Reminder to Women: Learn The Risk Factors for, and Warning Signs of, Peripheral Artery Disease

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Affecting approximately 8 million Americans, peripheral artery disease (PAD) can lead to heart attack, stroke, amputation and death.  PAD occurs when arteries in the legs become narrowed or clogged with fatty deposits, reducing blood flow to the legs.  This can result in leg muscle pain when walking, disability, amputation, and poor quality of life.  Blocked arteries found in people with PAD can be a red flag that other arteries, including those in the heart and brain, may also be blocked – increasing the risk of a heart attack or stroke.

A devastating disease that is often undiagnosed, many with the disease do not even know they have it.  That's because often PAD causes no recognizable symptoms.  However, some people with PAD may have one or more symptoms such as fatigue, heaviness, tiredness or cramping in the leg muscles (calf, thigh or buttocks) that occurs during activity such as walking and goes away with rest; foot or toe pain at rest that often disturbs sleep; skin wounds or ulcers on the feet or toes that are slow to heal.

Only about 10 percent of those with PAD experience the most common warning sign of leg pain typically associated with it, and this pain usually goes away while resting.  Many people experience no symptoms at all.  As a result, few sufferers receive prompt treatment.  Even so, PAD care leads to over 1.1 million medical office visits annually.

Most research available suggests nearly equal prevalence among men and women, yet "current data demonstrate most women still remain unaware of their risk," says Alan T. Hirsch, MD, professor of medicine, epidemiology and community health at the Lillehei Heart Institute at the University of Minnesota Medical School in Minneapolis.  "This common disease often goes unrecognized among women and all people age 50 and older, who are most likely to develop PAD."

"Women, in particular, suffer an immense burden from peripheral artery disease," Hirsch says.  "Women with PAD are two to three times more likely to have a stroke or heart attack than those without it, yet it's often unrecognized and untreated in women."

  • While everyone over the age of 50 is at risk for PAD, the risk increases if a person:
  • Smokes, or used to smoke
  • Has diabetes
  • Has high blood pressure
  • Has abnormal blood cholesterol
  • Is African-American
  • Has a personal history of coronary heart disease or stroke

"Women, who are typically the healthcare gatekeepers of families, must address their own care if they are to be healthy enough to manage their family's well-being," says Marge Lovell, RN, Institute Scientist, Victoria HospitalLondon, Ontario.  "It's just like the oxygen mask on an airplane.  If someone needs help, you put your mask on first so you stay well and are able to help the other person."

If a woman fits any of the risk categories previously detailed, she should talk to her healthcare provider about getting tested for PAD.  Typically, diagnosis involves a simple test called an ankle-brachial index to compare arm blood pressure to leg blood pressure.  Treatment includes diet and lifestyle changes, medication and supervised exercise.  Rarely, patients may require procedures to insert small, wire mesh tubes to open constricted blood vessels or surgical bypass surgery.

To help women understand the risks for, and symptoms of, peripheral artery disease and to get information about resources available, visit the PAD. Coalition website at padcoalition.org/resources/patient.php.