Nothing peripheral about this artery disease
Peripheral artery disease affects at least 12 million Americans, more
than heart disease and stroke combined. It kills some, maims others,
and makes life disagreeable or unbearable for countless more.
Comprehensive diagnosis and treatment guidelines from a coalition of
38 major medical organizations, to be followed in mid-2006 by a public
education campaign, aim to put peripheral artery disease on everyone’s
radar. It’s a worthwhile goal, since it likely affects most American
How did such a common malady remain an ’unknown’ disease
over the years? Peripheral artery disease spans so much of the body — all
of the arteries below the heart — that its diagnosis and treatment
have been split among several medical specialties.
Peripheral artery disease is a catchall term for problems with the arteries
that supply the feet, legs, kidneys, intestines, and other body parts
south of the heart.
- Narrowed leg arteries can cause claudication, a potentially disabling
leg pain that occurs with walking or exercise. Severely narrowed
or clot-blocked arteries are also responsible for thousands of foot
and leg amputations each year.
- Kidneys supplied by narrowed or blocked arteries can weaken or fail.
Poor blood flow to the kidneys can also lead to severe hypertension.
- Blood flow problems in the intestinal arteries can cause abdominal
pain after eating. In severe cases, they can lead to weight loss, malnutrition,
and even permanent damage to the bowel..
- The abdominal aorta, also falls into the territory of peripheral
artery disease. A small patch of the artery wall may weaken and bulge
outward. This is called an abdominal aortic aneurysm. Large ones can
rupture, with deadly consequences.
Throughout the body
One of the most important things to know about peripheral artery disease
is that it isn’t usually confined to the peripheral arteries. It’s
a systemic disease. If you have peripheral artery disease, you may also
have problems in the arteries that nourish the heart (coronary artery
disease) or those that supply the head and brain (carotid artery disease).
Likewise, trouble in the coronary or carotid arteries usually means restricted
blood flow to the legs, kidneys, or intestines.
What’s the connection? All three are signs of arteriosclerosis.
Triggered by smoking, a diet rich in saturated fats and refined carbohydrates,
and inactivity, arteries stiffen and narrow. Procedures to bypass or
open diseased arteries may ease symptoms. But they don’t fix the
problem. Peripheral artery disease must be attacked on all fronts with
every possible strategy for halting or reversing arteriosclerosis.
Find it early
The guidelines urge doctors to be more aggressive about asking their
patients about leg pain or numbness, foot or leg wounds that aren’t
healing properly, and abdominal pain after eating. Another crucial question
is whether they have parents or siblings with peripheral artery disease
or an abdominal aortic aneurysm.
The guidelines promote wider use of two physical exams. The first exam
tests the blood vessels - measuring blood pressure in both arms and checking
pulses at various points in the body. It also includes checking the abdomen
for signs of an aortic aneurysm. The second exam is called the ankle-brachial
index. It is a comparison of the blood pressure measured at your ankle
against the pressure measured just above the elbow.
Does everyone need such an extensive workup for peripheral artery disease?
No. But testing is a good idea if any of the following applies to you:
- You have leg pain while walking that goes away when you rest.
- You have heart disease, carotid artery disease, or kidney trouble.
- You have a family history of peripheral artery disease.
- You are under age 50 and have diabetes and one other risk factor
for arteriosclerosis, such as high blood pressure or cholesterol.
May 2006 update
Back to Previous