Discovering PAD: Learn the Signs and Save a Life

Peripheral artery disease (PAD) is a serious but often overlooked condition that affects over 8.5 million Americans. Many people remain undiagnosed until they experience complications such as stroke, heart attack, or limb amputation.

Understanding PAD symptoms, risk factors, and treatment options can help individuals seek early diagnosis and intervention.

What is PAD?

PAD is a form of atherosclerosis, where cholesterol-rich plaques build up in the arteries, narrowing blood flow to the legs. This condition often signals the presence of blockages in other arteries, including those in the heart.

Dr. Umberto Campia, a vascular medicine specialist at Brigham and Women’s Hospital, explains:

"Patients with PAD, which is caused by blockages in the vessels supplying blood to the legs, often have similar blockages in other areas, such as the heart."

Health Risks Associated with PAD

Because PAD restricts blood flow, it can lead to:

• Pain, cramping, and muscle fatigue in the legs.

• Disability and reduced mobility.

• Serious complications such as:

• Amputation

• Heart attack

• Stroke

Who is at Risk for PAD?

Several factors increase the likelihood of developing PAD:

• Age: The risk increases as people get older.

• Smoking: One of the strongest risk factors for PAD.

• Diabetes: Significantly raises the risk of artery blockages.

• High cholesterol and high blood pressure: Contribute to plaque buildup.

Dr. Campia highlights the importance of recognizing these risks:

"Patients with risk factors for heart disease are also at risk for blockages in their legs. Smokers and people with diabetes are three times more likely to develop PAD."

Common Symptoms of PAD

Many people with PAD experience no noticeable symptoms, making diagnosis challenging. However, for those who do, symptoms may include:

• Leg pain, cramping, or fatigue while walking, which eases with rest.

• Heavy or weak legs that tire easily.

• Persistent pain, ulcers, or slow-healing wounds on the feet and legs.

Dr. Campia notes that only 30% of patients with PAD exhibit classic symptoms. Many experience nonspecific leg discomfort, leading to delayed diagnosis.

Why Early Detection is Crucial

Even if PAD symptoms are mild or absent, undiagnosed blockages increase the risk of:

• Heart attacks and strokes due to atherosclerosis in other arteries.

• Severe blood flow restriction, leading to tissue damage and ulcers in the feet.

Treatment Options for PAD

The primary treatment approach focuses on managing risk factors, including:

• Quitting smoking.

• Managing high blood pressure, cholesterol, and diabetes.

• Encouraging exercise and healthy lifestyle changes.

Advancements in PAD Treatment: The COMPASS Trial

Traditionally, aspirin or clopidogrel has been used for secondary prevention in PAD patients. However, the COMPASS trial introduced a more effective approach:

• A low-dose anticoagulant (rivaroxaban) combined with aspirin was found to reduce heart attacks, strokes, and amputations more effectively than aspirin alone.

• The combination therapy resulted in only a slightly higher risk of bleeding.

Dr. Campia explains the impact of these findings:

"Previously, treatment only moderately reduced the risk of PAD-related complications. With the COMPASS trial results, we now have stronger evidence that adding low-dose rivaroxaban to aspirin offers better protection."

Why Raising Awareness Matters

Despite the serious risks of PAD, public awareness remains low.

• A study found that 74% of respondents were unfamiliar with PAD.

• Among those aware, only 25% knew that PAD increases the risk of heart attack and stroke.

• Even fewer understood its link to amputation.

By improving education and awareness, more patients can:

• Recognize early warning signs.

• Seek timely diagnosis.

• Access life-saving treatments.

Take Control of Your Vascular Health

PAD is a serious but manageable condition when detected early. If you have risk factors or symptoms, talk to your doctor about:

• Screening for PAD.

• Lifestyle changes and medical treatments to reduce complications.

• Newer therapies that offer better protection against heart attacks, strokes, and amputations.

By raising awareness and improving early diagnosis, we can help reduce the impact of PAD and improve long-term health outcomes.