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— January 6, 2020

Dangerous Ache

By Linda Melone
  • Painful blockages in leg circulation can signal possible heart problems ahead.

Do you feel pain, burning and fatigue in your hips or legs when walking or going up stairs? Those symptoms should never be ignored.

Heaviness or tiredness, or cramping in the muscles of the legs or buttocks, are often brushed aside as a natural part of aging. However, they may instead be signs of a serious cardiovascular issue called peripheral artery disease (PAD).

“This is particularly true if the pain goes away with rest and returns once the person resumes the activity,” says Michael Chan, MD, interventional cardiologist with St. Joseph Hospital in Orange County, California. This pain is called intermittent claudication.

“Peripheral” refers to arteries away from the heart in the outer regions of the body, most often the legs, according to the American Heart Association. PAD and coronary artery disease are similar in that they are both caused by atherosclerosis, in which arteries become narrow and prone to blockage. Atherosclerosis accounts for 90% of all PAD cases (Atherosclerosis 8/18).

Other symptoms of PAD include foot and toe wounds that heal slowly and a lower temperature in the lower leg or foot compared with the rest of the leg or body. Atrophied muscle, hair loss and shiny skin that’s cool to the touch may also be signs of PAD.

“Many patients with PAD are unaware of it, as they have no clear symptoms or they mistake symptoms of PAD for something else,” says Chan. “If severe and left untreated, PAD can lead to ulcerations in the leg or foot, gangrene and amputation.”

An estimated 8.5 million Americans have PAD, with the majority among people over age 60, according to the Centers for Disease Control and Prevention. People 80 and older make up more than 20% of all cases.

Poor Lifestyle, Greater Risk

The single fastest path to PAD is smoking, which increases risk by four times. Poor diet, high cholesterol, diabetes and lack of exercise also factor in. As Chan puts it, “PAD is a preventable disease.”

In addition, ethnicity can play a role in a person’s risk of developing PAD. African Americans are 50% more prone than other ethnicities; Chinese, on the other hand, have a 55% lower risk.

The dangers posed by PAD don’t stop at foot complications.

Patients diagnosed with poor peripheral circulation are at high risk for cardiovascular events, says Rishin Shah, MD, an interventional cardiologist with Texas Health Presbyterian Hospital in Plano, Texas.

“Up to 70% of people diagnosed with PAD will have a cardiac event, such as heart attack, in the next 10 years,” Shah notes. “I treat PAD patients the same as I do cardiac patients.”

Encourging Better Blood Flow

Want to avoid PAD? “The number one way to reduce your risk would be to not start smoking,” says Shah. “If you are already smoking, you should quit immediately.”

In addition, as Shah notes, “supervised exercise therapy has been shown to consistently help” with symptoms of poor leg circulation. The American Heart Association recommends getting a minimum of 150 minutes of moderate to vigorous exercise each week to significantly lower your risk for PAD.

Individuals living with diabetes are also at very high risk, which makes blood sugar control crucial.

“A vast majority of people can prevent diabetes by making lifestyle changes, including losing weight and eating a diet emphasizing whole, minimally processed foods, one that is rich in fruits and vegetables,” says Shah.

In addition to lifestyle changes, a study in the Journal of Biomedical Materials Research has found two phytonutrients, resveratrol and quercetin, to have beneficial effects on cells within artery walls. Both are found in red wine and have been shown to promote healing of vessel walls without the unwanted side effects associated with traditional PAD drugs. Shah adds that other research is focused on tools that can be used during minimally invasive procedures to help keep arteries open.

Unfortunately, PAD often goes unrecognized by patients and even by physicians.

“If you have any of the risk factors for PAD, please discuss with your physician whether screening is warranted,” Chan says. “It can be diagnosed with simple, non-invasive tests in your doctor’s office.”

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