|
E-mail this page to a friend!
Senior Citizen Health & Medicine
Senior Citizens Seldom Recognize Deadly Danger of
Peripheral Arterial Disease
Leg pain usually first signs of disease that hits 1
of 5 over age 70; victims usually dead in 5 years
 April 2, 2007 - David Dow thought he was having
back problems, and that his legs were hurting as a result. As it turns
out, that pain may have saved his life.
An otherwise healthy 57-year-old, he figured he
just needed to learn some back-strengthening exercises, so he found a
personal trainer to help him. But despite the workouts, his leg pain got
worse – making it hard for him even to walk from the car to the grocery
store entrance. He and the trainer suspected something else was wrong
and he sought the advice of his doctor.
Soon his doctor’s tests revealed the true cause:
blockages in the blood vessels of his legs. In fact, the arteries going
to his lower extremities were nearly 100 percent blocked. The cause?
Years of heavy smoking and high-fat meals, and other factors had caused
cholesterol, scar tissue and blood clots to build up inside his blood
vessels.
| |
Related Stories |
|
| |
Senior
Citizens Often Have Peripheral Arterial Disease Without Knowing It
(Follow this link to graphics explaining
PAD)
September
14, 2006 - More than 8 million men and women - one in 20 adults, mostly
senior citizens - have peripheral arterial disease (PAD), a largely
unrecognized condition which puts them at risk for heart attack and stroke.
The symptoms of PAD, such as fatigue, heaviness, pain and cramping in the
leg muscles when walking that go away with rest, are often mistaken for
signs of aging and ignored. More often, the disease is silent, causing no
noticeable symptoms. A coalition is launching a campaign to make Americans
more aware of this risk and a simple test for detecting the condition.
Read more...
Read the latest news on Senior
Health & Medicine |
|
Most people think this kind of clogged artery
disease, or arteriosclerosis, only happens in the heart. But as Dow’s
case shows, it can happen throughout the body. When it does, it’s called
peripheral arterial disease, or PAD (It is sometimes called peripheral
vascular disease [PVD], although PAD is a form, the most common form, of
PVD).
And in some people, PAD causes leg pain that acts
as an ‘early warning’ that someone is at high risk for a heart attack or
a stroke, says a University of Michigan Cardiovascular Center expert.
“This is the hallmark of a disease that’s all
over,” says James Stanley, M.D., a director of the U-M CVC and the
vascular surgeon who operated on Dow. “It’s like gray hair – you don’t
just get it on one side of your head. So if you’ve got this kind of
blockage in your leg, you’re going to have it other places.”
In fact, nearly a quarter of people who have leg
pain due to PAD will be dead in five years, mostly due to heart attacks
and other heart problems, Stanley says. For people like Dow, whose leg
pain kept them from walking even short distances, the odds are even
worse: as many as half will die by five years.
Fortunately, Dow got diagnosed and treated before
that happened to him. Stanley performed a bypass operation to open his
blocked leg arteries, similar to the bypasses that heart patients have.
A recent checkup showed he’s doing well.
“For sure, it’s a wake-up call,” says Dow, who has
quit smoking and changed his eating habits. “You know that old saying,
‘Where there’s smoke, there’s fire’? I’m
sure that I not only have the vascular issues in my lower extremities,
but I’m sure I have them in other parts of my body.”
Dow isn’t alone, says Stanley, who has operated on
thousands of patients with severe PAD in his decades as a professor of
vascular surgery at the U-M Medical School. Nearly 30 million people in
the United States have some form of PAD, though the vast majority are
“silent” cases that don’t cause symptoms.
Among people over age 70, nearly one person in five
has PAD.
Who’s most at risk for PAD? People over 50,
smokers, people with diabetes, people with high blood pressure, people
with high cholesterol, and people who are overweight or obese, Stanley
explains.
In other words, it’s the same group of individuals
who have a high risk of heart attack and stroke.
So, the advice for preventing PAD, or stopping it
before it gets serious, is largely the same as the advice for preventing
a heart attack or stroke: Quit smoking, eat healthier, get more
exercise, control your blood sugar if you have diabetes, lose weight,
and get your blood pressure and cholesterol levels checked. And ask your
doctor if you should take a daily aspirin to prevent clots, or drugs to
reduce your blood pressure and cholesterol.
Even though PAD makes people’s legs hurt or feel
tired when they walk or exercise — a symptom that doctors call
‘”claudication” which feels like a “Charlie horse” type cramp — one of
the best things to do is to walk more, says Stanley.
“The more a patient walks, the more likely it is
that they will develop little ‘detour’ blood vessels, called
‘collateral’ vessels, around the obstruction,” he explains. The large
majority of people can develop these vessels that will ease the pain.
But in some people, PAD has already gotten bad
enough to cause pain or numbness even when the person is sleeping –
something called “rest pain.” Stanley says this pain often awakens
patients from sleep. It most often occurs in the ball of the feet and
may feel like someone has wrapped a bandage around the foot. This level
of symptoms is ominous, he says, because it indicates a more severe
blockage without adequate collateral vessels.
Another sign of severe PAD is the development of
painful sores, or ulcers, on the feet and toes. These occur because the
blood flow to the lower leg isn’t enough to feed the tissue, and it
begins to break down. People with diabetes, whose bodies have an
especially hard time healing such ulcers, are most at risk. Left
untreated, skin ulcers can get worse and even turn into gangrene — often
leading to amputation.
The vast majority of PAD cases are nowhere near
this serious. But people who don’t get help for symptoms when they first
start may find their problem becoming much worse over time.
So, Stanley recommends that anyone who has
discomfort in their leg or legs, especially new pain that lasts more
than a week, should talk to a doctor. She or he might perform a Doppler
examination – a painless, non-invasive ultrasound test that detects
blood pressure in the extremity.
The Doppler test can tell whether someone has PAD
and how bad the blockage might be. Depending on the result, the doctor
might recommend an MRA (magnetic resonance arteriogram) of the leg, or a
conventional arteriogram that involves injecting dye into the leg
arteries through a device called a catheter.
If a severe blockage is found, like in Dow’s case,
there are several options. Two are similar to those for heart patients:
a minimally invasive procedure like an angioplasty that opens blockages
with a tiny balloon, or bypass surgery to place a new graft to carry
blood into the blocked area.
There are also promising new options on the
horizon, to help the body grow new blood vessels in the blocked area.
The U-M CVC the first place in the world where patients with severe PAD
can volunteer for an experimental new gene-therapy treatment called
MultiGeneAngio.
The MultiGeneAngio trial takes cells from a vein in
the patient’s arm, adds in new genes that encourage the growth of blood
vessels, and then injects the cells into the blocked artery using a
minimally invasive technique. Right now, it’s still being tested for
safety and to find the right dose of cells, says Michael Grossman, M.D.,
the U-M interventional cardiologist who is leading the study at U-M.
But
if the study proves successful it may one day become a new treatment
option for patients.
Until that day, the best weapon against PAD is
better knowledge of the fact that pain in the legs is more than an
inconvenience. “If one has PAD there are two issues,” says Stanley.
“What happens to your leg, and what happens to your life.”
Facts about peripheral arterial disease or PAD:
• Peripheral arterial disease, or PAD, is
sometimes called peripheral vascular disease. Both names describe the
blocking of blood vessels in the peripheral parts of the body, away from
the heart.
• The blockages are caused by the buildup of
cholesterol, scar tissue and blood clots within the blood vessel – the
same thing that happens in the blood vessels that feed the heart.
• PAD interferes with the flow of blood to the
legs and feet, which can cause pain or numbness in the legs. When the
pain occurs while a person is walking or exercising, it’s called
claudication. When it occurs as a person is sleeping, it’s called rest
pain.
• Similar blockages in the heart or brain may
cause a heart attack or stroke.
• People with PAD, especially PAD that causes
pain, have a much higher than normal risk of having a heart attack or
stroke. PAD is considered a warning sign for more serious,
life-threatening problems.
• PAD is more likely to develop in people who
have an inherited (genetic) tendency to develop blocked arteries, and in
people over age 50. It’s also much more common in people who smoke,
people who have have diabetes, high levels of blood fat (for example,
cholesterol) and high blood pressure, and in people who are overweight.
African-Americans appear to have a higher risk than other groups.
• PAD can be diagnosed using an ultrasound test.
• People who have PAD should quit smoking if they
haven’t already done so.
• PAD can be treated using exercise, dietary
changes, good blood-sugar control, and medications to reduce blood
pressure and cholesterol. Severe cases are treated with minimally
invasive procedures or surgery.
Find more on the Web at:
>>
U-M
Cardiovascular Center: Peripheral Vascular Disease
>> PAD Coalition:
“Stay in Circulation”
>>
PAD Coalition: Spanish-language information
>>
More information and links from
MedlinePlus, click
>>
National Heart, Lung and Blood Institute: PAD information
>> Stay in Circulation: Take Steps to
Learn about PAD Web site:
www.aboutpad.org
Click to More Senior News on the
Front Page
Copyright: SeniorJournal.com |
