The Most Dangerous Disease You’ve Never Heard Of

The answer: peripheral arterial disease (PAD), according to Alan Hirsch MD, speaking to the national press Club in DC. The federal government is starting a campaign to make more people aware of PAD, which affects more than 12 million Americans. Without early detection and proper treatment, one in four people with PAD will have a heart attack, stroke, amputation of a limb, of die within the next 5 years.

PAD is due to atherosclerosis, which blocks arteries supplying blood to the legs, feet, kidneys, and intestines. And people with diabetes, who are at especial risk for atherosclerosis, have a greater risk of amputation, especially if their blood sugar levels are poorly controlled.

Apart from diabetics, there are other groups of people who are at greater risk of PAD: those who smoke (and former smokers), and African-Americans. What’s troublesome is that there are often few or no symptoms until the process is quite advanced. One of the most common symptoms is claudication. This is pain in the calf muscle that occurs after you have walked a certain distance; the pain stops after you rest a bit. The distance-to-pain and the time it takes to go are usually fairly constant over a period.

Your doctor may diagnose PAD by measuring the blood pressure in your arm and ankle, and comparing the two readings. There are more sophisticated ways of using this approach, with Doppler ultrasound, for instance. Diagnosis and treatment are relatively easy. But what’s important about PAD is that it’s cause – atherosclerosis – is common to coronary artery disease and carotid disease, and thus with future risk of heart attack or stroke.