My non profit organization The PAD Coalition (www.beatpad.org) kicked off the season with a visit to a local church recently. After several years of campaigning to increase public awareness about Cardiovascular disease, I am always surprised at the number of people who have a poor understanding of the process. As a healthcare system, we clearly do a very poor job of educating people about identifying the symptoms of disease. We are stuck in a "Medical Treatment Model" instead of a disease prevention model
Peripheral Arterial Disease or PAD is a subset of Cardiovascular disease. PAD is the term for blockages that occur outside of the heart including the blood vessels of the neck (carotid) responsible for strokes; the blood vessels of the legs that are responsible for pain with ambulation (claudication) , gangrene and amputations; the blood vessels of the kidneys responsible for hypertension and kidney failure just to name a few
Of these groups, the legs are by far the most easily diagnosed by patient's complaints, physician examination and very easily performed tests like the ABI (Ankle Brachial Index). This is important for several reasons. One, if we identify developing blood vessel blockages in the legs, we can become more aggressive in treating the medical factors of blood pressure, lipids and diabetes as well as smoking cessation. If these fail to improve the symptoms, then many procedures are available to improve the situation
More importantly, if a patient has abnormal circulation in the arteries of the legs, there is an 80% chance that they will have significant blockages in the blood vessels of the heart. By identifying this process by a patient complaints of pain in the legs with ambulation or more sever symptoms of ulceration; we are alerted to be very aggressive in treating the identical risk factors for heart disease. If patients and primary care doctors were aware of this very simple premise and applied it every day, we would make a significant impact on the prevention, identification and treatment of heart disease.
The problem is that although vascular specialists are familiar with this 5-10 minute evaluation, the familiarity of non specialist is much less. That's why it is just as important to improve awareness among PCP's, nurses, NP's as it is for patients. In fact, if one can measure their blood pressure, you can measure your ABI
photo source www.cardiovascularsystemsinc.com