Peripheral Artery Disease (PAD) and Its Connection to Obesity

Peripheral artery disease, or PAD, is a condition that affects millions of Americans, yet many don’t know much about it. Peripheral artery disease is essentially atherosclerosis of the peripheral arteries – those in our arms and legs. It’s much like the far better-known condition of coronary artery disease. When we think about peripheral artery disease, we must imagine the size of the arteries that feed the arms and legs. While large compared to minor arteries, they are significantly smaller than those that feed the heart. As such, due to excess serum (blood) cholesterol or fat circulating in the blood attaching to the walls of the arteries, peripheral artery disease can occur well before coronary artery disease.

Peripheral artery disease is classified into four types, each grading its severity. In the earliest stages, patients may not have any symptoms, but these may progress to symptoms when they exercise. Eventually, the symptoms may become persistent, directly correlated to the amount of occlusion or blockage within the artery.

How to Understand Whether You Have Peripheral Artery Disease

Diagnosing peripheral artery disease is surprisingly simple, painless, and easy – requiring an ankle-brachial index (ABI). This procedure puts cuffs around the arms and legs and measures blood flow through those arteries. ABI testing can be done manually, but new technology has made it more precise and helpful.

There are also various telltale signs that you may have peripheral artery disease. Because of reduced blood flow to the extremities and especially the legs, patients can begin to see some swelling around the ankles, and their skin can feel cold or clammy. As mentioned above, symptoms like pain and swelling when exercising are also common in moderate cases of PAD. The symptoms can be more evident in advanced cases, such as losing leg hair and having shiny skin due to the edema or swelling in the extremities.

Managing PAD

If you have obesity, there is a higher risk of developing PAD, and you should speak to your primary care physician or our office about checking for this potentially debilitating condition. If you have been diagnosed with PAD, there are options for treatment. Blood-thinning medications can allow for easier passage of blood through the arteries. Proper hydration, losing weight, stopping smoking, and generally healthier lifestyle choices are also crucial in arresting the progression of PAD. Finally, an interventional cardiologist may be able to help manage PAD with several procedures, including angioplasty, where a balloon catheter is threaded into the artery and pushes the plaque against the artery wall. An atherectomy can also be used to drill out any hardened plaque. For particularly problematic concerns, an arterial bypass is an option to get blood around the blockage and save the limb.

Being that losing weight and getting healthier is such a big part of preventing PAD, many patients may also benefit from a discussion with Dr. Higa about bariatric surgery or other non-surgical weight loss modalities to improve their health.

The Bottom Line

As we know, metabolic disorders can cause a constellation of symptoms, conditions, and diseases that can be bothersome or even debilitating. PAD is an important condition to look out for, and understanding its symptoms, causes, and treatments can help you best manage it.