Trucker MD
Peripheral artery disease, also known as PAD

John McElligott, MD
Jeffrey Heinrich, Ed. D, PA-C

Peripheral artery disease (PAD) is a common problem in the general population that affects 8 million Americans, some of whom are in the trucking business as professional drivers.

It's not just about the legs, although it is most commonly associated with leg disease. PAD can occur anywhere but the heart. In the heart, it is called coronary artery disease.

PAD is a narrowing of arteries. The beginning of the process is fat and cholesterol building up in arteries, which is called plaque. This plaque builds up slowly and silently. This disease may be a sign of more widespread arterial fatty deposits reducing blood flow to such vital organs as the heart and brain.

Risk factors for PAD

  1. Being more than 50 years of age.
  2. Active smokers and former smokers have a four times greater risk for PAD.
  3. People with diabetes are at high risk for PAD. One in every three people over the age of 50 with diabetes has PAD.
  4. High blood pressure is another risk factor. High blood pressure raises the risk of developing plaque in arteries due to the stress on the walls of the arteries.
  5. High lipid content in the blood is a risk factor. Triglycerides, cholesterol and free fatty acids all play a role.
  6. Prior history of stroke or heart attack increases the chances of PAD. It should also be noted that if you have PAD, you could have a good chance of having a stroke and/or a heart attack.
  7. African-Americans are two times more likely to have PAD, for reasons not clearly understood.

Symptoms of PAD

Cramping or muscle pain in your legs while walking or climbing stairs, which quickly disappears with a few minutes of rest, is known as "intermittent claudication." The location depends on where the artery is narrowed but, most commonly, claudication is found in the calf. The blockage is always above the area that is symptomatic. The pain ranges from mild to severe.

Symptoms in later stages include lower extremity numbness and weakness, decreased temperature in the lower leg and feet, change in color of the lower extremity, sores on the legs and feet, increase in leg pain, even at rest, and erectile dysfunction in men. Other signs include the fact that toenails quit growing and the hair on the legs falls out. People with diabetes can have sores on their feet and legs that don't heal.

I think I have symptoms, what's next?

If you have symptoms and signs of PAD, you should see your primary physician to be evaluated. If it's a mild case, you will be advised to change your eating habits to a low-fat diet and, if you are a smoker, to quit smoking. If the case is more severe, you will be referred to a vascular specialist. Both during treatment with medication and following, exercise is a big part of the treatment, but don't go crazy with it. The exercise needs to be moderate, so you make gradual progress.

How bad can it be?

If the disease continues to get worse, it could result in limb loss. Don't ignore the symptoms. According to the American Diabetes Association, amputation among people with PAD, which includes many people with diabetes, occurs in 1 in 2,174 people. LL