Staying in Circulation: Do You Have Peripheral Arterial Disease (PAD)?

"Stay in Circulation Week" is being celebrated in the third week of September 2007.

And no, contrary to public perception, it's not about being the most popular person on the block, by attending maximum number of parties, in a variety of fashionable clothes, and impressing everyone with your chutzpah.

The National Heart, Lung, and Blood Institute (NHLBI) -- part of the National Institutes of Health (NIH), U.S. Department of Health and Human Services (DHHS) , and several related medical professional associations have come together for celebrating this event and educating the general public.

"Staying in Circulation" is an effort tu educate people on the importance of maintaining good circulation of blood in your body. Blood is literally the lifeline , given that it carries essential ingredients that we get from foodstuff and medications, to the various parts of the body. In addition, and as is necessary, it also transports the waste products of the body, to the appropriate areas for further processing and dispatch.

So it is very important that the body plumbing remains excellent.

Why so much fuss over a small human body , you may ask.?

Well, things are not as small as you think. There are about 60,000 miles of blood vessels in our body,and while a woman has about 4.5 liters of blood in her body, a man has about 5.6 liters. The red blood cells, that are SO important for carrying Oxygen to the various tissues all over the body, get replaced every seven days, and two million of them die every second. About 7 to 8% of your weight is made up by your blood, and thanks to all the assorted junk we eat (as well as some good stuff occasionally) , our kidneys, actually filter around 400 gallons of blood a day.

As we grow older, just like the plumbing in old cities, problems are encountered. Those of us who swear by non-vegetarian food of the red kind, and turn up our noses at vegetables and fruits, tend to have problem-plumbing, replete with blockages. And just like in a city, where a blockage in a main pipe has more serious repercussions than blockages in a pipe just leading to a single residence, our body has these arteries, or main pure-blood carrying vessels , that often are the butt of the blockages.

Today, doctors are trying to educate folks about what is called P.A.D. or Peripheral Arterial Disease. September 2007 has been declared as the National Peripheral Arterial Disease (PAD) Awareness Month.

How important is this ? Well, 12 million Americans suffer from Peripheral Arterial disease, and lack of information about it is the fastest way to become a cardiac patient for life.

Movement is important to all humans. So it is imperative that we pay a lot of attention to the blood circulation in our limbs.

There is a main artery that goes down our legs, called the femoral artery. Like all other arteries in your body, this too can get clogged, as you grow older and pay the price , for indiscriminate indulgences when you were younger and more disobedient.

What happens, is that not only does this affected artery cause you problems while using your legs, but it also affects the blood supply all over your body, as it is a part of the entire circulatory system. This can cause blood deficits to the brain, affecting certain controls over the body and its functions.

One of the ways to find out if you have this Peripheral Arterial Disease, is a very easy experiment you can do at home.

It's called finding out your Ankle-Brachial Index.

You are asked to lie on your back, and systolic (upper) blood pressure readings are taken .

What you do is measure the blood pressure in your arm (call it A), and ankle (call it B), while you are resting. You then calculate the ratio of B/A, and that gives you the ankle brachial index (at rest). Lets call this ABI-1

Then you do a 5 minute walk on a treadmill, and take the same blood pressure readings again, say A1 and B1 , respectively. You again calculate B1/A1. We will call this ABI-2.

What do we learn from these ?

Firstly, if this ratio ABI is between 0.95 and 1.2, great !

(If, after exercise, this ratio drops, then you have something to worry about. That is if ABI-2 < ABI-1, you need to pull you self together, and get medical advice.

If the ABI is less than 0.95, significant narrowing of one or more blood vessels in the legs is indicated.

If the ABI is less than 0.8, pain in the foot, leg, or buttock may occur during exercise and doctors often refer to it as "intermittent claudication".

If the ABI is less than 0.4, these symptoms may occur when at rest.

If the ABI is 0.25 or below, severe limb-threatening PAD is probably present.

Typically, the severity of these Peripheral Arterial Disease symptoms, have a lot to do with age and your genetic disposition. Depending on the area of circulation effected and one's health and family history, the signs and symptoms of PAD may not arise until later in life. It is not unusual to see that most symptoms start occurring only after the artery has narrowed by 60 percent or more.

Our body has a great recovery mechanism, and sometimes, collateral circulation systems are created around the affected area of the artery. This refers to a network of smaller subsidiary blood vessels (around the affected artery area) , that is created by your body, in an effort to keep the circulation going, by one path or the other. This ability obviously differs from person to person, and so each person will have varying symptoms. Herein lies the importance of finding out your ABI, irrespective of whether you have any symptoms or not.

Older folks with long-standing diabetes, kidney disease etc, may have rigid blood vessels. For them, sometimes, instead of the ankle, the Toe blood pressure readings are considered using what is called a photoplethysmograph (PPG) infrared light sensor and a very small blood pressure cuff is placed around the toe for this purpose.

So what must you do to avoid getting this disease ? Well, the same things that you would do to avoid getting any kind of heart problems. Risk factors here include, smoking, diabetes, high blood pressure,high cholesterol, lack of exercise, sedentary lifestyle etc.

If you already have blood circulation problems in your legs, it is important that you avoid injuries and ulcers on your limbs, as inefficient blood supply to these areas, consequent to an advancing PAD, will affect wound healing.

Even if you do not have any leg pain, its a good idea to do a preliminary check for your PAD at home in the form of the Ankle Brachial Index, and see your doctor if necessary. After all, prevention is always better than the cure, if there is a cure, that is !

Various hospitals and sites across the nation, will be offering screening for Peripheral Arterial disease, in September, and you can find out what is happening in your part of America, from http://legsforlife.org/findlfl.shtml
.

Sources :

http://legsforlife.org/findlfl.shtml
http://www.webmd.com/heart-disease/Ankle-brachial-index-test
http://www.svunet.org/spectrum/07/0807-PAD-awareness.htm