Peripheral artery disease is a slow, progressive, sometimes life-threatening vascular disease that is caused by narrowing or blockages of the arteries in the peripheral arterial system, or the arteries in the limbs. When plaque builds up, blood flow to the limbs is limited and can result in a variety of health problems, which in its most severe form includes limb amputation. Spreading awareness will help educate those who know little about PAD, because this disease is widely underdiagnosed and undertreated.
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What is PAD?
PAD is a deadly chronic condition affecting approximately 20 million Americans. Patients who have PAD have a 33% 5-year mortality rate, with common complications including stroke and heart attack, and diabetic foot ulcers progressing to infection, gangrene and amputation.
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PAD Risk Factors
Risk factors for PAD include hypertension, hyperlipidemia, tobacco use, diabetes, and age. 1 in 3 over the age of 50 with diabetes mellitus or a history of tobacco use have PAD, and regardless of these risk factors, 1 in 3 over the age of 70 suffer from this disease.
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PAD and Heart Disease
PAD is closely associated with heart disease, with 75% of those with PAD also having heart disease. Patients with heart disease and PAD are 6 times more likely to die from heart disease than those who have heart disease but don’t have PAD.
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PAD Symptoms
The classic symptom of PAD is claudication, characterized as a dull, cramping pain while walking. However, most patients don’t present with claudication or other typical symptoms, due to mischaracterization of the symptom (i.e. must just be old age), or the patient making lifestyle modifications (i.e. not walking) in order to not experience symptoms.
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PAD Consequences
If left untreated, leg pain may progress to resting leg pain, slow- or non-healing lower extremity wounds, gangrene and amputation. Whether or not a patient with PAD has typical symptoms does not affect PAD mortality.
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PAD and Healthcare Costs
PAD is a significant cost driver for the US healthcare system, costing $390 billion annually to treat and manage. The average annual cost of healthcare for a Medicare beneficiary is $12,000, but if they have PAD, the annual cost increases to more than $72,000. Amputation costs are a main driver, whereas approximately 100,000 lower extremity amputations are suffered by patients, due to PAD.
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PAD Treatment Options
Treatment options and early detection are key to improving patient outcomes and reducing the costs associated with treating and managing PAD. Discovering a patient who may be asymptomatic or not presenting with typical symptoms but having PAD, may undergo lifestyle modifications and low-impact interventions such as smoking cessation, nutritional counseling, or supervised exercise therapy.