TAKE CHARGE OF YOUR HEALTH Symptoms of PAD If bloodflow through leg arteries is sufficiently restricted, you may experience leg cramping or pain during walking—called intermittent claudication. Other symptoms of PAD that can also affect the feet include leg/feet numbness or weakness, hair loss on the lower extremities, a change in color (paleness/blueness) in the legs, and cold legs. More severe PAD may cause burning or aching in the feet and toes, particularly while a person is lying flat, and may result in open sores or ulcers— even gangrene. PAD Risk Factors Some people with PAD, especially in the early stages, don’t experience any symptoms at all. So how would you know that you have the disease? If you have one or more risk factors for PAD, your doctor will likely check you for it during routine office visits. The No.1 risk factor for PAD is smoking. If you have diabetes or high blood pressure, you’re also at increased risk. Being male or older than age 50 should also prompt screening for PAD. Finally, if you or someone in your family has had heart disease or a stroke, you are more likely to develop PAD. Supported by an unrestricted educational grant from Pfizer Inc

Peripheral Arterial Disease Isn’t Just a Pain in the Leg Simply put, arteries are blood vessels that carry oxygen-rich blood from the heart to the rest of the body. You probably already know that arteries of the heart and brain can become clogged with fatty deposits called plaque (a process known as atherosclerosis), but did you know that arteries elsewhere in your body (peripheral arteries) can also become clogged? When peripheral arteries become narrowed by plaque, you have peripheral arterial disease (PAD).     Narrowed and “hardened” coronary arteries can cause angina, or chest pain; those that are completely blocked—because of plaque, a blood clot, or both—can cause a heart attack. Other events that can result from clogged arteries (and possibly blood clots inside those arteries) are mini-strokes and strokes. From this, you can tell that clogged peripheral arteries can cause damage throughout your body. When doctors use the term PAD, however, they are usually referring to disease involving arteries in the legs. Read on for important information you should know about PAD. Diagnosis When diagnosing PAD, your doctor will first ask you about symptoms and risk factors. Next, your pulses will be checked in the groin, knees, and ankles. Then, your doctor may want to calculate your ankle-brachial index score, which is based on the systolic blood pressure (SBP) in your ankle compared with the SBP in your arm. These blood pressures should be roughly the same. If the SBP in your ankle is much lower than that in your arm, however, your doctor may want to look further into the possibility of diagnosing PAD. The presence of intermittent claudication (or other PAD symptoms) or weak pulses in the groin, knees, or ankles supports the diagnosis.    To confirm that you have PAD, you may be asked to have an ultrasound or magnetic resonance angiogram (MRA) (similar to magnetic resonance imaging [MRI]). If your doctor is concerned that your PAD is so severe that you’ll likely need surgery to unclog the blood vessel, you will likely undergo angiography, a more invasive procedure that introduces contrast material into the blood vessels for a better image. Medical Treatments If your PAD has not progressed enough to warrant surgery, your doctor will likely approach treatment from two angles. He or she will prescribe an antiplatelet drug such as aspirin to reduce pain and to reduce the risk for blood clots. But, just as importantly, you’ll be asked to try to reduce your risk factors for atherosclerosis. So you’ll want to stop smoking, lose weight, control your blood sugar, and watch your cholesterol—not only the amount in your diet, but also the amount in your bloodstream. If your lipid profile (the levels of cholesterol and other fats in the blood) suggests that your PAD is likely to get worse, you’ll probably be given a cholesterol-lowering drug such as a statin. Surgical Treatments If your PAD is severe, you’ll need to undergo one of the following invasive procedures: endarterectomy (surgical removal of the lining of the artery); angioplasty (opening the clogged artery with a balloon-type instrument); or bypass graft surgery (bypassing the diseased vessel with a healthy one). A Final Word The buildup of plaque in your peripheral arteries can be stopped or even reversed with lifestyle changes and the right medications. At the same time, you’ll be reducing your risk for developing a heart attack or stroke later on.