What are the medical treatments used for PAD?
You have just been diagnosed with peripheral arterial disease. You’ve been told that there are blockages in the arteries of your legs that are preventing your legs and muscles from getting the oxygen they need to function properly. When you exercise, you feel pain in your legs.
The question now is, what can you and your healthcare team do to reduce your symptoms and avoid further long-term complications?
Opening up new “passages” for blood circulation to your lower limbs
It is possible to develop a secondary network of blood vessels in your legs that helps blood bypass the blockages in your arteries so you experience less pain with physical activity.
How can I help develop the arterial system in my legs?
You can do exercises that demand more oxygen from the rest of your body. Walking is the most effective exercise. A good starting goal is to walk 20 to 30 minutes a day, 3 to 5 times a week. One way you can make yourself walk more is to park your car further away when you go to the grocery store, for example.
Talk to your healthcare professional before starting a walking program to make sure there are no contraindications to this type of exercise, especially in terms of your cardiovascular health. Don’t worry, though – after an evaluation and the appropriate interventions, it’s quite rare that a patient is told they will not be able to exercise!
How can I make sure I don’t harm my legs while exercising?
It’s normal to feel moderate discomfort in your legs during these exercises; this is because the muscles in your limbs require more blood flow than your vascular system can actually provide! Simply rest until the pain disappears, then resume the exercise. Even if you need to take a break every 1 or 2 minutes, don’t give up! You have to give your body time to develop the blood vessels that will bypass the blockages in your leg arteries. In addition, even though you may feel that the exercise you are able to perform is very light, if you push yourself to the point of mild to moderate discomfort, it is still effective!
On the other hand, if:
- you experience persistent pain even after having stopped exercising
- you have pain even at rest
- sores appear on your legs
- these sores do not heal
Make an appointment with your healthcare professional as soon as possible!
How long should it take before I start to see an improvement in my symptoms?
You should start to see the positive effects of walking after a few weeks to a few months. Make sure you continue your follow-up with your healthcare professional during this period! In addition to giving you advice on other aspects of your treatment, he or she will be able to assess you regularly, and if the program is ineffective or complications arise, tell you if you need surgery.
Since walking has lasting benefits for your health on many levels, and since maintaining such an exercise program is important for managing the symptoms of PAD, we encourage you to continue your efforts over the long term and to gradually increase the intensity of your activity as your fitness improves!
Slow down the progression of arterial blockages by improving your lifestyle Many chronic diseases caused by bad lifestyle habits can also have a harmful effect on your arteries. That’s why it’s so important to adopt a healthy lifestyle in order to avoid and/or slow the progression of PAD!
Adopting a healthier lifestyle
Quitting smoking can slow progression of the disease
Giving up smoking is probably your greatest line of defence against PAD! In addition to having a direct toxic effect on your blood vessels, tobacco smoke impedes your ability to exercise and can cause other vascular diseases such as strokes or heart attacks.
If you want to quit smoking, you can get help by contacting a support group and/or by obtaining a prescription for nicotine supplements or specific smoking cessation medications from your healthcare professional. For more information, consult a healthcare professional and visit the Quit to Win! Challenge website.
Visit the Quit to Win! Challenge website
What other lifestyle changes can I make to help slow the progression of PAD?
Diabetes, hypertension (high blood pressure) and dyslipidemia (elevated cholesterol) are major risk factors for the onset and progression of PAD. It is therefore important to adopt a healthy diet, such as the Mediterranean diet, to help control and prevent these diseases.
It is also recommended to reduce salt intake and maintain a healthy weight to slow the progression of PAD. For more information, talk to a healthcare professional and click on the links below!
Visit the Quit to Win! Challenge website
Visit the Canada Food Guide
If I suffer from PAD, does it mean my lifestyle is unhealthy?
Unfortunately, it sometimes happens that, for genetic reasons, individuals with few or no unhealthy bad lifestyle habits nonetheless develop PAD. But don’t despair! Walking is still an excellent way to manage the disease and your healthcare professional can offer you treatments aimed at reducing your pain and avoiding complications!
Using medication to stop the progression of blockages
There is no specific drug for the treatment of PAD in Canada.
It is likely, however, that your healthcare professional will offer you two types of medication that can help in the treatment of several vascular diseases: one that lowers cholesterol and one that prevents spontaneous blood clots.
Why am I being offered a cholesterol-lowering medication?
In patients with PAD, the vast majority of the plaque build-up that blocks arteries is at least partly made up of cholesterol (fat).
In fact, regardless of your blood cholesterol results (as measured during your regular check-up), the presence of PAD is a sign that you need to lower your cholesterol level. Medication will slow the progression of PAD and also prevent complications such as stroke or heart attack (myocardial infarction).
The most common and effective cholesterol-lowering medications, both in tablet and injection form, are statins such as Atorvastatin (sold under the brand name Lipitor® or as a generic) and Rosuvastatin (sold under the brand name Crestor® or as a generic).
Why am I being offered a medication to prevent blood cloth?
It sometimes happens that a cholesterol plaque built up in an artery suddenly ruptures, causing a complete and rapid blockage in the diseased artery. When this occurs in an artery in the brain, the result is a stroke; when it happens in a coronary artery, it causes a myocardial infarction (heart attack). When it happens in the arteries of the legs in patients with PAD, it requires an emergency intervention and can sometimes even lead to amputation.
The first step in the formation of a blood clot in an artery is the accumulation of platelets, the blood cells that help stop bleeding. In patients with intermittent claudication and PAD, a medication called an “antiplatelet” is often prescribed to reduce the risk of this complications. The most commonly known antiplatelet is acetylsalicylic acid (Aspirin®), but other antiplatelet medications and anticoagulants are also available, depending on your condition.
Are there any other medications that can help slow PAD?
Since diabetes, hypertension (high blood pressure) and dyslipidemia (high cholesterol) can all put you at higher risk for PAD, controlling these chronic diseases is essential in order to slow the progression of PAD.
Medications often play an important role in the management of these chronic diseases. If you have one of them, your healthcare professional will prescribe the medication best suited to your condition and make recommendations to help you improve your lifestyle. For each of these diseases, there are medications with additional benefits for patients with arterial diseases, including PAD. Don’t hesitate to talk to your healthcare professional!