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What Your Legs Could Be Telling You About Your Heart Health

Approximately nine million Americans over the age of 50 are living with a disease that affects their legs and raises their risk of having a heart attack. Unfortunately, many with the disease do not even know they have it. February is Heart Month, and the Vascular Disease Foundation and its P.A.D. Coalition are urging Americans to listen to their legs and be alert to the signs of peripheral arterial disease, or P.A.D.

P.A.D. occurs when arteries in the legs become narrowed or clogged with fatty deposits, reducing blood flow to the legs. This can result in leg muscle pain when walking, disability, amputation, and poor quality of life.  If you have blocked arteries somewhere in the body, you are likely to have them elsewhere. Thus, P.A.D. is a red flag that other arteries, including those in the heart, are likely affected – increasing the risk of a heart disease, heart attack and even death.

In many, P.A.D. is a silent disease, causing no recognizable symptoms. People with P.A.D. may have one or more of the following symptoms:

* “Claudication” – fatigue, heaviness, tiredness or cramping in the leg muscles (calf, thigh or buttocks) that occurs during activity such as walking and goes away with rest.
* Foot or toe pain at rest that often disturbs sleep
* Skin wounds or ulcers on the feet or toes that are slow to heal (or that do not heal for 8 to 12 weeks).

“Often, people think leg discomfort or slow healing sores are just a part of aging, yet they can be signs of a serious disease,” stated Joseph Caporusso, DPM, Chair of the P.A.D. Coalition. “Through early detection and proper treatment, we can reduce the devastating consequences of P.A.D. and improve the nation’s cardiovascular health.”

Everyone over age 50 is at risk for P.A.D., and your risk increases if you:

Smoke, or used to smoke

Have diabetes

Have high blood pressure

Have abnormal blood cholesterol

Are African American

Have a personal history of coronary heart disease or stroke

The screening test for P.A.D. is called the ankle-brachial index, a painless, non-invasive test that compares the blood pressure in the ankles with the blood pressure in the arms. National medical guidelines recommend that certain individuals be tested for P.A.D., including:

Adults under 50 years of age with diabetes and at least one other risk factor such as a history of smoking, abnormal cholesterol or high blood pressure

Adults aged 50 years or older with diabetes or a history of smoking

Adults aged 70 years or older

Adults with one or more symptoms of P.A.D.

If you fit into any of the above groups, talk to your health care provider about being tested for P.A.D.

AnginaBlog.com Editor’s Note:  PAD or Peripheral Artery Disease might seem to some like Angina of the Legs.  PAD causes pain in the legs, especially when walking and can make walking, climbing stairs etc difficult.  PAD is due to narrowing of the arteries that supply the legs with needed blood and may be caused by the same factors that cause Angina in the heart, atherosclerosis, diabetes, smoking etc.

The following article is a news release regarding PAD from the Journal of the American College of Cardiology

Peripheral artery disease harder on women

Women with PAD lose ability to walk short distances and climb stairs sooner than men

CHICAGO — Small calf muscles may be a feminine trait, but for women with peripheral artery disease (PAD) they’re a major disadvantage. Researchers at Northwestern Medicine point to the smaller calf muscles of women as a gender difference that may cause women with PAD to experience problems walking and climbing stairs sooner and faster than men with the disease.

The study was published in the February 2011 issue of the Journal of the American College of Cardiology.

Peripheral artery disease affects eight million men and women in the United States. The disease causes blockages in leg arteries, and patients with PAD are at an increased risk of having a heart attack or stroke, said Mary McDermott, M.D., professor of medicine and of preventive medicine at Northwestern University Feinberg School of Medicine and physician at Northwestern Memorial Hospital.

McDermott and a team of researchers observed 380 men and women with PAD for four years, measuring their calf muscle characteristics and leg strength every year. Oxygen is needed to fuel calf muscles, and blockages in leg arteries prevent oxygen from reaching the calf muscles of people with PAD.

The researchers also tracked whether or not the patients could walk for six minutes without stopping and climb up and down a flight of stairs without assistance every year.

“After four years, women with PAD were more likely to become unable to walk for six minutes continuously and more likely to develop a mobility disability compared to men with the disease,” said McDermott, lead author of the study. “When we took into account that the women had less calf muscle than men at the beginning of the study, that seemed to explain at least some of the gender difference.”

Interestingly, men in this study experienced a greater loss of calf muscle annually than the women. But the men had more lower extremity muscle reserve than the women. That may have protected men against the more rapid functional decline women experienced.

“We know that supervised treadmill exercise can prevent decline, so it’s especially important for women with PAD to get the diagnosis and engage in walking exercise to try and protect against decline,” McDermott said.

Journal of American College of Cardiology

NIH/National Heart, Lung and Blood Institute, NIH/National Center for Research Resources, NIH/National Institute on Aging

Contact: Erin White
ewhite@northwestern.edu
847-491-4888