March 1, 2010
Dr. John Keyser and Dr. Patrick Ryan
It isn't only accidents and wars that result in amputations; peripheral arterial disease (PAD) can lead to loss of a leg. The disease affects more than 8 million people in the U.S., especially those over 50, African Americans, and Hispanics are at risk for PAD. It is estimated that one of every 20 Americans over the age of 50 has PAD. Baby boomers approaching the age of 50 need to be aware of their vascular health and the associated diseases, including PAD.
Most people are unaware of the disease called PAD. It is particularly difficult to know when you have PAD because normally there are no symptoms in the early stages of the disease. As the disease develops, those affected may experience discomfort or pain in their legs when they walk, but no pain when they rest. Because of the lack of symptoms, it is very important that people aged 50 and over discuss their risk factors with their primary care physician.
Risk factors of Periperhal Arterial Disease
Healthy peripheral arteries are smooth and unobstructed, allowing blood to flow freely to the legs and provide oxygen, glucose, and other nutrients to legs. Typically with age, the peripheral arteries build up plague, a sticky substance made up mostly of fat and cholesterol. Plaque narrows the passageway within the arteries and causes them to become stiff.
PAD results when the peripheral arteries become too narrow or obstructed and limit the blood flow to the legs. If left untreated, PAD can cause pain or aching in the legs, difficulty with walking, resting pain in the foot at night in bed, non-healing sores or infections in the toes or feet, and can lead to limb loss in its most severe form.
In addition these serious arterial conditions, those with PAD should understand that people with the disease may be more likely to suffer heart attacks and stroke. The diagnosis of PAD can be established, and its severity confirmed by a simple, noninvasive Doppler examination. Depending on the severity of the condition, treatment options may include lifestyle changes, medications, minimally invasive angioplasty/stenting, or open bypass surgery.
Baby boomers need to understand how to maintain a healthy vascular system as they become seniors. By 2015, the U.S. Census reports an expected 87 million people aged 55 and older, up from 67 million in 2005. Since vascular disease primarily affects seniors, the number of vascular disease cases is expected to rise dramatically.
The vascular system is made up of arteries and veins that carry oxygen-rich blood throughout the body to vital organs, the brain, and legs. As we age, our arteries tend to thicken with a build-up of plaque and cholesterol, get stiffer, and narrow. When blood flow is restricted, vascular diseases, like carotid artery disease, can lead to stroke; peripheral arterial disease can lead to problems walking and in the most advanced cases, foot ulcers, gangrene and possible amputation; and abdominal aortic aneurysm can result in death if not treated early.
These five practices are not new, but with so many people reaching senior status, it is important they are reminded about the positive impact they can have on their vascular health:
People aged 55 and older should talk with their primary care physician about their vascular health. Vascular disease can be controlled if diagnosed and treated early. Vascular surgeons can treat these diseases with lifestyle changes, medical management, minimally invasive endovascular angioplasty and stent procedures, and open bypass surgery.
Everyone understands the importance of maintaining healthy cholesterol levels to protect their heart, but many are not aware of how high cholesterol levels threaten the health of their entire vascular system. Vascular diseases cause strokes, death from ruptured aortic aneurysm, and pain when walking, or leg amputation in the worst cases.
It is just as important to maintain healthy levels of cholesterol for your entire vascular system as it is for your heart. High levels of low-density lipoprotein cholesterol are one of the major risk factors for vascular disease that can result in paralysis, blindness, or speech abnormality due to stroke and even death by a ruptured aortic aneurysm.
The vascular system is made up of all the body's arteries and veins. Healthy vessels are smooth and unobstructed, allowing oxygen-rich blood to flow freely and deliver glucose and nutrients to the vital organs, brain, legs, and arms. Typically with age, the vessels build up plaque, a sticky substance made up mostly of fat and cholesterol. The plaque narrows the passageway within the vessels and causes them to become stiff. Vascular disease results when the vessels become too narrow or obstructed, and limit the flow of blood.
Here are a few suggestions to take control of your cholesterol levels:
Other risk factors for vascular disease include: high blood pressure, smoking, obesity, lack of exercise, and diabetes. People who are 55 or older, particularly those who have a family history of vascular disease, should discuss their risk factors with their primary care physician. The three most prevalent vascular diseases are:
Peripheral arterial disease occurs when the peripheral arteries in the leg become too narrow or obstructed and limit the blood flow to the legs. If left untreated, peripheral arterial disease can cause pain or aching in the legs, difficulty with walking, resting pain in the foot at night in bed, non-healing sores or infections in the toes or feet, and can lead to limb loss in its most sever form. In addition, it can be associated with other serious arterial conditions leading to heart attacks and stroke. African Americans and Hispanic populations have a higher occurrence of PAD.
Carotid artery disease occurs when the carotid arteries in the neck become narrow and stiff with plaque. Strokes result either from obstruction of the blood flow to the brain by or when bits of plaque and clots break off from the plaque and flow to the brain.
Abdominal aortic aneurysms (AAA) occur when the wall of the aorta, the largest artery in the body, progressively weakens and begins to bulge. An AAA may continue to enlarge and eventually rupture if left untreated, causing severe internal bleeding and possibly death.