One in six over-55s at risk from arterial condition, says IHF

Heart healthMore than one in six people over 55 have an arterial condition in their lower limbs which can lead to heart attack or stroke, the Irish Heart Foundation (IHF) has said.

Peripheral arterial disease (Pad) causes a narrowing of the arteries which supply the legs with blood and leads to inadequate blood flow to lower limbs.

People with the condition are six times more likely to die from heart attack or stroke, but, the IHF said, sufferers may be unaware they have the disease.

"The majority of patients with Pad have no symptoms and many symptomatic patients do not report their symptoms to their physician, believing them to be a natural manifestation of the aging process," Dr Philip Crowley, GP, said. Typical symptoms include leg pains, usually when walking, which many Pad sufferers attribute to arthritis, but one- third will have no symptoms.

However, the IHF said, the condition was easily detectable through a simple blood pressure test which can be performed at a GP's surgery.

Screening for Pad involves a 10-minute test using an "ankle brachial index". This measures the blood pressure at both arm and ankle. The rate of return of blood to the vessels is measured and this indicates whether there is adequate blood flow to the lower limbs. The procedure is non-invasive and requires only minimal removal of clothing.

The IHF is advising GPs to screen patients over 55 years, particularly where they are smokers, have high blood pressure, high cholesterol or diabetes.

"In one study 50 per cent of diabetic patients were found to have Pad. The identification and appropriate management of this often unidentified, high-risk patient group represents a significant opportunity to improve survival and reduce the risk of heart attack and stroke," Martin O'Donohoe, vascular surgeon, said.

The condition was not reversible, but it was manageable, both trough lifestyle and medication, Mr O'Donohoe said.

"By far the most impactful intervention after smoking cessation is the medical management available, such as the appropriate use of statins for cholesterol management, ACE inhibitors for blood pressure lowering and anti-platelet therapy."

Many patients with Pad fear they might face amputation. However, Mr O'Donohoe said, this was performed in a small minority of cases. "Only approximately 2 per cent of patients require amputation. Early identification and management of the risk factors reduces the risk of surgery."

Around 10 per cent of Pad sufferers will require bypass surgery, but, as the surgery is performed on the leg not the heart, it presents fewer risks and can be performed under epidural.

The mortality risks associated with Pad were greatly under appreciated, the IHF said. Without intervention, patients with Pad are more likely to die within the next five years than patients with colorectal or breast cancer.