Treating Peripheral Arterial Disease



Peripheral Arterial Disease (PAD) is a disease of the arteries, the blood vessels that carry blood from the heart to the rest of the body. It usually develops when fatty deposits (plaques) build up on the walls of the arteries (this is called atherosclerosis), causing the arteries to become narrowed. This in turn restricts the flow of blood to the muscles in the limbs. The disease typically affects the legs, causing pain on walking, although often there will be no symptoms and sufferers are frequently unaware that they have it. It is however important to detect and treat the disease as it increases the risk of heart attack or stroke and PAD is classed as equivalent to coronary heart disease (CHD). It is a common problem in older people with around 1 in 10 people aged between 60 and 70 suffering from PAD, and this rises to 2 in 10 over the age of 70. It is more common in men than women.

Diagnosing Peripheral Arterial Disease

Despite the fact that PAD is so prevalent it is often not diagnosed and even when a diagnosis is made appropriate treatment goals are often not set. This is a missed opportunity to effectively treat a high risk population. The relatively simple ankle –brachial pressure index test (ABPI) can be used to detect PAD and this is something that can easily be done in the GP surgery. It is a test that measures blood pressure at the ankle and in the arms and compares the ratio of the two. Lower blood pressure in the legs compared with the arms is an indication of blocked arteries.


We now have evidence that shows that lowering lipid levels with the use of statins reduces the risk of heart attack and stokes in people suffering from PAD. In addition, there is some evidence that suggests that this treatment also improves symptoms and preserves kidney function. We also have emerging evidence showing that taking statins a few weeks before surgery also helps to reduce any associated risks. Other vascular risk factors also need to be addressed including type-2 diabetes and high blood pressure, both of which are common among people with PAD. Furthermore, PAD is very strongly associated with smoking. People with PAD also benefit from taking antiplatelet medication such as aspirin.

As far back as 1994 the vascular surgery and vascular disease prevention teams at the Royal Free Hospital set up a weekly outpatient clinic that addresses the medical aspects of treating PAD and it would be encouraging to see this model being followed. 

An abbreviation for ankle brachial pressure index Full medical glossary
One of the most used medicines. Full medical glossary
Disease leading to fatty deposits in the inner walls of the arteries, which reduce and may eventually obstruct blood flow. Full medical glossary
A fluid that transports oxygen and other substances through the body, made up of blood cells suspended in a liquid. Full medical glossary
The pressure of blood within the arteries. Full medical glossary
blood pressure Full medical glossary
Relating to the arteries supplying the heart itself. Full medical glossary
A disorder caused by insufficient or absent production of the hormone insulin by the pancreas, or because the tissues are resistant to the effects. Full medical glossary
The process of determining which condition a patient may have. Full medical glossary
One of the three main food constituents (with carbohydrate and protein), and the main form in which energy is stored in the body. Full medical glossary
The death of a section of heart muscle caused by an interruption in its blood supply. Also called a myocardial infarction. Full medical glossary
One of two bean-shaped organs that are located on either side of the body, below the ribcage. The main role of the kidneys is to filter out waste products from the blood. Full medical glossary
Tissue made up of cells that can contract to bring about movement. Full medical glossary
A craving to eat non-food substances such as earth or coal. Full medical glossary
Any flat, raised patch; for example, a raised patch on the skin, fatty deposit in the inner wall of an artery, or layer over the surface of a tooth. Full medical glossary
Structure in the blood that helps the blood to clot. Full medical glossary
One of a class of drugs that inhibit cholesterol formation in the liver. Full medical glossary
A class of drugs that inhibit cholesterol formation in the liver. Full medical glossary
Any sudden neurological problem caused by a bleed or a clot in a blood vessel. Full medical glossary
Relating to blood vessels. Full medical glossary