Ep. 5 - Do you have peripheral artery disease? And does it matter?

Cardiovascular Matters

Welcome to Cardiovascular Matters, a podcast dedicated to discussing all aspects of cardiovascular health and disease. Today we're joined by Dr. Craig Walker, a leading cardiologist and expert in peripheral artery disease. Dr. Walker will help us understand what PAD is, who is affected, and why early detection and treatment is so important for overall health and longevity. For many, PAD presents no symptoms but it serves as an important indicator of systemic atherosclerosis. Let's listen in as Dr. Walker addresses these topics and more.
Keypoints:

• PAD affects over 28 million Americans
• Major risk factors are smoking, diabetes, family history, high cholesterol, high blood pressure
• Even asymptomatic PAD is a marker for increased cardiovascular risk and death
• Sick legs are rarely attached to totally healthy people
• PAD patients have higher risk of heart attack than those who already had one

Dr. Craig Walker begins the discussion by explaining that peripheral artery disease (PAD) is more common than many realize, affecting over 28 million Americans. The major risk factors for PAD are smoking, diabetes, family history of cardiovascular disease, high cholesterol, and high blood pressure. PAD develops as a result of atherosclerosis, or hardening of the arteries due to plaque buildup. This restricts blood flow to the limbs, usually the legs.

While PAD often causes no symptoms, even asymptomatic PAD is an important marker for increased cardiovascular risk. Dr. Walker discusses studies that showed individuals with PAD are at higher risk of heart attack, stroke, and early death. This is because the same atherosclerotic process affecting the legs is also occurring in other arteries of the body. He emphasizes that screening for PAD is important, as a simple pulse check or ankle-brachial index test can identify patients who may be at risk.

Treatment involves lifestyle changes like quitting smoking, improving diet, increasing physical activity, and managing underlying conditions like diabetes and high blood pressure. Medications are also important such as statins to lower cholesterol, aspirin or Plavix for anticoagulation, and cilostazol to improve leg blood flow. For those with critical limb ischemia, procedures may be needed to restore blood flow through angioplasty or surgery. Dr. Walker stresses the need for a multidisciplinary approach involving primary care, cardiology, and vascular surgery.
In closing, Dr. Walker has emphasized that PAD is a widespread yet often overlooked condition that signifies increased risk for other cardiovascular problems. Simple screening can identify those with PAD, even if asymptomatic, so they can make lifestyle changes and receive the medical care and monitoring warranted by their higher risk profile. A multidisciplinary approach is key to properly managing PAD patients and preventing limb loss or other complications down the road. Thank you for joining us today on Cardiovascular Matters. Be sure to subscribe so you don't miss our next episode, where we will delve deeper into PAD treatment options.
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