David Baxter PhD
Late Founder
Leg pain is an often-overlooked sign of heart disease
by Andr? Picard, Globe and Mail
Tuesday, Oct. 27, 2009
Peripheral artery disease, which causes leg cramps during exercise, is a strong marker for heart disease and stroke. But it needs to be diagnosed more frequently, an Alberta research says
The nagging pain you feel in your legs when you walk might be an important clue that you have heart troubles, researchers are warning.
That's why they're urging everyone over the age of 40 to get a simple test for peripheral artery disease.
?PAD is a serious heart disease,? said Ross Tsuyuki, a professor of medicine at the University of Alberta in Edmonton. ?It's a strong marker for heart disease and stroke.?
The diagnostic test, which can be done at a doctor's office or a pharmacy, consists of measuring blood pressure in the leg as well as in the arm, then comparing the two. If blood pressure in the leg is 90 per cent or less than in the arm, a person likely has PAD.
Dr. Tsuyuki, a pharmacist-researcher, said PAD is caused by narrowing of the arteries that supply blood to the legs, and it's usually a strong indication that similar problems are occurring in the arteries of the heart and brain.
Blocked arteries? either from a build-up of plaque or a blood clot ?can trigger a heart attack or stroke.
The symptoms of peripheral artery disease include leg cramps while walking or exercising, coldness or numbness in both legs, and leg sores that don't heal.
Dr. Tsuyuki said the pain experienced by people with PAD is often likened to chest pain from the heart. That's why PAD is sometimes called ?angina in the legs.?
Those at highest risk are current or former smokers, people with diabetes, and those with other risk factors for heart disease and stroke such as high blood pressure or high cholesterol.
But many people have no, or very mild, symptoms, or they dismiss the leg pain as an inevitable by-product of aging.
Dr. Tsuyuki said it's a mistake not to consider leg pain as serious as pain directly in the heart: ?It's unique in that it manifests itself in the legs, but it's just as urgent.?
In research presented Monday at the Canadian Cardiovascular Congress in Edmonton, Dr. Tsuyuki and his research team set up 10 screening clinics at pharmacies and physicians' offices in Alberta.
They tested 362 volunteers over the age of 50 and discovered 17 cases of PAD. That works out to almost 5 per cent of those tested, quite a high rate for a screening test, though the sample was not a random one.
Dr. Tsuyuki noted that virtually all the patients with PAD were unaware they had arterial problems.
The research team followed the patients diagnosed with PAD for several months after the initial test and found that 88 per cent had a follow-up visit with a physician to discuss their cardiovascular disease risk. More than half also underwent treatment ? either medication or lifestyle changes ? for PAD.
While the research was done on those aged over 50, the team said anyone over 40 could benefit from screening for PAD, especially considering it is easy and cheap.
Beth Abramson, a cardiologist and spokeswoman for the Heart and Stroke Foundation of Canada, said that not enough family physicians ? or patients ?pay attention to leg pain, and they need to be made aware of the ?leg-heart connection.?
She said people who get leg cramps while walking or exercising often suffer from claudication, which is ?angina of the legs and puts you at risk of heart attack.?
Patients with PAD need to be aggressively treated for high blood pressure or high cholesterol, or for underlying diabetes, to avoid symptoms getting worse, Dr. Abramson said.
In 2005, the most recent year for which there are detailed data, 67,343 Canadians died due to cardiovascular disease, according to Statistics Canada.
by Andr? Picard, Globe and Mail
Tuesday, Oct. 27, 2009
Peripheral artery disease, which causes leg cramps during exercise, is a strong marker for heart disease and stroke. But it needs to be diagnosed more frequently, an Alberta research says
The nagging pain you feel in your legs when you walk might be an important clue that you have heart troubles, researchers are warning.
That's why they're urging everyone over the age of 40 to get a simple test for peripheral artery disease.
?PAD is a serious heart disease,? said Ross Tsuyuki, a professor of medicine at the University of Alberta in Edmonton. ?It's a strong marker for heart disease and stroke.?
The diagnostic test, which can be done at a doctor's office or a pharmacy, consists of measuring blood pressure in the leg as well as in the arm, then comparing the two. If blood pressure in the leg is 90 per cent or less than in the arm, a person likely has PAD.
Dr. Tsuyuki, a pharmacist-researcher, said PAD is caused by narrowing of the arteries that supply blood to the legs, and it's usually a strong indication that similar problems are occurring in the arteries of the heart and brain.
Blocked arteries? either from a build-up of plaque or a blood clot ?can trigger a heart attack or stroke.
The symptoms of peripheral artery disease include leg cramps while walking or exercising, coldness or numbness in both legs, and leg sores that don't heal.
Dr. Tsuyuki said the pain experienced by people with PAD is often likened to chest pain from the heart. That's why PAD is sometimes called ?angina in the legs.?
Those at highest risk are current or former smokers, people with diabetes, and those with other risk factors for heart disease and stroke such as high blood pressure or high cholesterol.
But many people have no, or very mild, symptoms, or they dismiss the leg pain as an inevitable by-product of aging.
Dr. Tsuyuki said it's a mistake not to consider leg pain as serious as pain directly in the heart: ?It's unique in that it manifests itself in the legs, but it's just as urgent.?
In research presented Monday at the Canadian Cardiovascular Congress in Edmonton, Dr. Tsuyuki and his research team set up 10 screening clinics at pharmacies and physicians' offices in Alberta.
They tested 362 volunteers over the age of 50 and discovered 17 cases of PAD. That works out to almost 5 per cent of those tested, quite a high rate for a screening test, though the sample was not a random one.
Dr. Tsuyuki noted that virtually all the patients with PAD were unaware they had arterial problems.
The research team followed the patients diagnosed with PAD for several months after the initial test and found that 88 per cent had a follow-up visit with a physician to discuss their cardiovascular disease risk. More than half also underwent treatment ? either medication or lifestyle changes ? for PAD.
While the research was done on those aged over 50, the team said anyone over 40 could benefit from screening for PAD, especially considering it is easy and cheap.
Beth Abramson, a cardiologist and spokeswoman for the Heart and Stroke Foundation of Canada, said that not enough family physicians ? or patients ?pay attention to leg pain, and they need to be made aware of the ?leg-heart connection.?
She said people who get leg cramps while walking or exercising often suffer from claudication, which is ?angina of the legs and puts you at risk of heart attack.?
Patients with PAD need to be aggressively treated for high blood pressure or high cholesterol, or for underlying diabetes, to avoid symptoms getting worse, Dr. Abramson said.
In 2005, the most recent year for which there are detailed data, 67,343 Canadians died due to cardiovascular disease, according to Statistics Canada.
