Peripheral Arterial Disease (PAD) is a common problem that affects almost 10 percent of the population. It is estimated that one in every 20 adults over the age of 50 has PAD. It is when blood vessels begin to narrow leading to decreased blood flow to the lower legs and feet. This disease is called Peripheral Arterial Disease because it affects the peripheral or outer arteries of the body, such as those in the legs. However, the same process will be happening in the blood vessels of the brain and heart increasing the risk of a heart attack or stroke.

How does it develop? Arteries are blood vessels that carry blood away from the heart and supply essential nutrients and oxygen to every part of the body. Normally the artery is a smooth tube for the blood to travel over. Sometimes when the blood travels through the arteries it can leave deposits, called plaques, which stick to the inside of the vessel. This is known as atherosclerosis. Over many years, these plaques build-up and cause the inside of the artery to get tight and narrow.

What are the causes of peripheral arterial disease? There are some conditions and habits that raise your chance of developing PAD. These include:

• Over the age of 50.

• Those who smoke or used to smoke have up to four times greater risk of PAD

• Have diabetes. One in three people over the age of 50 with diabetes is likely to have PAD

• Have high blood pressure. High blood pressure raises the risk of developing plaques in the blood vessels.

• Have high blood cholesterol. Excess cholesterol and fat in the blood lead to plaques forming in the blood vessels

• Have a personal history of vascular disease, heart attack, or stroke – one in three chance of also having PAD

• African heritage - you are more than twice as likely to have PAD as your white counterparts.

• Most people with PAD have one or more conditions or habits that raise the risk for heart disease.

Symptoms

One of the first symptoms PAD is an ache or cramp in your leg muscles when you're walking. It most commonly occurs in the calf muscle, but can also occur in the thigh or buttock muscles. This is called intermittent claudication and is relieved when you stop walking and rest.

In some people, the disease progresses and the amount of blood going down the leg/foot is not enough to carry the nutrients and oxygen to that the feet need. Because of this, the individual will get pain in their feet even when they're not walking or moving. This is known as rest pain and is a symptom of critical limb ischemia. Without nutrients and oxygen getting down into the foot, the skin is unable to function properly and can break down into an ulcer or wound. If an individual has rest pain or skin breakdown they are at high risk of losing their foot or leg by an amputation.

Tests for Peripheral Arterial Disease. If you have symptoms or suspect you have PAD, see your doctor as soon as possible. Your doctor will take a medical and family history, perform a physical exam, and conduct diagnostic tests. These may include an Ankle Brachial Index (ABI) which check the blood supply to your feet. Based on the results of this test more tests may be ordered such as ultra sound Doppler or an Angiogram.

Treatments for peripheral arterial disease

Early treatment of PAD can restore your mobility, decrease your risk for heart attack and stroke, and possibly save your life. The overall goals for treating PAD are to reduce any symptoms, improve quality of life, and prevent amputations. There are three main approaches to treating PAD. Your doctor will decide on the best treatment options for you, based on your medical history and the severity of your condition.

1. Lifestyle Changes

PAD treatment often includes making long-lasting lifestyle changes. If you have PAD, or are aiming to prevent it, your health care provider may prescribe one or more of the following:

• Quit smoking. Don't smoke, and if you do, quit. Consult with your health care provider to develop an effective cessation plan and stick to it.

• Lower your numbers. Work with your health care provider to normalize any high blood pressure, cholesterol, and blood glucose levels.

• Follow a healthy eating plan. Eating a plant-based diet is best. Choose foods that are low in saturated fat, transfat, and cholesterol. Be sure to include lots of whole grains, vegetables, and fruits.

• Get moving. Make a commitment to be more physically active. Aim for 30 minutes of moderate-intensity activity on most, preferably all, days of the week. Exercise is key to improving vascular health.

• Aim for a healthy weight. If you are overweight or obese, work with your health care provider to develop an effective weight loss plan.

2. Medication

Your health care provider may prescribe one or more medications to help:

• Lower high blood pressure and cholesterol levels and treat diabetes;

• Thin the blood to prevent the blood clots that could cause heart attacks or strokes; and

• Reduce leg pain while walking or climbing stairs.

3. Special Procedures and Surgeries

If the blood flow in one of your limbs is completely or almost completely blocked, you will be seen by a vascular surgeon who will perform surgery to open up the blood vessels but medications and lifestyle changes are still needed to make sure the surgery is successful long term. Procedures such as angioplasty and bypass graft surgery will not cure PAD, but they can improve the blood flow to your legs and your ability to walk as well as help wounds to heal.

I am certain you have seen people wearing long white socks or maybe worn them yourself but, did not realize they meant something more. Well, September is Peripheral Arterial Disease Awareness Month and wearing one white socks brings awareness of lower extremity amputations and Peripheral Arterial Disease. It highlights the plight of persons who have these conditions, how to prevent and treat them.

If you have any symptoms of PAD or want to be tested, visit your podiatrist or your primary care physician. For more information on PAD email us at foothealth242@gmail.com or visit www.thesalsal.org or www.PADcoalition.com. To see a podiatrist visit Family Foot Centre on Independence Highway or call 605- 3668 or 341-3668 for an appointment or visit Bahamas Surgical Associates Center at Hilltop Medical East Terrace Centerville or call 603-1814-16 for an appointment. In Grand Bahama visit Lucayan Medical Center on East Sunrise Highway or call 373-7400 for an appointment.

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