What is peripheral artery disease (PAD)?

Peripheral artery disease (PAD) is estimated to affect over 202 million people worldwide.1

The disease itself forms via atherosclerosis, a condition defined by a build-up of plaque (or fatty deposits) within the arteries. This plaque build-up causes the arteries supplying the limbs (known as the peripheral arteries) to narrow and harden, thereby restricting blood flow to the limbs.2,3

PAD is sometimes used interchangeably with PVD, or peripheral vascular disease, however PAD refers more specifically to the presence of plaque build-up in the arteries, whereas PVD may affect any blood vessel outside of the heart, including the arteries veins or lymphatic vessels.4,5

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Risk factors for PAD

In order to understand the risk factors for PAD, it is important to know the risk factors for atherosclerosis (plaque build-up).2,6

Family history

Older age (65+)

Males

High cholesterol

High blood pressure

Diabetes

In addition, lifestyle factors that can put people at higher risk of atherosclerosis include:

Lack of exercise

Smoking

Being overweight or obese

Unhealthy diet

Stress

What can you do to reduce your risk?

What to do if you think you may be at risk

Symptoms and complications of PAD

Symptoms of peripheral artery disease

Many people with PAD do not experience any symptoms, however those that do may have symptoms including:3

– Leg pain or cramping (the most common symptom)

– Leg weakness and/or numbness

– Sores on feet and/or legs that will not heal

– Changing skin colour

– Shiny, bald skin on legs

Complications of peripheral artery disease

Acute limb ischaemia
Acute decrease in blood flow to the limb due to plaque in the peripheral arteries breaking off or causing a blockage.11

Amputation 
If blood flow to the limbs is heavily restricted, this can result in tissue death or amputation.3,12

Diagnosis of PAD

There are a variety of ways in which PAD can be diagnosed. Your doctor will usually collect information about your medical history, do a physical examination and conduct a blood test. They may also carry out one of the following tests:13

Ankle-brachial index:

a non-invasive exam that compares blood pressure in the ankle and the arm. This is done using a blood pressure cuff and an ultrasound to examine both blood flow and pressure.

Ultrasound:

an imaging technique that can help your doctor evaluate blood flow through your blood vessels and identify narrowed arteries.

Peripheral angiogram:

a special dye is injected into your blood vessels, which allows the doctor to view blood flow through the arteries as it happens, using imaging techniques such as x-ray.

Treatment of PAD

The current standard of treatment includes lifestyle changes, prescription medication and sometimes surgery.

Medications for PAD13

For cholesterol control
Statins

For high blood pressure
Antihypertensives

For diabetes control
Insulin/ antiglycaemic drugs

For blood clot prevention
Antiplatelets
Antithrombotics

Main surgeries for PAD

Angioplasty

Peripheral revascularisation
If experiencing acute limb ischaemia or critical limb ischaemia, when in the chronic (longer term) and not acute stage.15

Bypass surgery13

The remaining risk of PAD

PAD patients are at higher risk of also having coronary artery disease and other vascular diseases. They are therefore at risk of associated complications such as heart attack and stroke, should plaque build-up block blood flow to the heart and/or brain.16

It is important to understand that your risk of further complications may still remain even after preventative treatment as plaque build-up can still occur. This is why it is necessary to monitor your vascular health and take necessary steps to control plaque build-up and keep your quality of life as good as it can be.

Scientists are also undertaking research in an area called vascular protection, to explore how risks for further complications can be lowered.

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