Peripheral arterial disease (PAD) refers to atherosclerosis or hardening of the arteries in the circulation ” peripheral” to the heart. The relevance of PAD is underscored by its frequency, as much as 15 percent of the population over 65, and its association with coronary and or cerebrovascular disease. Indeed, many studies show that 9 percent of people who have obstructive PAD also have significant coronary or cerebrovascular disease, hence the diagnosis of PAD indicates the need to evaluate for underlying coronary or cerebrovascular disease. Futhermore, early intervention for PAD, coronary and cerebrovascular disease with exercise, diet changes, selective medications, and mechanical interventions can improve quality of life and, in select instances, save limb and life.
In general, anyone over 60 who has 2 or more risk factors for vascular disease, such as high blood pressure, high cholesterol, tobacco history, diabetes, family history of early (before age 65), vascular disease, or obesity, should undergo PAD screening with an ankle brachial index test (ABI). ABI is a simple office test consisting of measuring the ankle & arm blood pressures using a Doppler Device. Normally, ABI runs 0.91-1.10. An abnormal ABI, that is less than 0.91 suggests the presence of obstructive lower extremity arterial disease and indicates need for additional evaluation and treatment. PAD may result in pain or tightness in the buttock, thigh, or calves, however, commonly people will simply note leg fatigue, loss of balance or even impared sensation in the feet. In any case, much can be done to improve people’s ability to walk and pursue active livestyles once the diagnosis is made.