Eliminating four risk factors can reduce PAD cases.
When it comes to peripheral artery disease (PAD) among men, common risk factors have a strong cumulative effect. That’s among the findings of a recent Harvard study published in The Journal of the American Medical Association. “The more risk factors one accumulates, the higher the risk, and the severity of risk factors increases risk,” says author Dr. Ken Mukamal, associate professor of medicine at Harvard Medical School.
PAD and its risks
PAD is caused by plaque buildup in the walls of the arteries in your limbs, especially your legs. These clogged arteries put you at risk for ulcers and even gangrene. In addition, people with PAD are at an increased risk for heart attack or stroke.
Researchers found that most PAD cases in men have four main risk factors: smoking, high cholesterol, high blood pressure, and type 2 diabetes. “These risk factors are even more powerful predictors of PAD than they are of coronary disease or stroke,” says Dr. Mukamal.
If you have even one of the risk factors, says Dr. Mukamal, it’s vital that you don’t get another, since “every additional risk factor doubles one’s risk of developing PAD.” Develop all four of the risk factors, and you’re putting yourself at a 15-fold greater risk for PAD than those with no risk factors, according to the study.
Peripheral artery disease
Illustration: Scott Leighton
Blood flows freely through a normal artery (A).
Symptoms and diagnosis
Unfortunately, PAD’s main symptoms—leg pain or cramping and leg fatigue with walking and stair climbing—are often chalked up to aging or being out of shape. As a result, the condition often goes undiagnosed. “Someone with PAD may blame it on arthritis in his knees,” says Dr. Mukamal. “And the slow, insidious nature of PAD means that individuals often adjust to the problem.”In contrast to other causes of leg pain, the pain of PAD typically occurs only when you start walking, and goes away promptly when you stop.
What you can do
Checking for PAD starts with a physical exam that includes feeling the pulse in your limbs. Your doctor may order a noninvasive test called an ankle-brachial index to compare the blood pressure in your arms and legs. You may also undergo an ultrasound to determine if a specific artery is blocked.
If you do have PAD, it’s very important to address the risk factors, which means quit smoking, and get high cholesterol, high blood pressure, and diabetes under control. Surgery or stenting to improve blood flow may be warranted if one of your limb arteries is severely narrowed.
But remember that prevention can help you dodge all of this. Researchers say that avoiding all four main risk factors can eliminate the vast majority of cases of PAD before they start.