User:Mr. Ibrahem/Peripheral artery disease
Medical condition / From Wikipedia, the free encyclopedia
Peripheral artery disease (PAD) is an abnormal narrowing of arteries other than those that supply the heart or brain.[5][15] When narrowing occurs in the heart, it is called coronary artery disease, and in the brain, it is called cerebrovascular disease.[4] Peripheral artery disease most commonly affects the legs, but other arteries may also be involved – such as those of the arms, neck, or kidneys.[4][16] The classic symptom is leg pain when walking which resolves with rest, known as intermittent claudication.[2] Other symptoms include skin ulcers, bluish skin, cold skin, or abnormal nail and hair growth in the affected leg.[3] Complications may include an infection or tissue death which may require amputation; coronary artery disease, or stroke.[4] Up to 50% of people with PAD do not have symptoms.[2]
Peripheral artery disease | |
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Other names | Peripheral vascular disease (PVD), peripheral artery occlusive disease, peripheral obliterative arteriopathy |
An arterial insufficiency ulcer in a person with severe peripheral artery disease[1] | |
Specialty | Interventional radiology, vascular surgery |
Symptoms | Leg pain when walking which resolves with rest, skin ulcers, bluish skin, cold skin[2][3] |
Complications | Infection, amputation[4] |
Causes | Atherosclerosis, artery spasm[5][6] |
Risk factors | Cigarette smoking, diabetes, high blood pressure, high blood cholesterol.[4][7] |
Diagnostic method | Ankle-brachial index < 0.90, duplex ultrasonography, angiography[8][9] |
Treatment | Stopping smoking, supervised exercise therapy, surgery[10][11][12] |
Medication | Statins, ACE inhibitors, cilostazol[12] |
Frequency | 155 million (2015)[13] |
Deaths | 52,500 (2015)[14] |
The greatest risk factor for PAD is cigarette smoking.[4] Other risk factors include diabetes, high blood pressure, kidney problems, and high blood cholesterol.[7][17] The most common underlying mechanism of peripheral artery disease is atherosclerosis, especially in individuals over 40 years old.[6][18] Other mechanisms include artery spasm, blood clots, trauma, fibromuscular dysplasia, and vasculitis.[5][17] PAD is typically diagnosed by finding an ankle-brachial index (ABI) less than 0.90, which is the systolic blood pressure at the ankle divided by the systolic blood pressure of the arm.[9] Duplex ultrasonography and angiography may also be used.[8] Angiography is more accurate and allows for treatment at the same time; however, it is associated with greater risks.[9]
It is unclear if screening for peripheral artery disease in people without symptoms is useful as it has not been properly studied.[19][20][18] In those with intermittent claudication, stopping smoking and supervised exercise therapy improve outcomes.[11][12][21] Medications, including statins, ACE inhibitors, and cilostazol may also help.[12][22] Aspirin does not appear to help those with mild disease but is usually recommended in those with more significant disease due to the increased risk of heart attacks.[18][23][24] Anticoagulants such as warfarin are not typically of benefit.[25] Procedures used to treat the disease include bypass grafting, angioplasty, and atherectomy.[10]
In 2015, about 155 million people had PAD worldwide.[13] It becomes more common with age.[26] In the developed world, it affects about 5.3% of 45- to 50-year-olds and 18.6% of 85- to 90-year-olds.[7] In the developing world, it affects 4.6% of people between the ages of 45 and 50 and 15% of people between the ages of 85 and 90.[7] PAD in the developed world is equally common among men and women, though in the developing world, women are more commonly affected.[7] In 2015 PAD resulted in about 52,500 deaths, which is an increase from the 16,000 deaths in 1990.[14][27]