In the realm of public awareness, the dangers of heart disease hold rank with some of the most life-threatening illnesses, such as diabetes and cancer. We all know what a crucial muscle our heart is—and we all are aware of the dire importance of protecting it.
The problem with this awareness, however, is that it doesn’t include one very vital aspect of cardiovascular health—and that gap in knowledge could cost you not only the enjoyment of the activities you love, but also your limbs and, ultimately, your life. I’m talking about peripheral artery disease (PAD)—a lesser-known condition marked by blockages in the arteries leading to your extremities, most commonly in the feet and legs.
If you’ve ever been stopped in your tracks by leg pain during a walk, experienced excessive coldness in your legs or feet compared with the rest of your body, or had a wound in your lower extremities that seemed to take an unusually long time to heal, then the contents of this article could help to save your life—whether you even realized it was in danger.
That’s because the scenarios I just mentioned are all hallmarks of PAD, many cases of which will go undiagnosed. Most times, these signs will be dismissed as natural aches and pains related to aging. What often begins as a minor discomfort can develop into a condition leading to amputation—and sometimes even death.
The Role of Free Radicals
PAD, like coronary artery disease, is a form of atherosclerosis. And as with other types of cardiovascular disease, the damaging process begins when low-density lipoprotein cholesterol (commonly known as LDL or “bad” cholesterol) encounters free radicals on the walls of your arteries. As you may know, free radicals are behind just about every chronic inflammatory process—and the development of atherosclerosis is no exception.
Free radicals are molecules that are missing an electron; this composition leaves the molecules unstable as they roam the body in an attempt to replace that electron. Believe it or not, free radicals are actually a normal by-product of cell metabolism—in particular, reactive oxygen and nitrogen species, which play an important role in the immune system. To maintain normal levels of free radicals, the body has evolved protective mechanisms that trap the excess free radicals that cause damage to cells, while not having to compromise their necessary functions. However, when the production of free radicals exceeds the body’s ability to remove them—a condition that can result from stress, smoking, drugs, environmental toxins, and even extreme sports—it results in what we call oxidative stress.
In this state, the excess amount of roaming free radicals in the body can ravage cell structures, proteins, and DNA—ultimately leading to a whole host of diseases, including atherosclerosis.
When unstable free radicals meet with LDL cholesterol in the lining of your arteries, they cause a reaction called lipid peroxidation. Specialized white blood cells—called macrophages—are called to the scene by neighboring vascular cells that recognize this new presence of oxidized LDL as a threat. These macrophages have so-called scavenger receptors that help them seek out pathogens and gobble them up to prevent them from doing further harm to your body.
Unfortunately, this defense mechanism is no match for the large amounts of oxidized LDL present in cases of atherosclerosis—the macrophages continue to ingest, forming fat-laden “foam cells.” Eventually, they will become so full that they burst, releasing oxidized LDL back into the arterial wall and triggering the inflammatory cascade all over again.
In time, this cycle of inflammation introduces other elements of the immune system into the mix—including T-lymphocytes and platelets—all of which build up together to form arterial plaque. A fibrous cap forms over this plaque, creating a lesion called an atheroma, which in turn causes the artery to harden. Unfortunately, this stage is only the beginning—in fact, atheromata can be found in most people as early as childhood.
Fortunately, there are steps that you can take to minimize the risk and symptoms associated with PAD—as well as your risk of coronary artery disease and other cardiovascular threats.
Crucial Changes for Better Blood Flow
The risk factors of cardiovascular disease, such as smoking, alcohol consumption, a diet high in saturated fat and cholesterol, sedentary lifestyle, obesity, glucose intolerance and diabetes, and high salt intake have been extensively studied as contributors to the vascular diseases of the heart, brain, and peripheral circulation. Luckily, a number of lifestyle options may avert the condition: maintaining a healthy body weight, moderating consumption of alcohol, exercising, reducing sodium intake, reducing stress, and altering intake of calcium, magnesium, and potassium.
The first and most obvious step is to shed excess weight through exercise and by adopting a heart-healthy diet, with heavy consumption of antioxidant-rich fresh fruits and vegetables—be sure to eat organic as often as possible because pesticides will only introduce aggravating toxins into your body. Moderate intake of high-fiber whole grains that are low on the glycemic index scale is also important, along with lean protein sources, like chicken, turkey, and fish. (Note that you’ll want to beware of excess mercury content in the latter.)
Other heart-healthy snacks include seeds and nuts and even small amounts of antioxidant-rich dark chocolate. Drinking red wine (in moderation) and green tea are also excellent ways to protect your heart.
Last, although fats should be limited insofar as they contribute to obesity, it’s more important that you choose “good” fats as opposed to “bad” fats. The saturated and trans fats that you’ll find in red meat, butter, and most fast foods are more likely to clog arteries than unsaturated choices are, such as olive oil and fish oil—the latter of which can actually boost your heart health by improving your LDL/HDL ratio and soothing inflammation. And as I mentioned before, reducing inflammation is vital.
There’s no question that stress reduction is essential to that goal—and the best way to achieve this is always a matter of personal taste. Choose any activity that appeals to you most, whether it’s music, art, or a calming activity like meditation, yoga, or t’ai chi. Exercise is also a fantastic stress reliever, and simply walking regularly can help you to stay fit while relaxing your mind.
Unfortunately, the symptoms of PAD pose a particular problem in this regard. And, as you may already know, peripheral atherosclerosis can make any type of exercise—even leisurely walking—into a painful and unpleasant experience. The technical term for this type of cramping is called “intermittent claudication”—and you may find that you can only make it one or two blocks before you’re unable to continue walking.
There’s no doubt about the impact that this type of condition can have on both your health and your quality of life, and restoring your mobility often requires more than simply altering your dietary habits. But mainstream treatments that address the specific symptoms of PAD are rare—only one drug, Cilostazol, is available for cases of intermittent claudication, and its side effects include headache, diarrhea, and heart palpitations.
To me, this does not make for a solution—at least, not a very good one.
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