PERIPHERAL Arterial Disease (PAD) is a common condition in which a build-up of fatty deposits in the arteries restricts the blood supply to the peripheral parts of the body — mainly the feet and legs.

The fatty deposits are called atheromas and are made up of cholesterol and waste substances.

PAD often goes hand in hand with coronary heart disease because both conditions are caused by the same thing, which is the build-up of atheromas in the arteries. This process is called atherosclerosis.

Peripheral Arterial Disease can also be caused by inflammation or infection in the peripheral blood vessels, injury to the limbs, and the irregular anatomy of the arteries or muscles. As many as one in five people over 65 suffer, to varying degrees, with this condition, and it is more common in men than women.

The high-risk factors are:

1. Smoking;

2. Obesity;

3. Raised cholesterol;

4. Raised blood pressure;

5. Diabetes; and

6. Family history of heart disease and strokes

SYMPTOMS

Some people have no symptoms at all and when they do come on, the process is very gradual. The most common symptom of PAD is pain in the calf or thigh muscles when exerted.

This pain usually disappears after a few minutes of rest. The medical term for this process is intermittent claudication. Most patients describe being able to walk a certain distance, then having to stop and rub the calf until the pain subsides.

Other symptoms include:

• Hair loss on the legs and feet;

• Brittle and slow growing nails;

• Shiny, thin skin;

• Muscle wastage in the legs;

• Erectile dysfunction in men;

• Non-healing ulcers in the leg and feet; and

• Numbness and weakness in the legs and feet.

In very serious cases, patients may feel pain constantly in their legs and may be unable to move the affected limb. The skin may change tone, temperature and colour, and the limb may swell. This is a medical emergency and the patient should seek immediate medical assistance.

DIAGNOSIS

A physical examination involves taking the blood pressure at the foot and comparing it to the blood pressure in the arm. If the patient is healthy they should be roughly the same. If the pressure in the leg is lower than in the arm, this may indicate PAD.

Ultrasound scans and angiograms are also excellent diagnostic tools.

COMPLICATIONS

The blockage of an artery can lead to a condition we term critical limb ischaemia.

This is when the blood flow is so restricted that the limb effectively starts to “die”. These patients are also more likely to develop coronary heart disease, stroke and angina.

TREATMENT

Stop smoking.

Exercise. A supervised programme is the best therapy for poor circulation in the leg.

Maintain a healthy diet that is low in saturated fats. These are found in foods like butter, red meat, cream, cheese, ghee, cakes, and biscuits. Eat plenty of fibre, fruits and vegetables.

Maintain a healthy weight.

If the patient has other conditions related to PAD, like diabetes or hypertension, they should be carefully monitored by the general practitioner.

General practitioner’s may prescribe various drugs like statins to lower the cholesterol, blood thinners like asprin to prevent clots, pain relievers, blood pressure regulators, amongst others.

If the patient’s PAD is life-threatening, surgery may be advised.

Natural treatments include: Ginko Biloba; grape seed extract; horse chestnut seed extract; policosand (a natural cholesterol-lowering compound).

Before embarking on any treatment you should consult your doctor as there may be side effects even though the product is natural.

Angela Davis BSc (Hons) DPodM MChS is a podiatrist with offices in Montego Bay (293- 7119), Mandeville (962-2100), Ocho Rios (974- 6339), Kingston (978-8392), and Savanna-la- Mar (955-3154). She is a member of the Health and Care Professions Council in the United Kingdom.