Peripheral vascular disease - self-care; Intermittent claudication - self-care
Peripheral artery disease (PAD) is a narrowing of the blood vessels that bring blood to the legs and feet. It can occur when cholesterol and other fatty material (plaque) build-up on the walls of your arteries.
PAD is mostly seen in people above 65 years of age. Diabetes, smoking, and high blood pressure increase the risk of PAD.
The two main symptoms of PAD are pain at rest and cramps in the legs mostly during physical activities (intermittent claudication).
Managing the risk factors can reduce the risk of further cardiovascular damage. Treatment mainly includes medicines and rehabilitation. In severe case, surgery may also be done.
A regular walking program will improve blood flow as new, small blood vessels form. The walking program is mainly as follows:
- Warm up by walking at a pace that does not cause your normal leg symptoms.
- Then walk to the point of mild-to-moderate pain or discomfort.
- Rest until the pain goes away, then try walking again.
Your goal over time is to be able to walk 30 to 60 minutes. Always talk with your health care provider before you start an exercise program. Call your provider right away if you have any of these symptoms during or after exercise:
Make simple changes to add walking to your day.
- At work, try taking the stairs instead of the elevator, take a 5-minute walk break every hour, or add a 10- to 20-minute walk during lunch.
- Try parking at the far end of the parking lot, or even down the street. Even better, try walking to the store.
- If you ride the bus, get off the bus 1 stop before your normal stop and walk the rest of the way.
Stop smoking. Smoking narrows your arteries and increases the risk of blood clots forming. Other things you can do to stay as healthy as possible are to:
- Make sure your blood pressure is well-controlled.
- Reduce your weight, if you are overweight.
- Eat a low-cholesterol and low-fat diet.
- Test your blood sugar if you have diabetes, and keep it under control.
Take Care of Your Feet
Check your feet every day. Inspect the tops, sides, soles, heels, and between your toes. If you have vision problems, ask someone to check your feet for you. Look for:
- Dry and cracked skin
- Blisters or sores
- Bruises or cuts
- Redness, warmth, or tenderness
- Firm or hard spots
Call your provider right way about any foot problems. DO NOT try to treat them yourself first.
If you are taking medicines for high blood pressure, high cholesterol, or diabetes, take them as prescribed.
Your provider may prescribe the following medicines to control your peripheral artery disease:
- Aspirin or a medicine called clopidogrel (Plavix), which keeps your blood from forming clots
- Cilostazol, a medicine that widens (dilates) the blood vessels
DO NOT stop taking these medicines without first talking with your provider.
When to Call the Doctor
Call your provider if you have:
- A leg or foot that is cool to the touch, pale, blue, or numb
- Chest pain or shortness of breath when you have leg pain
- Leg pain that does not go away, even when you are not walking or moving (called rest pain)
- Legs that are red, hot, or swollen
- New sores on your legs or feet
- Signs of infection (fever, sweats, red and painful skin, general ill feeling)
- Sores that do not heal
Creager MA, Libby P. Peripheral artery disease. In: Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 10th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 58.
Nayor MG, Beckman JA. Atherosclerotic risk factors. In: Cronenwett JL, Johnston KW, eds. Rutherford's Vascular Surgery. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 28.