Managing PAD and Other Risks

If you have peripheral artery disease, or PAD, there are a few things to keep in mind:

1. Complications of PAD aren't limited to the affected limb.

People living with PAD are at risk for worsening leg pain with exercise and even amputation(s) (loss of a limb) due to permanent tissue damage. This can happen because the skin was deprived of blood supply and vulnerable to injury.

If you have symptoms of PAD, it is likely that they will remain relatively stable for a time. However, the risk of having a heart attack or stroke will — perhaps silently — worsen.

2. Even if you have PAD, but no symptoms, it's important to take care of your heart.

Although you might not have symptoms, or if they are mild, you still need to pay attention to your heart. People with PAD have a higher chance of having a heart attack and stroke.

"If you have PAD, you could also be hiding significant coronary or cerebrovascular disease. Think of it as a red flag, and talk with your care team." – Gregory Piazza, MD, FACC, Brigham and Women's Hospital in Boston

Lowering your overall cardiovascular risk is critical if you have PAD, and may include:

• Exercise therapy — a supervised exercise program during which you will be asked to walk to the point of moderate pain (claudication — leg pain during walking that is relieved by rest) then rest and repeat.
• Lifestyle changes, including daily (walking) exercise and eating a healthy diet
• Weight loss
• Not smoking
• Managing other health risk factors such as blood pressure, blood sugar and cholesterol

3. Know your overall risk for blocked arteries.

There are calculators that your health care team can use to estimate your risk of having a heart attack or stroke over a set period of time. It's important to know your personal risk and to understand that it changes over time. This can help you and your doctor develop a plan to aggressively manage your risk factors — those things that make heart disease and stroke more likely.

4. If you smoke, find help to quit.

It's not easy to kick the habit. But if you have PAD, you need to reach out and get the help and support you need to stop smoking. Why?

People who smoke are 2 to 6 times more likely to develop PAD, and the symptoms and complications tend to be worse. Smokers also tend to develop symptoms sooner, usually between 40 and 50 years old.

5. Ask questions.

Talk with your health care team about PAD and cardiovascular disease, especially if you already have PAD or suspect you might have it. Here are some questions to help get you started:

• I've heard PAD can be a red flag for heart disease. Is that a concern for me?
• What steps can I take prevent or slow other arteries being affected?
• How will we know if other arteries in my body are affected?
• What tests do I need to assess my heart health and risk for stroke?
• How often should I have arterial testing done?
• What are the best treatment options for me?
• What are the signs and symptoms of heart disease or stroke?