Ask the Doctor - Peripheral Vascular Disease

Ask the Doctor and Saint John's: Peripheral Vascular Disease - A Common Problem for the Elderly

Q. What is peripheral vascular disease and who is at risk?

A. By Samuel Ahn, M.D., vascular surgeon at Saint John’s Health Center.

Peripheral vascular disease is a circulatory problem in which narrowed or blocked arteries reduce the blood flow to your limbs. Also called peripheral artery occlusive disease (PAD), it is quite common among people as they age. Around 16 million people in the United States are limited in the distance they can walk because of PAD.

The risk factors for this disease include a history of smoking, diabetes, high blood pressure, high cholesterol levels and advanced age.  Basically as everyone ages, everyone gets hardening of the arteries to some degree.

Many people who have blocked arteries to the legs don’t know it because they think slowing down is just part of aging. Instead of being able to run or jog for exercise, they discover they can only walk. As their condition worsens, they can only walk short distances. In the early stages, a common symptom of PAD is fatigue or cramping in the legs or buttocks during activity. The cramping subsides when the person stands still.

To diagnose PAD, we simply take a blood pressure of the leg and arm to see how much blood is getting to the limbs. We can also conduct an ultrasound examination of the limbs, the neck and the abdomen to evaluate blood flow and assess the degree and location of blocked arteries. Once we have a diagnosis and know the severity of the problem, we can determine treatment. Most people with PAD can be treated with lifestyle changes and medications, or both. If necessary we can perform minimally invasive procedures such as angioplasty in which we open up the arteries with a balloon or stent, or in advanced disease, we can do an open surgical bypass operation.
  
Our first course of treatment, however, is to reduce the following risk factors, which can not only prevent the disease from getting worse, but can also reverse symptoms.

• Quit smoking
• Get active – regular exercise such as walking is an important component of long-term health.
• Eat nutritious, low-fat foods and avoid foods high in cholesterol.
• Maintain a healthy weight
• Follow your doctor’s recommendations for controlling high blood pressure and high cholesterol.
• If you have diabetes, follow your doctor’s recommendations for controlling your blood sugar and taking care of your feet.