Peripheral Artery Disease (PAD)

What is Peripheral Artery Disease?

Peripheral artery disease is a major condition in which the arteries that carry blood to the arms, legs, and other parts of the body become narrowed or blocked. This usually occurs due to a buildup of fatty deposits, known as plaque, inside the arteries. Reduced blood flow in arteries can cause pain, cramping, numbness, and other symptoms, particularly during physical activity. PAD most commonly affects the legs and is often associated with other cardiovascular conditions.

What are the Types of Peripheral Artery Disease?

Peripheral artery disease can be classified based on the severity of symptoms and the location of the affected arteries.

How Common is Peripheral Artery Disease in India?

Peripheral artery disease is an increasingly common health concern in India, particularly among people with type 2 diabetes mellitus (T2DM). A recent meta-analysis of 23 studies involving nearly 1,97,000 individuals with T2DM found that the pooled prevalence of PAD in India is 18%, indicating that nearly 1 in 5 people with diabetes may be affected by the condition. PAD often starts without clear symptoms, so many people do not know they have it until problems develop. That is why early screening and timely care are so important, especially for people with diabetes or other heart-related risks.

What are the Symptoms of Peripheral Artery Disease?

Symptoms of PAD often develop gradually and may worsen over time as blood flow becomes more restricted. Some symptoms include:

• Leg Pain While Walking (Claudication): Pain, cramping, or aching in the calves, thighs, or hips during physical activity that improves with rest.

• Leg Weakness: Reduced strength or heaviness in the legs during movement.

• Numbness or Tingling: A sensation of numbness or pins and needles in the legs or feet.

• Coldness in the Lower Leg or Foot: One leg or foot may feel colder than the other due to reduced blood circulation.

• Slow-Healing Wounds: Cuts, sores, or ulcers on the legs or feet may heal slowly or not heal at all.

• Changes in Skin Colour: The skin on the legs or feet may appear pale, bluish, or shiny.

• Hair Loss on Legs and Feet: Reduced blood flow may result in decreased hair growth.

• Weak Pulse in the Legs or Feet: Pulses in the affected limb may be weaker than normal.

• Pain at Rest: In advanced PAD, leg or foot pain may occur even when resting.

What Causes Peripheral Artery Disease?

Peripheral artery disease may be caused due to various reasons such as:

• Atherosclerosis: Plaque buildup narrows the arteries and reduces blood flow to the limbs.

• Smoking: Smoking damages blood vessels and significantly increases the risk of PAD.

• Diabetes: High blood sugar levels can damage blood vessels and accelerate plaque formation.

• High Cholesterol: Elevated cholesterol levels contribute to the development of atherosclerosis.

• High Blood Pressure: Uncontrolled blood pressure can damage artery walls over time.

• Obesity: Excess body weight increases the risk of cardiovascular disease and PAD.

• Advancing Age: The risk of PAD increases with age, especially after 60 years.

• Family History: A family history of PAD or cardiovascular disease may increase risk.

What are the Complications of Peripheral Artery Disease?

People with peripheral artery disease can face several complications, including:

• Critical Limb Ischaemia: When blood flow is severely reduced, it can lead to ongoing pain, ulcers, and damage to tissues.

• Non-Healing Wounds: Poor blood flow can slow down healing and raise the chance of infection.

• Gangrene: If tissue is badly damaged, it can die and may sometimes need to be removed by amputation.

• Heart Attack: PAD increases the risk of heart attack because of blocked arteries throughout the body.

• Stroke: Blocked arteries can make strokes and other heart problems more likely.

• Reduced Mobility: Ongoing leg pain can make it hard to stay active and may lower your quality of life.

When Should I See My Healthcare Provider?

You should consult a healthcare provider if you experience any symptoms that may indicate PAD, particularly such as:

• Pain, cramping, or discomfort in the legs while walking.

• Numbness, weakness, or coldness in the legs or feet.

• Slow-healing wounds or ulcers on the feet or legs.

• Changes in skin colour or hair growth on the legs.

• Leg pain that occurs even while resting.

• Risk factors such as smoking, diabetes, high cholesterol, or high blood pressure.

How is Peripheral Artery Disease Diagnosed?

In order to confirm peripheral artery disease, your doctor may prescribe one or several of the below tests based on your symptoms and risk factors:

How is Peripheral Artery Disease Managed?

Some crucial ways to manage peripheral artery disease are the following:

• Lifestyle Changes: Quitting smoking, maintaining a healthy weight, and exercising regularly can improve circulation.

• Medications: Medications may be prescribed to lower cholesterol, control blood pressure, prevent blood clots, and manage symptoms.

• Exercise Therapy: Supervised exercise programmes can help improve walking distance and reduce symptoms.

• Managing Underlying Conditions: Proper control of diabetes, high blood pressure, and high cholesterol is essential.

• Angioplasty and Stenting: A minimally invasive procedure may be performed to open blocked arteries.

• Bypass Surgery: In severe cases, surgery may be needed to reroute blood flow around blocked arteries.

What is the Prognosis for Peripheral Artery Disease?

The prognosis for Peripheral Artery Disease depends on the severity of the disease and how early it is diagnosed. Many people can successfully manage it through lifestyle changes, medications, and regular medical care. However, untreated PAD may lead to serious complications such as limb loss, heart attack, or stroke. Early treatment significantly improves long-term outcomes.

Can Peripheral Artery Disease Be Reversed?

Peripheral artery disease (PAD) usually cannot be fully reversed, especially when there is already a lot of plaque in the arteries. Still, with early diagnosis and the right treatment, it is often possible to slow down or manage the disease. Although PAD usually causes lasting damage to the arteries, making healthy lifestyle changes, taking medication, and getting medical treatment can help improve blood flow, ease symptoms, and slow the disease. Getting help early gives you the best chance for good results.

How Can I Prevent Peripheral Artery Disease?

You can lower your risk of Peripheral Artery Disease by following these tips:

• Avoid smoking and tobacco products.

• Exercise regularly and stay physically active.

• Maintain a healthy weight.

• Eat a heart-healthy diet that is low in saturated fats.

• Keep your diabetes, blood pressure, and cholesterol under control.

• Limit alcohol consumption.

• See your doctor for regular check-ups.

• Take medicines as prescribed by the doctor.

Does Health Insurance Cover Peripheral Artery Disease?

Yes, most health insurance plans in India cover treatment for Peripheral Artery Disease if it is medically necessary. This usually includes tests, hospital stays, medicines, angioplasty, surgery, and care for complications. If you are diagnosed with PAD before you buy insurance, it may be considered a pre-existing condition. In that case, you might have to wait 2 to 4 years for full coverage, depending on your insurance company.

How Much Health Insurance Coverage is Needed for Peripheral Artery Disease Treatment?

If you are under 40, it is usually recommended to have health insurance coverage of ₹5 to 10 lakh. Adults, seniors, or people with heart risk factors should think about getting coverage of ₹10 to 15 lakh or more, since PAD may need long-term care, procedures, or surgery.