PAD/PVD (Peripheral Arterial (Peripheral Vascular) Disease) can be very serious. There are many ways to prevent and treat this condition.
What is Peripheral Arterial Disease?
Peripheral Arterial Disease (PAD), also known as Peripheral Vascular Disease (PVD), is a condition where arteries narrow, reducing blood flow and circulation to the limbs. The patient may suffer from leg pain when walking. PAD or PVD can also be a symptom of a larger problem: atherosclerosis. If fatty deposits in the arteries are widespread, this can affect the heart and the brain.1 Plaque that builds up is made of fat, cholesterol, fibrous tissue, and calcium. If the plaque hardens, it can make the arteries more narrow. PAD can affect the kidneys, stomach, arms, head, and heart, as well as the legs. Besides leg pain, the limbs can have numbness. Another complication of PVD is that the body will struggle with fighting infections; also, tissue death (gangrene), and leg amputation could result. PVD/PAD can lead to heart disease and strokes. The number one risk factor of PAD/PVD is smoking.2 Other risk factors include obesity (a BMI of 25 or more), diabetes, physical inactivity, high cholesterol, and high blood pressure. While those can be controlled, other factors (i.e., aging, family history), cannot.3 Some patients may show no symptoms of PAD, while others might have “intermittent claudication”, or pain and cramping in the arms and legs during exercise, but not when resting. Calf pain from walking is a common sign. Other patients may have a more serious condition where the pain occurs during rest, typically at night, when lying down face up. Other signs of PVD are weakness and muscle atrophy, numb or cold extremities, hair loss and color change of the feet, thickened toenails, and painful ulcers (generally in the toes).4
It is first important for PAD/PVD patients to quit smoking. From there, medical management of diabetes, hypertension, and cholesterol will occur. Doctors may prescribe antiplatelet drugs and statins to reduce clots and cholesterol. Patients will also need to engage in regular exercise, such as treadmill exercising, to “open up alternative small vessels”. Other prescribed medications include cilostazol and pentoxifylline to relieve claudication symptoms. There are surgical treatments as well, for patients who are unresponsive to standard treatments, including plaque excision, bypass grafting, and amputation.5 In addition to medical treatments, patients should engage in lifestyle changes for the PAD/PVD. Smoking cessation, exercising, aiming for a healthy weight, and eating a healthy diet are all helpful in preventing and treating this disorder. Whole grains, fruits, and vegetables are part of a healthy diet.6 Some dietary supplements can also be beneficial in the treatment of PVD/PAD. Inositol hexaniacinate, a form of vitamin B3, can reduce cholesterol. Garlic can “inhibit platelet aggregation”, making them less sticky. Vitamin B6 can inhibit clotting, lower blood pressure, and decrease homocysteine levels. Homocysteine is used to evaluate cardiovascular disease risk. Dosage of supplements should be discussed with a healthcare professional.7 Airplane travel can increase clot risk in patients with PAD, so they may need to wear compression stockings, walk around (if possible), avoid alcohol and watch their fluid intake.8