How is PAD treated?
Early intervention is very important. If patients stop smoking, if their diabetes is well controlled, if their blood pressure is normalized with either diet or medication, if their cholesterol is normalized with diet or medication – these things can help to greatly change the progression of the disease and significantly reduce the likelihood that the patient will be limited by vascular disability, require an amputation, bypass procedure or suffer a heart attack or stroke.
What are the current drug therapies for PAD?
For every PAD patient, reducing risk should be the primary goal of treatment, and healthy lifestyle changes are the first step. Medications also play a key role in treatment, with several types of drugs working together to reduce stroke and heart attack risk. One class of drugs called antiplatelet agents includes a common household medication – aspirin – that prevent platelets from sticking together and forming clots in the artery. There is also a prescription antiplatelet called clopidogrel (Plavix).
Everyone who has atherosclerosis – including patients with PAD – should be on a cholesterol lowering medication. Most patients should be on a statin. Statins lower both total cholesterol and LDL cholesterol (bad cholesterol).
Blood pressure also needs to be monitored in PAD patients and, in many cases, lowered. For patients with evidence for PAD an ACE (angiotensin converting enzyme) inhibitor, or angiotensin receptor blocker should decrease the rate of heart attack, stroke and renal (kidney) insufficiency and increase walking distance capability. Also, patients with high blood sugar should be put on antidiabetic drugs, since this condition can also lead to heart attack and stroke.
What treatments are used to specifically address leg pain?
The aforementioned types of medications, combined with the right lifestyle changes, can reduce a patient’s stroke and heart attack risk. But none of these therapies address the leg pain of PAD called claudication, which requires its own treatment strategy. Pain from intermittent claudicating is caused when leg muscles do not receive the oxygen rich blood required during exercise. The pain can be severe enough to hinder a person from walking.
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