Let’s learn about peripheral artery disease.

Peripheral artery disease, also referred to as PAD, is a condition that involves the narrowing or blocking of the arteries. As for arteries, those are blood vessels that carry oxygen-rich blood from the heart to the rest of the body, including the arms and legs.

When these arteries become blocked or narrowed due to a buildup of plaque — a mixture of fat, cholesterol and other substances — it restricts the flow of blood to the limbs. This leads to serious health complications, such as heart attacks, strokes or even lower extremity amputations.

Nationally, PAD is significantly more prevalent in the Black population compared to the non-Hispanic white population, across all age groups.

Within our Paducah market service area specifically, research has found that Black PAD patients are 4.68 times more likely to have a lower limb amputation than white PAD patients. This statistic is double the national average, and the highest disparity in the state of Kentucky.

Because of this alarming data, our ministry, along with many community partners, have started working together to help address this issue locally.

In fact, last month, in partnership with KentuckyCare and Janssen, Mercy Health held a PAD screening event at the Paducah Community Kitchen, where 53 people were assessed for their risk of PAD at no cost. 

So, what are the risk factors for developing peripheral artery disease?

“There are several risk factors that predispose an individual to PAD in the future,” Simone Fearon, MD, a cardiologist at Mercy Health – Heart and Vascular Institute, Cardiology, shares. “Importantly, many of these are preventable and are collectively referred to as risk factors due to lifestyle habits.”

She continues, “for example, smoking or regularly breathing in secondhand smoke, inadequate physical activity, stress and poor diet choices that are high in saturated fat cause unhealthy buildup of plaque in the arteries. Additionally, having certain medical conditions, including diabetes, high blood pressure, obesity and chronic disease of the kidneys may also predispose to PAD. There are also other intrinsic factors, including age and race, that are not preventable or not modifiable. Individuals over the age of 65 and who are African American are at a higher risk for the disease.”

What are the symptoms of peripheral artery disease?

The symptoms of PAD can vary depending on the severity of the condition and the individual’s overall health.

Some of the most common symptoms include:

• Pain or cramping in the legs, particularly when walking or exercising
• Numbness or weakness in the legs or feet
• Slow toenail growth
• Sores or wounds that heal slowly, particularly in the lower limbs
• Changes in skin color or temperature in the legs
• Hair loss on the feet and legs
• Weak or absent pulses in the legs and feet

It’s also important to note that 40 percent of people with PAD may not experience any symptoms, particularly in the early stages of the disease. However, even without symptoms, PAD can still increase the risk of other serious health conditions, such as heart attack and stroke.

How is peripheral artery disease diagnosed?

Diagnosing PAD typically involves a combination of physical exams, medical history reviews and imaging tests. During a physical exam, a health care provider may check for weak or absent pulses, listen for abnormal sounds in the arteries and assess the skin on the legs and feet for any signs of reduced circulation.

Imaging tests, such as ultrasound or angiography, may also be used to assess the blood flow and identify any blockages or narrowing in the arteries. And finally, blood tests may be used to check for conditions that increase the risk of PAD, such as high cholesterol or diabetes.

Are their treatment options for peripheral artery disease?

The treatment for PAD often depends on the severity of the condition and the individual’s overall health.

Lifestyle changes, such as quitting smoking, adopting a healthy diet and exercising regularly, can help manage the symptoms of PAD and reduce the risk of complications. Medications may also be used to manage symptoms and reduce the risk of complications.

Some of the most common medications used to treat PAD include:

• Antiplatelet drugs: These medicines help prevent blood clots from forming, which can reduce the risk of heart attack and stroke.
• Cholesterol-lowering medications: These medications can help reduce the buildup of plaque in the arteries, which can improve blood flow.
• Blood pressure medications: These medications can help lower blood pressure, which can reduce the risk of complications from PAD.

In some cases, more advanced treatments may be needed to restore blood flow to the affected limbs.

These treatments may include:

• Angioplasty and stenting: In this procedure, a catheter with a balloon on the tip is inserted into the blocked or narrowed artery. The balloon is then inflated to widen the artery, and a stent may be placed to help keep the artery open.
• Bypass surgery: In this procedure, a blood vessel from another part of the body is used to create a bypass around the blocked or narrowed artery, allowing blood to flow more freely.
• Amputation: In severe cases, amputation of the affected limb may be necessary to prevent further complications.

“If you think you are at risk of developing PAD, it is important to speak with a health care provider right away,” Dr. Fearon advises. “A great place to start would be with your primary care provider. They will be able to refer you for screening tests and, if necessary, refer you to a vascular medicine specialist for further management. In parallel, your primary care provider can work with you to help you better control your risk factors for PAD and potentially slow the progression of the disease.”

Learn about the heart and vascular services we provide at Mercy Health.