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PAD: Be Careful of Changes in Your LimbsWhat kind of disease is PAD?

About peripheral arterial disease (PAD)

Peripheral arterial disease is the narrowing or obstruction of arteries in the legs and feet due to arteriosclerosis, causing reduced blood flow.

Symptoms include numbness, pain, and coldness in the feet and legs while walking. As the disease progresses, walking may become impossible and the feet and legs feel painful (intermittent claudication) even when at rest.

Arteriosclerosis progresses throughout the body, and so arteriosclerosis in the lower limbs and legs is connected to arteriosclerosis in the heart and brain, which may trigger angina, a heart attack, a stroke, or other conditions.

How PAD develops

As people reach an advanced age, their blood vessels become harder and increasingly fragile. This is exacerbated by lifestyle-related diseases such as diabetes, high blood pressure, and high cholesterol; cholesterol builds up inside the arteries (in the lumen), resulting in blood vessels becoming even harder and more fragile. As the condition progresses, the inside of the blood vessels becomes narrower, causing poor blood circulation; this condition is called arteriosclerosis (Figure 1).

When blood flow deteriorates due to arteriosclerosis, the organs, muscles, and other tissues can become damaged by an insufficient supply of oxygen and nutritional impairment. Arteriosclerosis can occur in any artery in the body, including the feet and legs.

Figure 1: Intravascular obstruction

The arteries that primarily deliver blood to the limbs are called peripheral arteries. When arteriosclerosis develops in the peripheral arteries it causes poor circulation in the limbs; this is referred to as PAD. PAD causes numbness and pain, and if it worsens it may cause ulcers, and in severe cases necrosis. It is the most common disease of the peripheral arteries.
Since PAD is a disease of the blood vessels, it is treated by doctors who specialize in vascular surgery and cardiovascular disease.

PAD has a high rate of association with heart attacks and strokes.

PAD is caused by arteriosclerosis in the legs and feet, meaning that PAD is associated with life-threatening health conditions that are also caused by arteriosclerosis such as angina, heart attacks, and strokes. Early detection and treatment are important to prevent PAD from worsening to a severe degree, and to guard against dangerous complications.

Arteriosclerotic diseases including PAD are on the rise.

Health conditions caused by arteriosclerosis, such as angina, heart attacks and strokes, are increasing in Japan with the aging of society and the Westernization of eating habits and lifestyle. PAD, which is arteriosclerosis of the feet and legs, is no exception, and the number of PAD patients is increasing year by year. PAD is not a rare disease.

The relationship between metabolic syndrome and PAD

Metabolic syndrome is a combination of lifestyle-related conditions including high blood sugar, high blood pressure, high cholesterol, and obesity. Whilst in themselves they are not immediately life-threatening, if not properly dealt with, in combination they may cause arteriosclerosis, which increases the risk of suffering from angina, heart attacks, strokes and diabetes.

The same conditions that lead to metabolic syndrome can lead to arteriosclerosis in the blood vessels of the limbs, which in turn can cause PAD. In addition to the disease being relatively unknown, subjective symptoms are not easy to spot, and so few sufferers will visit their doctor on suspicion of having PAD during its early stages. By the time the disease is diagnosed, symptoms may have progressed significantly, and in many cases it will have developed into a serious condition requiring surgery.
Those who have lifestyle-related diseases need to pay particular attention to avoid PAD; if you do develop PAD, an early diagnosis and appropriate treatment are required to avoid complications.

Think of PAD as a whole-body disease

Even though PAD symptoms are only felt in the limbs, arteriosclerosis itself is not limited to the limbs and could affect blood vessels throughout the body. It is important to consider PAD a disease of the whole body and to manage it appropriately. If neglected, PAD could cause other conditions such as heart attacks, angina, or strokes.

There are a number of treatment approaches available, selected according to how far the disease has progressed and the treatment goal. These include drug treatment, physical therapy, and surgery. Many people continue to lead active lives just as they used to thanks to catching the disease early and getting appropriate treatment.

Through learning about PAD you can also find out more about a variety of other diseases such as arteriosclerosis and metabolic syndrome, which are contributing factors to PAD, as well as cardiovascular disorders such as heart attacks, angina, and strokes. The more aware you are of how the disease progresses, the better you can control it at an earlier stage. This, in turn, may make it easier to keep other diseases in check that could otherwise follow.