Drug Treatments & Lifestyle Choices – living with peripheral artery disease
"The causes of arterial disease
are smoking, diabetes,
high cholesterol, high blood pressure and family history."
What treatment is available?
Dealing with the risk factors
For everyone with arterial disease it is vital to treat the cause of the problem to stop it getting worse and spreading to affect other arteries. This means dealing with the risk factors. It is sometimes necessary to treat the symptoms with exercise and tablets and by improving the blood supply to the leg.
It is important to deal with smoking, cholesterol, blood pressure etc to help try and stop the disease getting any worse. This is also important because it reduces the risk other problems such as heart attack. Most people with arterial disease worry about the risk of amputation (this is rare) what they should be worrying about is the risk of a heart attack which is the same as if they had angina.
People with arterial disease should be on a cholesterol tablet (statin) and a blood thinning tablet (usually 75mg clopidogrel once a day).
Exercise
This helps the muscles keep going for longer and is also good for all the arteries. Any exercise is helpful but walking is best, it is important to keep it going for long enough to train the muscles, 20 minutes three times a week is a suggested minimum, it should be hard enough to produce an ache but not so hard that you have to stop. It works best if you build it into your daily routine for example, walking the dog, going to the paper shop, walking to work. Exercise programmes, particularly supervised ones, can improve the distance people can walk by about 50%.
Tablets
There are a number of tablets which are available to help treat claudication. Recently NICE has issued guidelines on the subject, which recommend naftidrofuryl oxalate (trade name Praxilene). You may wish to discuss this with your GP. How effective they are varies from person to person but they can produce a worthwhile improvement in walking distance.
Summary Treatment of peripheral arterial disease.
If you have pain at rest, gangrene, or arterial ulcers then you need urgent referral to a vascular surgeon!
Assuming you have pain on exercise (intermittent claudication) only:
- Treat the cause: Stop smoking, make sure blood pressure, cholesterol, and any risk factors are controlled (see above).
- Exercise, especially supervised exercise programme if available.
- Consider Praxilene (see above)
- If your symptoms are seriously affecting your quality of life despite this then see a vascular surgeon to discuss whether you should have an angioplasty or a bypass to improve the blood supply.