Lifestyle Changes Found Critical in Fighting Peripheral Arterial Disease

The composite endpoint was major adverse clinical outcome (MACO) of the asymptomatic limb at clinical follow-up, which was defined as the development of intermittent claudication (IC), critical limb ischemia (CLI), or need for subsequent endovascular or surgical revascularization.

The researchers found that one-third of the 122 patients developed symptoms of pain or ulceration, and almost half of these then required treatment. Overall, only 13.9% of the initial group required treatment, so that even though PAD progressed over time, the researchers did not believe they had enough evidence to advocate early minimally invasive treatment of PAD in patients who had no initial symptoms. The study was published in the September 2009 issue of the Journal of Vascular and Interventional Radiology.

"While this study is useful in examining the possibility of treating PAD earlier, additional research into the factors that cause PAD progression and the rate of progression, along with methods to slow the disease, need to be conducted,” said lead author interventional radiologist Aoife Keeling, M.D., of Northwestern Memorial. "Prevention of PAD progression is vital and can be achieved with risk factor modification, for example, if individuals stop smoking, watch their diets, lower their cholesterol and have their blood pressure monitored.”

PAD occurs when plaque accumulates in arteries that supply blood to areas of the body other than the heart and brain. Since plaque blocks the leg arteries first, PAD is considered a red flag for several life-threatening vascular diseases, such as heart attack and stroke. PAD causes a range of symptoms, from no symptoms to pain in the legs while walking (IC), to its most severe form that results in pain in the feet and legs at rest that can progress to ulcers and eventual gangrene (critical limb ischemia). The disease's progression can result in limb loss and even in death.

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