Guidelines

Peripheral Artery Disease in the Legs Guidelines (2017)

The American Heart Association and American College of Cardiology updated their guidelines on the management of peripheral artery disease – a common circulatory condition that affects about 8.5 million Americans. Peripheral artery disease, often called PAD, is similar to coronary artery disease and occurs when narrowing arteries reduce blood flow to the limbs. PAD most often affects the legs, but it can also affect the stomach, arms and head.

Since PAD is associated with increased cardiovascular risk, experts recently updated guidelines to improve detection and treatment of this common condition. And here’s what every patient should know about the latest recommendations, which focus on the management of PAD in the legs.

Improve Screening

The guidelines highlight the need for improved screening of PAD. As authors explain, PAD can be detected with a simple test called the ankle-brachial index, which measures blood pressure in the arms and ankles using an ultrasound device and blood pressure cuffs. This test should be done on patients with symptoms of PAD, which can include leg pain as well as walking impairment, non-healing wounds and gangrene.

Routine Testing

Authors also note that patients at risk for PAD should be routinely assessed for this condition. Typical risk factors for PAD include smoking, high blood pressure, atherosclerosis, diabetes, high cholesterol, older age (greater than 60) and family history of PAD. For patients with any of these risk factors, it’s important that providers complete a thorough medical history, review symptoms and conduct brief medical exams. By catching PAD early, patients can work with providers to reduce symptoms and prevent complications.

Effective Treatment

The new guidelines also highlight the need for optimal treatment for PAD, which tends to include medication and exercise. Depending on symptoms, some patients also may benefit from stents or other procedures that improve blood flow to the legs. The goal of these treatments is to minimize symptoms and improve quality of life while cutting risk for heart events and complications.

Education, Awareness

Lastly, the report highlights the need for better education and more awareness for PAD. PAD is a serious condition that raises risk for leg problems, heart attack and stroke. Patients need to be educated about this condition and assessed for PAD, when appropriate. Patients diagnosed with PAD also should know the importance of treatment. These therapies can improve both outcomes and quality of life.

Read the full update to these guidelines in the Journal of the American College of Cardiology