PAD: Be Careful of Changes in Your Limbs

Peripheral Arterial Disease (PAD) Q&A

Q
Why does PAD worsen with diabetes?
A

Diabetes not only accelerates arteriosclerosis, but is also often accompanied by the obstruction of arteries below the knees (lower leg arteries) and makes it difficult for alternate blood flow pathways (collateral circulation) to develop, which results in a high degree of ischemia in the feet/legs and a tendency for the condition to become severe.

Q
What are some concrete steps that can be taken to manage PAD from a lifestyle perspective? Also, what can be done to guard against PAD?
A

Generally, precautions you can take to prevent PAD are the same as those used to maintain good health overall. In particular, avoid smoking, and if you have a condition such as diabetes, high blood pressure, or high cholesterol, be sure to manage those conditions carefully. Adequate exercise is also essential.

Q
Is there a genetic link in the development of PAD? What is the probability that children of a PAD patient will develop PAD?
A

While it is likely that there are genetic factors that predispose people to diabetes, high cholesterol, and high blood pressure, it is not thought that PAD itself is hereditary. Environmental factors including lifestyle are thought to be important.

Q
If drug treatment is used to treat PAD, is it necessary to continue taking that medicine forever? Will the condition gradually worsen even if medicine is used?
A

PAD is not a localized disease that only affects the limbs; it is often accompanied by arteriosclerosis in arteries throughout the body. That is why patients need to continue taking medicine in order to prevent complications such as ischemic heart disease and cerebrovascular disease. Aging is a major risk factor in the progression of the disease and so progression of arteriosclerosis to some degree may be unavoidable. Men are also much more likely than women to develop PAD. Get enough exercise to encourage the development of alternate blood vessels (collateral circulation) in order to prevent poor circulation from worsening. Care is also needed to avoid infections (athlete's foot, etc.) and injuries to the feet/legs.

Q
What are the side effects with drug treatment for PAD?
A

Anti-platelet medications may cause a tendency to bleed, such as bleeding under the skin (bruising) and bloody urine. Depending on the type of anti-platelet used, the drug may cause liver damage or gastrointestinal damage. Drugs that have a vasodilator effect may cause hot flushes in the face, headache, diarrhea, palpitations, and other conditions.

Q
Is it better to try to walk even though my feet and legs hurt due to intermittent claudication?
A

Exercise therapy is effective when you repeatedly rest shortly before the pain becomes so bad that you cannot walk, and then walk again when the pain subsides. Using this method, it is better to walk as much as possible. Exercise helps manage the disease, especially in patients with diabetes.