Central treatment for peripheral artery disease

Content provided by the Faculty of the Harvard Medical School

Central treatment for peripheral artery disease

Heart care is important for people with narrowed leg arteries.

If you have peripheral artery disease, keep this in mind: The leg bone's connected to the heart bone.

Okay, so there's no such thing as the heart bone. But the message of the folk song "Dem Bones" — that all parts of the body are connected — definitely applies to peripheral artery disease. This catchall condition includes potentially disabling pain that occurs with walking or exercise (claudication), as well as circulation problems in the kidneys, intestines, aorta, and other parts of the body below the heart. Most cases stem from the same atherosclerosis that gives rise to heart disease.

Doctors have traditionally treated peripheral artery disease as something separate from heart disease. A study from the Netherlands suggests that they're smoke from the same fire and benefit from the same protective therapies. This work is in line with sweeping guidelines published in spring 2006 that aim to tie these conditions together with a coordinated system of diagnosis and treatment.

Helpful medications

Researchers examined more than 2,400 men and women who were referred to Erasmus Medical Center in Rotterdam for the treatment of peripheral artery disease. Almost 40% had already had a heart attack, and most of the others were at risk for one because of high blood pressure or cholesterol, diabetes, or smoking. As described in the March 21, 2006, Journal of the American College of Cardiology, as these individuals were treated and followed, the researchers tracked their health and medications.

During the eight-year study, nearly half of the participants died. By crunching the numbers, the researchers teased out characteristics that were connected to death and survival. Kidney failure, high cholesterol, high blood pressure, and heart disease pointed participants in the direction of early death. In contrast, taking one or more common cardiovascular medicines offered protection against dying early. Participants who took a cholesterol-lowering statin were half as likely to have died during the study as those not taking one. The use of aspirin, beta blockers, and ACE inhibitors also improved survival.

Coping with peripheral artery disease

Blockage in an artery supplying a leg, kidney, or the intestines poses trouble for these "peripheral" parts of the body. It is also a signal that there's probably trouble brewing in vessels that nourish the heart and brain. If you have peripheral artery disease, the odds are good that you have heart disease, and vice versa.

Peripheral artery disease can cause pain, limit activity, and cast a pall on life. It may even necessitate the amputation of a limb. But it isn't usually deadly. What kills half or more of the people who have it are heart attacks and strokes. So it makes sense to do what you can to prevent these even as you work to improve blood flow to the legs, kidneys, or elsewhere.

In people with heart disease, drugs such as statins, aspirin, ACE inhibitors, and beta blockers prevent heart attacks and strokes. Small studies show that they do the same things for people with peripheral artery disease. If you aren't on one or more of these, ask your doctor to get with the guidelines.

While medications are good, exercise is even better. Think of it as a two-fer: Exercise is a key way to improve blood flow in clogged peripheral arteries as well as an excellent way to rejuvenate your heart's arteries.

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Last updated:	July 24, 2007