Peripheral Artery Disease Common, Manageable

Peripheral Artery Disease Common, Manageable
“Anything that increases the risk of plaque buildup in the blood vessels can increase the risk of PAD ,” Dr. Muppala says.
Peripheral artery disease, or PAD, is a common circulatory problem that affects more than 12 million people in this country. Caused by atherosclerosis the buildup of plaque in the arteries PAD affects the blood vessels of the lower extremities. Interventional cardiologist Murali Muppala, M.D., says that the risk factors for PAD are similar to those for coronary artery disease and the condition is most common in people age 50 and older. Anything that increases the risk of plaque buildup in the blood vessels can increase the risk of PAD, Dr. Muppala says.

Specific risk factors include:

  • Increase in low-density lipoprotein (LDL) bad cholesterol and triglycerides and a decrease in highdensity lipoprotein (HDL) good cholesterol
  • Smoking
  • Diabetes Hypertension high blood pressure
  • Family history
  • Obesity
  • Lack of exercise
  • Chronic kidney failure

Dr. Muppala says 50 percent of people with PAD do not experience symptoms, but if and when they do, they can include leg cramping and heaviness with activity that gets better with rest.

Other common symptoms include:

  • Hair loss
  • Numbness in the legs
  • Legs feeling cold
  • Loss of calf muscle mass
  • Change in color with elevation or dangling of legs
  • Painful ulcers in the toes

Diagnosis can be done by a simple physical examination or a noninvasive test, like ankle-brachial index (ABI), which compares the blood pressure between the arm and the affected leg. Other noninvasive tests include ultrasound, CT and magnetic resonance angiogram (MRA). Angiography is the gold standard for diagnosis, Dr. Muppala says.

Using small plastic tubes inserted in the groin, we inject iodine contrast into the blood vessels, which allows us to view the blood flowing through the arteries. There is a wide range of treatment options for PAD, says general and vascular surgeon John Moss, D.O.

Less invasive options may be available, like supervised walking programs and lifestyle modification like smoking cessation, weight reduction and controlling diabetes, high blood pressure and cholesterol, Dr. Moss says. There also are medications that improve blood flow. Other, more invasive treatment options include removing plaque from the arteries, angioplasty or bypass surgery.

PAD is a lifelong condition that requires the medical management of underlying risk factors, lifestyle modification and the coordination of care from specialized physicians.

Managing PAD

Lee Memorial Home Health helps patients stay healthy while managing their PAD by:

  • Assessing the patient s knowledge about the disease.
  • Teaching patients about the symptoms, causes, risk factors and what they need to do to manage their care at home.
  • Reconciling medications including those prescribed and those purchased over-the-counter and providing education about the dosages, interactions, effects and side effects of the medications.
  • Checking patient s skin for any wounds and advising them on what to watch for and how to take care of them.
  • Assessing pain and teaching the patient how to manage it.

To learn more about Lee Memorial Home Health, call 239-418-2900 or email

John Moss, D.O.
General & Vascular Surger
Lee Physician Group
8380 Riverwalk Park Boulevard
Suite 100
Fort Myers, FL 33919


Murali Muppala, M.D.
Lee Physician Group
14051 Metropolis Avenue
Fort Myers, FL 33912



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