Peripheral Artery Disease and Intermittent Claudication
DescriptionAn in-depth report on the causes, diagnosis, and treatment of peripheral artery disease
Alternative NamesIntermittent Claudication
Between eight and 10 million American adults have peripheral artery disease (PAD). The prevalence ranges from 3% in young adults to between 12% and 29% in people over 65. (These numbers are expected to rise as the population ages.) Intermittent claudication occurs in about one-third to one-half of PAD patients.
Although it is commonly believed that PAD occurs more often in men than women, current research now indicates that both genders are equally susceptible.
People in northern regions tend to have a higher risk than those in southern areas. In one study, Caucasians had a higher risk for PAD than people from India or the people of African descent from the Caribbean. Such findings are counter to studies suggesting higher risks for heart disease in African Americans and for diabetes in populations from India.
Heart Disease Risk Factors
The major risk factors for heart disease and stroke are also the most important risk factors for PAD and intermittent claudication. (The combination of such conditions with PAD also produces a more severe form of the heart or circulatory disease.)
They include the following:
Emerging or Possible Risk Factors
Homocysteine. Abnormally high blood levels of the amino acid homocysteine are strongly linked to an increased risk of heart disease, stroke, and peripheral artery disease. (Not all studies support a strong association, however. Some research suggests that the harmful effects of homocysteine may be more pronounced in men than in women.) Homocysteine may harm the lining of the arteries and reduce blood flow. Excessive levels occur with deficiencies of vitamins B6, B12, and folic acid.
Some experts believe that high levels of homocysteine are only indicators, not causes, of heart disease. However, studies are noting a strong association between this compound and heart disease. For example, a 2000 study reported that lower homocysteine levels after taking folic acid and vitamin B12 were associated with more open blood vessels and improved blood flow
Infectious Agents. Some microorganisms and viruses have been under suspicion for triggering inflammation and damage in the arteries that contributes to heart disease and peripheral artery disease.
The primary suspect has been Chlamydia pneumoniae (a non-bacterial organism that causes mild pneumonia in young adults). This is based on the following:
It should be noted that many people have been infected with C. pneumoniae and some studies have found no evidence that it increases the risk for heart disease.
Other infectious organisms under investigation for triggering disease process in the blood vessels including the following:
No clear association has been found with any of these, however.