Here’s what you should know about PAD
PAD develops when cholesterol sticks to an artery wall. The cholesterol plaque slowly builds up by accumulating more fats and other substances, causing a condition called atherosclerosis. Over time, atherosclerotic plaque enlarges and hardens, which blocks blood flow.
You can develop PAD in any artery outside your heart, but the condition most commonly affects the legs. The first sign of PAD is typically pain and cramping that occurs when you walk, then goes away when you rest.
Without treatment, PAD progresses to cause a severe condition called critical limb ischemia. At that stage, you have pain even when resting. As tissues don’t get enough blood, you develop nonhealing ulcers and infections in your foot and around your ankle.
Obesity increases your risk of PAD
Obesity alone increases your risk of PAD. In medical terms, that means obesity is an independent risk factor for PAD. If you primarily carry your weight around your waist, your risk is even higher.
The impact of obesity on your body is complex and involves an increase in many different hormones and biochemicals. One of the biggest factors linking obesity and PAD, however, is inflammation.
Fat stores in your body, also called adipose tissue, releases substances called proinflammatory cytokines. As blood levels of cytokines increases, you develop body-wide inflammation. Your arteries are especially susceptible to inflammation. Inflammation in turn contributes to atherosclerosis.
It’s also important to know that obesity is associated with PAD that progresses to cause critical limb ischemia. Obese patients are much more likely to develop critical limb ischemia compared to those with a healthy weight.
Losing weight can lower your risk for PAD, improve arterial function in your legs, and prevent critical limb ischemia.
Obesity, metabolic disorders, and their impact on PAD
While some obese patients are otherwise healthy, it’s more common for obesity to occur together with other chronic health conditions. Obesity increases your risk of developing metabolic disorders such as diabetes, high blood pressure, high cholesterol, and cardiovascular disease.
On their own, each of these metabolic disorders raises your risk for PAD. Here are two examples:
Excess body weight is one of the driving forces of insulin resistance, a condition in which your body can’t use insulin properly. When insulin resistance goes untreated, it becomes full-blown diabetes. Diabetes causes inflammation and slows blood flow, dramatically accelerating atherosclerosis and subsequently, PAD.
High blood pressure
High blood pressure damages arterial walls, creating the perfect spot for cholesterol to build up, restrict blood flow, and lead to PAD.
When you have multiple metabolic disorders, they produce a cumulative effect. The more conditions you have, the more your overall chance of PAD increases.
Screening for PAD
Anyone who’s at risk — whether you’re obese and metabolically healthy, or you’ve been diagnosed with several conditions that boost the risk of PAD — should consider PAD screening.
We screen for PAD using a quick, noninvasive procedure that uses blood pressure cuffs and a small ultrasound device to compare the blood pressure in your arm with the blood pressure in your ankle.