Peripheral Vascular Disease (cont.)

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Who is at risk for peripheral artery disease?

Peripheral artery disease (or peripheral arterial disease) is a common condition that affects approximately ten million adults in the U.S. About 5% of people over the age of 50 are believed to suffer from peripheral artery disease. Peripheral artery disease is slightly more common in men than in women and most often occurs in older persons (over the age of 50). The known risk factors for peripheral artery disease are those that predispose to the development of atherosclerosis. Risk factors for peripheral artery disease include:

  • High blood levels of the bad LDL cholesterol and triglycerides
  • Low blood levels of the good HDL cholesterol
  • Cigarette smoking
  • Diabetes mellitus (both type 1 and type 2 diabetes)
  • High blood pressure (hypertension) or a family history of hypertension
  • A family history of atherosclerotic disease
  • Chronic renal failure
  • Overweight or obesity
  • Physical inactivity

In peripheral artery disease, the risk factors are additive, so that a person with a combination of two risk factors -- diabetes and smoking, for example -- has an increased likelihood of developing more severe peripheral artery disease than a person with only one risk factor.

What are the symptoms and signs of peripheral artery disease?

Approximately half of people with peripheral artery disease do not experience any symptoms. For patients with symptoms, the most common symptoms are intermittent claudication and rest pain.

  • Intermittent claudication refers to arm or leg pain or cramping in the arms or legs that occurs with exercise and subsides with rest. The severity and location of the pain of intermittent claudication vary depending upon the location and extent of blockage of the involved artery. The most common location of intermittent claudication is the calf muscle of the leg, leading to leg pain while walking. The pain in the calf muscle occurs only during exercise such as walking, and the pain steadily increases with continued walking until the patient has to stop due to intolerable pain. Then the pain quickly subsides during rest. Intermittent claudication can affect one or both legs.
  • Rest pain occurs when the artery occlusion is so critical that there is not enough blood and oxygen supply to the lower extremities even at rest and represents a more serious form of the condition. The pain typically affects the feet, is usually severe, and occurs at night when the patient assumes a supine position (lying down, face up).

Other symptoms and signs of peripheral artery disease include:

  • Numbness of the extremities
  • Weakness and atrophy (diminished size and strength) of the calf muscle
  • A feeling of coldness in the legs or feet
  • Changes in color of the feet; feet turn pale when they are elevated, and turn dusky red in dependent position
  • Hair loss over the dorsum of the feet and thickening of the toenails
  • Painful ulcers and/or gangrene in tissue where there is critical ischemia; typically in the toes
Medically Reviewed by a Doctor on 6/28/2012

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