Leg artery disease often goes undetected

Many middle-aged adults may be walking around with a dangerous health problem and not even know it.

The condition called peripheral artery disease, or PAD, occurs when arteries in the legs become narrowed or clogged with fatty deposits, reducing blood flow to the legs. PAD affects about 8 million Americans.

PAD is as serious as heart disease, Dr. Ross Tsuyuki of the University of Alberta in Edmonton noted in a telephone interview with Reuters Health, "but, in general, it is under-recognized by the public and by our health care system."

In 10 pharmacies in Central and Northern Alberta, Tsuyuki and colleagues had five pharmacy students screen 362 adults over age 50 for PAD. The screening procedure, which is fairly simple, compares the blood pressure in the leg to that of the arm.

Seventeen people who were screened - about 5 percent - had PAD. And, importantly, Tsuyuki said, 80 percent of the people found to have PAD were previously unaware they had the dangerous condition.

"PAD is a very strong risk factor for poor outcome, including heart disease, stroke and lower limb amputation," Tsuyuki said.

"We informed them of what we found and followed up with them and most of them had gone to see their family physician for treatment," Tsuyuki said, which may include aspirin or other anti-blooding clotting therapies and aggressive cholesterol-lowering treatments.

While the US Preventive Services Task Force currently does not recommend routine screening for PAD, Tsuyuki thinks it is worthwhile to screen people at high risk for PAD. "That would include people who already have heart disease and people who've suffered a stroke. They would be the highest priority," he told Reuters Health.

"The second highest priority," he added, "would be people middle-aged and beyond who are at high risk for heart disease and stroke, such as people with high blood pressure, diabetes and high cholesterol."

The researcher reported his team's findings over the weekend at the 2009 Canadian Cardiovascular Congress, co-hosted by the Heart and Stroke Foundation and the Canadian Cardiovascular Society.

In a statement from the meeting, Heart and Stroke Foundation spokesperson Dr. Beth Abramson said: "People don't recognize that leg cramps while walking may be due to circulation problems that put them at risk for heart disease and stroke."

While PAD may have no symptoms, there often are some warning signs, such as leg pain during exercise, open leg sores that don't heal, feeling of coldness or numbness in one or both legs, pain in the toes at night.

Current or ex-smokers are at increased risk for PAD as are people with diabetes, high blood pressure, high cholesterol and heart disease.

--
By Megan Brooks