If you’re having trouble walking, don’t be too quick to dismiss your problem as a normal sign of aging. You could be experiencing symptoms of peripheral arterial disease, a serious but treatable condition.
Although most people know that a narrowing or blockage in the coronary arteries can lead to a heart attack, many don’t realize that the same type of blockage in other arteries in the body can have serious consequences.
It is estimated that 10 million American adults have peripheral arterial disease.
(EAP) or PAD). This disease is characterized by reduced blood flow due to narrowing of the arteries that carry blood from the heart to the rest of the body. It usually affects the legs and feet, and causes walking symptoms such as weakness, fatigue, pain or cramps that disappear within 10 minutes after resting.
“We see a lot of people say, ‘Oh, I thought I just had arthritis.’ Or: ‘I thought I was getting old and my legs were tired.’ Some say: ‘I thought he had problems because he had put on weight.’ They deny the problem and don’t bring it up at their doctor’s visits until more serious symptoms appear,” says Aidan Hamm, MD, a vascular surgeon, a member of the fellowship-trained team of vascular surgeons at Bethesda Hospital East and Bethesda Hospital West, which form part of Baptist Health.
“The legs are asking for more blood, but it can’t be given because there are blockages in the arteries,” explains Dr. Hamm.
Dr. Hamm points out that peripheral arterial disease is progressive. If left untreated, it can cause widespread vascular damage and other health problems. In the United States, PAD causes about 150,000 leg amputations each year.
“The degree of severity varies from people who have the disease but have no symptoms, to those who come in with limb-threatening emergencies and need to be rushed to the operating room right away,” says Dr. Hamm. As with most diseases, the earlier PAD is detected, the more successful treatment will be, he adds.
What causes PAD?
PAD occurs when a buildup of fatty deposits, known as plaque, causes blood vessels to narrow and stiffen, a condition known as atherosclerosis. Plaque sticks to the walls of the arteries and can prevent blood from reaching the organs and the rest of the body. It is one of the most common causes of heart disease.
“Atherosclerosis can occur anywhere in the body: not only in the arteries of the heart, but also in the legs, arms, arteries of the kidneys, the intestines and the brain. Everywhere,” says Dr. Hamm. “Treatment can range from conservative medical therapy to minimally invasive or complex surgical interventions.”
Anyone can get peripheral arterial disease, but some risk factors can make it more likely, such as smoking, high blood pressure, high cholesterol, and being age 60 or older. Diabetics and black people also have a higher rate of PAD.
How is PAD treated?
“This is a serious disease,” says Ian Del Conde, MD, a cardiologist and vascular medicine specialist who treats PAD patients at Miami Cardiac & Vascular Institute, also part of Baptist Health. “All people with PAD are at high risk for a cardiac event. Aggressive preventive measures need to be taken.”
If you are diagnosed with peripheral arterial disease, treatment will depend on its severity, location, and your general health. Doctors want to make sure the disease doesn’t progress in the first place, so patients often take drugs to lower blood pressure and cholesterol. You may also be given medication to prevent a blood clot from forming, which can occur when a blood vessel narrows.
In more advanced cases, intervention options include a minimally invasive procedure called angioplasty, in which a small catheter is threaded through an artery in the wrist or groin to the blockage and a balloon is inflated, pushing the plaque against the walls of the artery. Some patients may need an atherectomy, in which plaque is removed from the artery. Others may undergo a bypass procedure, using a blood vessel from another part of the body or a synthetic vessel.
Why is PAD disturbing?
Because PAD is so prevalent and can have serious consequences, medical organizations across the country have come together to raise awareness. September is Peripheral Arterial Disease Awareness Month, although this condition is a cause for concern year-round.
“When people come in with advanced disease, it’s much more difficult to save things, especially when it comes to saving limbs,” says Dr. Hamm. “If they had come a little earlier, we could have done something – whether minimally invasive or aggressive, like open revascularizations – to save limbs, prevent strokes or prevent aneurysms.”
People who have been diagnosed with heart disease need to be especially vigilant, according to Dr. Hamm.
“If plaque and atherosclerosis start to build up in the heart, it’s a harbinger that it’s somewhere else,” he says. “Getting screened and followed up early is a good way to prevent complications.”
what you can do
Because the hardened arteries that cause leg problems can also affect blood vessels in the heart and brain, it’s important to talk to your doctor about your risk. Additionally, you can improve your health profile by maintaining a healthy weight, increasing physical activity, controlling blood sugar levels if you have diabetes, quitting smoking, and avoiding all types of tobacco or nicotine.
Even if walking is hard for you, don’t give up. Avoiding exercise may be a natural response for those who experience claudication, the technical name for pain when walking. However, a recent study suggests that people with restricted blood flow to their legs and feet can improve their long-term walking ability if they put in a little effort.
The study, published in the Journal of the American Heart Association, found that people with PAD who walked at a speed that caused painful symptoms increased their leg function over time more than those who walked at a more comfortable pace. However, this “no pain, no gain” approach should be approached with caution, supervision, and in consultation with your doctor.
“If you notice that walking is becoming increasingly difficult, if you have trouble keeping up with others, or if you have pain when you walk, talk to your doctor,” advises Dr. Hamm. “People with peripheral arterial disease can lead active and long lives, but they should monitor their status and consult with a health care professional.”