Family History and Peripheral Artery Disease
Family history could more than double risk of developing PAD.
Peripheral artery disease (PAD) is a serious health condition currently affecting about 8.5 million Americans. It is caused by the build-up of plaque in the arteries, known as atherosclerosis, which reduces blood flow in the legs and causes pain and numbness in the lower extremities. Although peripheral artery disease is treatable with lifestyle changes, medications and procedures, it greatly increases risk for heart disease, stroke and heart attack.
Those at greatest risk for PAD include smokers, adults older than 50, and those with other cardiovascular risk factors, such as high blood pressure and diabetes. And as with many cardiovascular conditions, family history plays a role in risk for PAD. But just how much?
A study published in the Journal of the American College of Cardiology recently followed over 2,400 men and women in the United States for four years to measure the relationship between family history and prevalence of PAD through the use of questionnaires and physical examinations. They found that adults with a family history of peripheral artery disease were 83% more likely to develop this condition, while those with a family history of severe peripheral artery disease were 2.42 times as likely to develop this condition than those without any family history of the disease.
This study shows that family history plays an important role in risk for the development and severity of PAD. It also raises questions whether this relationship is the result of genetic factors, shared environmental factors (such as lifestyle), or a combination of both. Regardless of the cause, it is important that those with a family history of PAD reduce all other risk factors for the condition, such as smoking and high cholesterol, to minimize risk of developing it.
Questions for You to Consider
- How is PAD diagnosed?
Doctors often diagnose PAD by using the ankle-brachial index (ABI) to assess blood flow to the legs. The ABI is a simple test that can be done in your doctor’s office. During the test, you lie flat while your doctor measures the blood pressure in both arms using a standard blood pressure cuff and a small hand-held Doppler ultrasound probe. The ultrasound probe detects the first sound of blood flow as the cuff is deflated; that’s the upper number in your blood pressure. Your doctor then measures the blood pressure in both ankles by placing an inflatable blood pressure cuff between the ankle and calf and again using the Doppler ultrasound probe to listen for blood flow.
The next step is to calculate the ratio of the highest ankle pressure to the highest arm pressure on the same side of the body. This is the ankle-brachial index. If the blood pressure in the ankle is a lot lower than in the arm, it is a sign that a blockage is interfering with blood flow to the lower leg.
What are the warning signs of PAD?
The first inkling that you have PAD is often a painful cramp in the calf or thigh that occurs repeatedly when you walk, but disappears when you’re at rest. This symptom is known as intermittent claudication. People with PAD often curtail their activity to avoid further pain. However, inactivity only worsens the condition, creating a downward spiral.
As PAD becomes more advanced, other symptoms may develop including:
- Aching or burning in your feet and toes, especially when lying down at night
- Redness or other color changes to the skin on your feet
- Skin on the feet that feels cool to the touch
- Sores on your toes or feet that do not heal