Peripheral Arterial Disease and Smoking
“About 80% of the patients whose legs or extremities I have to amputate are current smokers. If they are not current smokers, then they almost certainly used to smoke.
If patients presenting with PAD have never smoked, I have cause to doubt whether they have the disease at all.” -Mr. Daryll Baker, Consultant vascular surgeon, Royal Free Hospital.
The most common cause of peripheral arterial disease (PAD) is atherosclerosis. In atherosclerosis, fatty deposits (plaques) build up in your artery walls and reduce blood flow.
PAD mimics a condition similar to coronary artery disease and carotid artery disease where fatty deposits build up in the inner linings of the artery walls.
These blockages restrict blood circulation, mainly in arteries leading to the kidneys, stomach, arms, legs, and feet.
Robert S. Schwartz, MD states: “Atherosclerosis and PAD is pretty much the same thing. Atherosclerosis is the hardening of the arteries.
It’s the plaque that builds up; it’s the calcium, the fats, the fibrous tissue, the scarring that grows into the arteries and stops the blood from flowing into the legs.”
In the UK, about 2.7 million people age 55 or older, have some degree of peripheral arterial disease and almost 8-12 million people in the United States who have this disease are unaware of having this condition.
PAD is often silent for a very long time before you will notice any symptoms. Some Symptoms of PAD may include:
- Foot pain that does not go away when you stop exercising
- Cold and numb feet or toes
- Leg numbness or weakness
- A change in the color of your legs
- Decreased leg strength, function, and poor balance
- Experiencing discomfort within the muscles of the calves or the thighs, or the buttocks may be indicative of claudication (PAD leg pain occurs in the muscles, not the joints)
- Hair loss on your feet and legs
- Changes in your nails
- Foot pain at rest, which indicates that PAD is getting worse
- Foot or toe wounds that will not heal or heal very slowly
- Erectile dysfunction
*Symptoms of peripheral vascular disease depend on what artery is affected and how severely the blood flow is reduced.
One of the serious sub effects of peripheral vascular disease is Buerger’s disease (thromboangiitis obliterans). It is characterized by a combination of inflammation and clots in the arteries and veins that obstruct blood flow.
Brandon Carmichael is a young man who has suffered this disease to an extreme, having had his left leg amputated below the knee from smoking.
The risk of peripheral vascular disease is dramatically increased in smokers. When a person stops smoking, regardless of how much he or she may have smoked in the past, their risk of peripheral vascular disease rapidly declines.
In a Health Briefing on Silent Epidemic, Peripheral Arterial Disease article Alan T. Hirsch, MD, Chair, P.A.D. Coalition states, “Peripheral arterial disease is the most dangerous disease that most Americans have never heard of”.
The same article continues with the following warning: “People with peripheral arterial disease – P.A.D. – have up to a six-fold increase in cardiovascular death. Without early detection and proper treatment, one in four people with P.A.D. will suffer a heart attack, stroke, amputation or die within the next five years.”
If you add a bad diet and a sedentary lifestyle into this equation, you probably have a prescription to die much younger. How many smokers with Peripheral Arterial Disease have died of a heart attack or stroke where the connection to smoking as a risk factor fell silent?
An absence of a pulse in your legs or arms should immediately alert your health care provider to seek further testing for Peripheral Arterial Disease. eMedicineHealth has an excellent article on Exams and Tests regarding Peripheral Arterial Disease. It is very important that you consult with your health care provider if you believe that you are at risk for this disease.
Are you a smoker? If you are a smoker the most important thing you can do for your health is to educate yourself about smoking-related diseases. If you are an ex-smoker, you also need to stay abreast of learning about smoking-related diseases. Knowledge is power!
- Smoking Got Me – The Story of Brandon Carmichael
- Health Briefing On Silent Epidemic, Peripheral Arterial Disease, September 11, 2006
- Peripheral arterial disease (PAD) Mayo Clinic
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