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Vascular Health 101

Understanding what Vascular Disease is can help you recognize symptoms and take preventative action, further protecting yourself from future Heart Disease.

Peripheral Arterial Disease

Untreated, peripheral arterial disease raises a person's risk for heart disease and stroke, as well as serious leg damage.

A simple test on your ankle could give you a heads-up on heart disease.

It's called an ankle-brachial index, or ABI, and it's used to detect signs of poor blood flow in your legs. That can be a symptom of peripheral arterial disease (PAD), a narrowing of the arteries that is linked to heart disease and stroke.

What is peripheral arterial disease?

PAD is a form of peripheral vascular disease, a term that refers to diseases of blood vessels outside the heart and brain, according to the American Heart Association (AHA).

PAD happens when arteries leading to the arms, legs, feet, kidneys or stomach become narrowed.

The earliest symptoms of PAD are often a cramping pain and fatigue in your legs and buttocks during physical activity, notes the AHA. This pain, called claudication, goes away after a few minutes of rest.

The pain is a sign that not enough oxygen-rich blood is getting to your legs during exertion. Because your muscles' need for oxygen decreases at rest, the pain stops when the physical activity stops.

"That may be a sign you have blocked arteries in your legs," says Nieca Goldberg, MD, a cardiologist and volunteer for the AHA.

As the disease progresses, you might notice pain at rest too, she says. Other symptoms of PAD include numbness or tingling in the lower legs and feet; coldness or change in the color of your legs, feet and toes; and slowed healing of sores or infections in the lower extremities.

why screening is important

Although the symptoms of PAD usually show up in the legs, the problem is rarely confined to that area.

PAD usually develops as a result of atherosclerosis, the buildup of fatty deposits in the linings of arterial walls, according to the Society of Interventional Radiology(SIR). People with PAD often have the same fatty buildup in other arteries too, such as those in the heart and brain. That raises their risk for heart attack and stroke. Left untreated, PAD also can result in loss of feeling in the leg, gangrene and amputation.

That's why the American Diabetes Association and the SIR recommend using the ABI test to screen people at high risk for the disease.

During the ABI test, a doctor uses a special stethoscope to compare the blood pressure in the feet and arms.

An ABI test can alert your doctor to decreased circulation in your legs. He or she might also order other tests, such as an imaging test to check blood flow.

According to the SIR, if an ABI test suggests that you may have PAD, you might need other tests to confirm the diagnosis. These tests may include ultrasound, magnetic resonance angiography (MRA) and computed tomography (CT) angiography.


you might want to ask your doctor about screening if you:

• Are older than 50.
• Have diabetes.
• Smoke.
• Have high blood pressure or high cholesterol levels.
• Are overweight.
• Have a family history of heart or vascular disease.
• Have a sedentary lifestyle.

You should also see your doctor, of course, if you have any symptoms of PAD.

treatment and prevention

The 1st line of treatment and prevention for PAD is changing your lifestyle to lower your risk for heart disease and stroke, Dr. Goldberg says. And the 1st item on the list of lifestyle changes is for people who smoke to quit.

Other lifestyle modifications include:

Controlling diseases such as diabetes and high blood pressure.
Lowering cholesterol levels.
Beginning a regular exercise program, such as walking.
Choosing a healthy, low-fat diet.

Medications used to treat PAD include antiplatelet agents, such as aspirin, and medicines to lower cholesterol, such as statins.

In the rare cases where these treatments don't work, surgery might be needed to open clogged arteries.

"There is a lot that can be done if you have PAD," Dr. Goldberg says.

Start by seeing your doctor if you think you are at risk.


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Cardiology Services

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