When every step you take is painful or your legs get easily fatigued, your quality of life can be severely hampered. But if the cause of these symptoms is peripheral vascular disease (also known as peripheral artery disease), a condition that affects 8 to 10 million Americans, there's more to be concerned about than just your ability to walk long distances. Although peripheral vascular disease (PVD) itself is not fatal, the underlying cause can be. To help you protect yourself, Chad Jacobs, MD, a vascular surgeon at Rush University Medical Center, shares five things every adult should know:
PVD symptoms can be confusing.
If you have PVD, you most likely have blockages in other areas. Peripheral vascular disease is the manifestation of a far more serious problem: atherosclerosis, a disease in which your arteries become clogged with plaque, fatty deposits that restrict blood flow. "PVD doesn't exist in a vacuum," says Jacobs. "Atherosclerosis is widespread, so if you have a buildup of plaque in the arteries of your leg, you're highly likely to have that same plaque buildup in the arteries of neck, heart and/or kidneys." That explains why people with PVD are four to five times more likely to have a heart attack or stroke. "Early detection of PVD can help you not only address PVD, but also prevent heart attacks, strokes and kidney failure because you can address the underlying cause, the atherosclerosis," Jacobs adds.
Many people with PVD don't have symptoms at all, and others may mistake PVD symptoms for normal aging-related aches and pains, or other conditions such as arthritis, anemia, spinal stenosis and nerve damage. The most common PVD-related symptom is claudication
— crampy leg pain while walking, climbing stairs or exercising that generally goes away with rest. However, it's important to note that nearly everyone who has PVD, even those who don't have leg pain or discomfort, experience problems with walking: They find they simply can't walk as fast or as far as they used to. People with the most extreme form of PVD, critical limb ischemia, experience extreme pain, as well as nonhealing sores and wounds in the legs and feet. If left untreated, the only life-saving option for these patients is amputation.
"If you’re having any issues related to walking, or you have any other symptoms of PVD (see sidebar), don't ignore them," says Jacobs. "Talk to your doctor as soon as possible. The symptoms may not actually be caused by PVD, but if they are, treatment will help prevent far more serious health problems down the road."
Smokers are at high risk for PVD — even after they quit. Yet another reason to steer clear of cigarettes: The risk of PVD is up to four times higher for those who smoke or have a history of smoking. For instance, researchers at Harvard Medical School found that the more cigarettes a woman smokes daily, the more likely she is to develop PVD. Women who kicked the habit within the past 10 years are less likely to develop PVD than current smokers, but it’s still far better to never have smoked at all.
Treatments have come a long way. "
Early treatment of PVD can help restore your mobility, decrease your risk of heart attack, stroke and amputation, and possibly save your life," says Jacobs. Accomplishing these goals often involves a combination of approaches: making long-term lifestyle changes; taking medications to lower blood pressure and cholesterol levels, treat diabetes, prevent the formation of blood clots and help reduce leg pain; and, in some cases, having angioplasty and stent placement
or bypass surgery
to restore blood flow.
Physicians are Rush are also exploring the use of a patient's own stem cells as a way to grow new blood vessels and improve blood flow in the legs. Stem cell therapy is currently being studied in patients with critical limb ischemia who aren't good candidates for angioplasty and stenting or bypass surgery. The idea is that additional blood vessels will carry more blood into the legs, alleviating pain and helping to heal ulcers.
"Your doctor should work with you to create a personalized treatment plan based on your health and your specific combination of risk factors," says Jacobs.
Prevention is the best medicine.
While you can't do anything about some of the risk factors for PVD — such as age, race and family history — you can make lifestyle choices that will significantly lower your risk. The same advice doctors give for reducing your risk of heart attack and stroke will also help keep PVD away:
- Don't smoke. If you currently smoke, quit immediately.
- Keep your vital numbers — blood pressure, cholesterol and blood glucose — at healthy levels.
- Eat a healthful diet that's low in saturated fat, trans fat and cholesterol and high in whole grains and fresh produce.
- Be active, including at least 30 minutes of moderate-intensity activity most days of the week.
- Maintain a healthy weight (use this body weight calculator to determine a body weight that may be appropriate for you).
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