September is Peripheral Artery Disease, or PAD, awareness month. PAD is a condition which may be unfamiliar to many, yet it affects more than 230 million people worldwide. In the U.S. alone, it’s estimated that more than 8 to 12 million people live with PAD, putting them at risk for serious complications.

At Vascular Care Specialists of Los Angeles, Dr. Mathew Cheung and Dr. Peter Lin discuss what you should know about peripheral artery disease. Since September is PAD Awareness month, spreading awareness will help educate those who know little about PAD since this disease is widely underdiagnosed and undertreated.

PAD is a slow, progressive, sometimes life-threatening vascular disease that is caused by narrowing or blockages of the arteries in the peripheral arterial system, or the arteries in the limbs. When plaque builds up, blood flow to the limbs is limited and can result in a variety of health problems, which in its most severe form includes limb amputation. In patients with PAD, they may experience wounds in lower leg, leg pain when walking, or leg cramps triggered by activity.  These are all common symptoms of PAD.

The goal throughout September is to draw special attention to the symptoms and risk factors of PAD,  providing tips on how to prevent and detect the disease. To show just how common PAD can be, here are some facts to be aware of:

• PAD affects 12%-14% of the world’s population.
• One in three diabetics over age 50 suffers from PAD.
•  Approximately 150,000 lower-limb amputations in the U.S. can be attributed to PAD each year.
• About 20%-50% of people with PAD are asymptomatic.
• Smoking increases the likelihood of developing PAD by 400%.

Unfortunately, many people are not aware that they have PAD, as it is often asymptomatic or similar to the symptoms of arthritis or simply old age.  However, some PAD symptoms you should not ignore are leg fatigue, changes in the appearance of your legs, decreased hair growth on your legs and feet, leg pain, and lower limb sores that will not heal. If you are experiencing any of these symptoms, it is important to see a doctor right away.

Early detection of PAD is crucial, as waiting can lead to more serious complications. If left undiagnosed or untreated, PAD can lead to amputation. Vascular diseases, including PAD, are now responsible for 80 percent of all amputations. It is important to recognize the potential severity of PAD and how ignoring your symptoms can lead to amputation. Pay close attention to your body and make regular visits to your doctor so you can identify any disease including PAD before it progresses.

There are a few risk factors that can contribute to PAD. Smoking is one of the biggest contributors to PAD, as it damages the inner layers of your arteries and causes plaque to build up. The sooner you quit smoking, the sooner you begin to lower your chances of developing PAD. Other risk factors include advanced age, high cholesterol, diabetes, high blood pressure, obesity, lack of exercise, and a family history of vascular disease. If someone in your family has suffered from a vascular disease, your chances of developing PAD are greater. Knowing your family history can be vital so you can watch for the early signs of the disease.

The best way to prevent PAD or the progression of PAD is to reduce the symptoms. In most cases, this means a lifestyle change. Regular physical activity is often an effective treatment. Here are some useful tips to improve your lifestyle and reduce your risk for PAD.

1. Get active with regular physical activity

A peripheral artery disease exercise program is recommended for all patients living with PAD, but particularly for those with claudication, or poor circulation in the leg arteries due to plaque buildup. Exercise, combined with lifestyle changes, may slow or stop the progression of PAD. Potential benefits include:

• Reducing limb pain and symptoms
• Improving exercise ability
• Preventing or improving physical disability
• Decreasing the risk of cardiovascular events, such as heart attack and stroke

Although PAD reversal is not possible, regular physical activity can help relieve the symptoms of PAD. In the beginning, walking may cause pain. However, by alternating activity and rest in timed intervals, you’ll begin to build up the length of time that you can walk before feeling pain.

Experts recommend that PAD patients exercise in a monitored environment, like on a treadmill at a cardiac rehabilitation center. If you aren’t able to go to a cardiac rehab center, your doctor may recommend a community- or home-based program that’s appropriate for your condition. The American Heart Association also recommends that patients with PAD participate in structured exercise therapy (SET), which has been shown to produce better results than unsupervised training. Exercise should be tailored to each patient and should include specific instructions for the type, frequency, intensity, and duration. The most effective structured exercise is conducted in a hospital or outpatient facility.

2. Diet plays a role in slowing PAD

Two popular diets make eating healthy easier. These plans have been shown to prevent cardiovascular disease or decrease the progression.

• The Mediterranean Diet – The Mediterranean diet promotes high proportions of olive oil; legumes, such as peas, beans, and lentils; unrefined cereals; fruits; and vegetables. It also includes moderate to high amounts of fish, moderate amounts of dairy, such as cheese and yogurt, and wine. The plan allows very limited amounts of meat and meat products.
• The DASH (Dietary Approaches to Stop Hypertension) Diet – The DASH diet limits sodium and overall fat intake and restricts alcohol. There is strong evidence this plan reduces hypertension, cardiovascular disease risk, and cardiovascular disease progression. By eating a variety of nutritious foods from all of the food groups, you’ll ensure that your body gets the proper nutrients it needs. Be sure to read Nutrition Facts labels and stick to recommended portion sizes.

Before beginning any diet program, it’s important to consult your physician to determine if there are any health issues that may affect you while changing your eating habits.

3. Quit smoking

Smoking is one of the top PAD risk factors, followed by ethnicity, diabetes, poor kidney function, high blood pressure and high cholesterol. Smoking increases the risk of developing PAD two to six times, according to the U.S. Centers for Disease Control and Prevention (CDC). The strong correlation between smoking and PAD has been the subject of research for more than 60 . In fact, 50 percent of PAD cases can be directly attributed to smoking. Additionally, current smokers are almost four times as likely to develop asymptomatic PAD as non-smokers. Additionally, it doesn’t take much to up your risk for developing PAD. Smoking even half a pack of cigarettes a day may increase your risk of having PAD by up to 50 percent.

By quitting smoking, you can prevent PAD from worsening and increase your chance of survival. In a recent study, PAD patients who continued to smoke were more than twice as likely to die within five years as those who quit within the year. Specifically, the risk of dying within five years for the quitters with PAD was 14 percent, compared to 31 percent for those who continued to smoke. Patients with extreme PAD who continued smoking were nearly three times as likely to die within five years compared to those who quit. Specifically, for patients with critical leg ischemia, quitting smoking reduced their risk of dying significantly — from a 43 percent mortality rate within five years for smokers to an 18 percent rate for quitters.

At Vascular Care Specialists of Los Angeles, we strive to provide the best service, care, and results possible. If you have leg symptoms related to peripheral arterial disease and would like to learn more about treatment options, give us a call at 626-275-9566 to schedule an appointment. You can also visit us at www.vcsla.com for more information.