Undetected block age in legs could increase the risk of stroke

Many elderly people who experience numbness, pain, cramps, and muscle fatigue in the legs or feet when they walk or exercise may be suffering from peripheral vascular disease (PVD) or lower leg PVD, a common but under diagnosed condition affecting millions of people worldwide.

Vascular disease, the major cause of stroke and heart attacks, is mainly due to atherosclerosis, which occurs when fatty deposits, or plaques, build up on the inside walls of the arteries that carry blood to any part of the body, causing them to narrow and harden.

Over the years, cholesterol and calcium build up inside the arteries, which occurs much earlier in people who smoke and those who have diabetes or high levels of cholesterol in the blood.

Symptoms of PVD in the lower limbs include weakness in the legs, numbness, tingling, coldness, change in skin color, rashes, and marks on the legs or feet. The skin on the lower legs may be dry and shiny and there may be poor toenail or hair growth.

"The risk of acquiring PVD increases as one gets older. It usually starts at the age of 40, with a prevalence of up to 4 percent of the general population, and may go up to 16 percent in older patients aged 30 and above going to as high as 25 to 30 percent in those aged 50 and above," said Ricardo Jose DT Quintos, Chief of Vascular Surgery at the National Kidney and Transplant Institute (NKTI). "Individuals with diabetes, heart and kidney failure, severe lung disease, or physical debilitation face a much greater risk."

According to Mr. Quintos, people with lower leg PVD may often have the same type of fatty build-up in the arteries supplying the heart, brain, and kidney. They are at a higher risk of stroke, heart disease, and kidney failure. People with PVD are also more likely to have diabetes and hypertension.

Lower leg PVD is a disease that is often asymptomatic but increases in severity over time. Left alone, it can at the very least, seriously impair a person’s mobility and independence.

It is estimated that less than 30% of PVD patients are diagnosed, mainly due to the fact that over 50% do not experience any symptoms like pain, shortness of breath, or thickening of the nape. Leg pain may be present in only 10% of patients, according to Mr. Quintos.

If PVD symptoms limit the blood flow to the lower legs and feet, this can lead to pain, poor healing of wounds, infections, or worse, amputation.

Unfortunately, many people with the early symptoms of lower leg PVD, especially pain while walking, assume that this is just part of getting old and do not seek medical attention until it is too late. Blocked arteries in the leg reduce the blood flow so that the surrounding muscles do not get enough oxygen, which causes leg muscles to cramp and suffer pain while walking or exercising. This condition called intermittent claudication usually goes away with rest.

If detected early, lower leg PVD can usually be treated with medication and exercise. Severe cases that require surgical intervention can be treated with angioplasty, a minimally invasive procedure that is already widely practiced in the Philippines.

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Undetected block age in legs could increase the risk of stroke