from worsening.
Make an appointment with your podiatric physician if you experience leg pain or any of the following symptoms:
- intermittent claudication—aches or cramps in your legs (that can radiate up to your hips and buttocks) is a common occurrence right after walking or climbing up the stairs
- muscle weakness
- hair loss on legs
- cool skin with a bluish tone, especially while walking
- no pulse felt in the feet
- open sores or ulcers that are slow to heal
- numbness or tingling in toes
- erectile dysfunction
- critical limb ischemia—one of the most dangerous symptoms of PAD, which occurs as a result of a blood clot blocking a narrowed artery leading to a lack of blood and oxygen in the lower limbs.
What to Expect During a Peripheral Arterial Disease Foot Treatment
Regular checkups with your podiatric physician will involve physical foot examinations to not only ensure your feet are healthy but free from cuts, calluses, and any other injuries that may lead to the formation of foot ulcers. If you're at risk of developing PAD—based on your family history, lifestyle, and current overall health—your podiatrist can conduct the following tests:
- ankle-brachial index (ABI) test—this compares the blood pressure rate in your arm with the rate in your ankle. An abnormal result may lead to other tests to determine the severity of PAD
- blood tests to determine levels of cholesterol and glucose in the blood, as well as the level of kidney function
- Doppler duplex ultrasound test—used to identify PAD blockage sites in the legs.
Reducing or eliminating certain risk factors will not only reduce the symptoms of PAD but enhance your overall wellness and increase your quality of life. Personalized treatment for patients with PAD can include:
- changes to lifestyle, including smoking cessation and increase in physical activity
- dietary changes
- use of medicine
- surgery—in the case of blocked arteries
- stress reduction
- daily foot checkups