At risk for peripheral arterial disease? Simple quiz provides key so you can circulate better

September 3, 2008

Ten million Americans have peripheral arterial disease (PAD), and research shows that the highest risk populations include African-Americans (twice as likely to develop clogged leg arteries), seniors (12-20 percent develop PAD) and diabetics (one in three who are over the age of 50 develop PAD). Legs for Life®—a community health and public information program—recommends that older Americans take its free, online self-assessment quiz.

The online quiz (www.legsforlife.org) helps assess health, family and lifestyle risks for PAD. The higher one's score, the more important it is for that individual to discuss the quiz's results with his or her doctor. Additionally, Legs for Life® offers a free national screening program dedicated to improving the cardiovascular health of the community with the early detection of PAD.

"Early detection and management of peripheral arterial disease, or PAD, can prevent its progression and help prevent painful walking, gangrene, amputation, heart attack or stroke," said interventional radiologist Timothy P. Murphy, M.D., Legs for Life® chair. "Older men and women need to be examined with the ankle brachial index (ABI) test that can diagnose PAD. Individuals need to know their ABI number the way they know their cholesterol, blood pressure or blood sugar number; it can save their lives," added Murphy.

African-Americans are twice as likely to develop PAD, with their increased risk making them as vulnerable as someone who smoked a pack of cigarettes a day for 20 years, explained Murphy. Seniors may typically dismiss warning symptoms as signs of getting older; however, just like clogged arteries in the heart, clogged arteries in the legs mean that one could be at risk for heart attack or stroke. And, individuals with diabetes are especially susceptible to PAD because diabetes affects every vascular bed in the body and increases the risk for accelerated atherogenesis—the formation of plaque build up in the lining of the arteries—placing 18.2 million Americans at risk, he noted. "The public at large—as well as the medical community—need to appreciate the importance of the diagnosis of PAD in terms of symptoms and avoiding amputation, but also importantly in how a diagnosis of PAD entails added risk of heart attack, stroke and death," noted Murphy.

PAD develops mostly as a result of atherosclerosis, a condition that occurs when cholesterol and scar tissue build up, forming a substance called plaque, which narrows and clogs the arteries and slows blood flow to the legs. Since plaque blocks the smaller leg arteries first, PAD is considered a red flag for several life-threatening vascular diseases, such as heart attack (the number one killer in this country) and stroke. Symptoms—such as leg pain while walking, numbness and tingling in the lower legs and feet, coldness in the lower legs and feet, or ulcers or sores on the legs or feet that don't heal—could be PAD warning signs. The disease's progression results in death for about one-third of patients.

With early detection, patients could be sent to an interventional radiologist sooner when intervention is most effective and less invasive treatments are an option. In many cases, PAD—and its progression—can be treated with medication, lifestyle changes (such as smoking cessation), diet and a structured exercise program. If needed, interventional radiologists can perform minimally invasive angioplasty and/or stenting to open a blocked artery in the leg and restore blood flow.

In September, free testing is available for PAD at nearly 100 Legs for Life® sites around the country. The ABI, a simple and painless test, compares the blood pressure in the legs to the blood pressure in the arms to determine how well the blood is flowing and if additional tests are needed. More than 322,000 people have been screened to date, with one in four at risk for PAD. Select sites will also screen for abdominal aortic aneurysm, stroke and venous disease.

While more than 50 percent of PAD patients may not show signs of the disease, screening is essential for diagnosis. Individuals should be tested if they

"As vascular experts, interventional radiologists can intervene early, help prevent vascular disease progression and provide minimally noninvasive treatment if needed," said Murphy. Legs for Life® began a decade ago because interventional radiologists recognized that the disease is a major public health problem with a growing incidence, yet awareness among the general public and nonvascular health care providers is low.

To take the free PAD risk assessment quiz to review the results with one's own doctor—or to request a screening appointment—visit http://www.legsforlife.org. Note: Legs for Life® sites provide a limited number of screenings; advance appointments are required. Many interventional radiologists offer year-round screening by appointment; a link to this information is provided on the Legs for Life® site.

Source: Society of Interventional Radiology