Peripheral arterial disease: More than just leg pain

It’s 3 p.m. and you get out of your office for a quick stretching and walking.

Then, you suddenly feel pain in your thigh and numbness in the leg as you walk, but the symptoms ease when you rest. You may not worry about it, but these could be symptoms of peripheral arterial disease (PAD).

PAD, a condition that is especially prevalent among those with diabetes, refers to the partial or complete blockage of major arteries outside the heart that supply blood to other important areas of the body, such as the brain, kidneys, arms and legs.

Symptoms include pain in the calf or thigh, discomfort, fatigue, and numbness in the legs when walking then eases during rest. One of the most common symptoms of PAD is intermittent claudication (IC). Patients with IC feel numbness and fatigue in the legs and this may affect their walking distance.

In addition to diet and exercise, drugs are prescribed to relieve symptoms of PAD and prevent further complications. Cilostazol is one of the drugs recommended to treat IC as it allows patients to increase their walking distance.

In a study comparing the effects of cilostazol and placebo (sugar pill) on walking distance, the maximal walking distance of cilostazol patients improved by 44 to 50 percent compared to 21 percent achieved by patients taking placebo.

In addition, cilostazol is utilized regularly for the prevention of secondary stroke. It has been shown to significantly reduce the risk of recurrent strokes without affecting the occurrence of intracranial hemorrhage.

In the Cilostazol Stroke Prevention Study, a randomized, placebo-controlled trial involving more than 1,000 Japanese patients, cilostazol was found to reduce the risk of secondary stroke by 41.7 percent compared with placebo, a statistically significant reduction of 1.5 percent.

Therapy with cilostazol also resulted in improvements in lipid profile, with significant increases in HDL-cholesterol levels of about 10 percent, and a significant decrease in triglyceride levels of about 15 percent.

To support Filipino patients in their fight against PAD, Otsuka Pharmaceutical launched the Improve Peripheral Arterial Disease Awareness Club (i-PAD), which aims to help doctors diagnose PAD among diabetic patients. It also aims to educate people about this disease, especially those who are at risk of it.

Under i-PAD is the Bantay Paa project, which aims to determine the prevalence of PAD among diabetic patients through ankle brachial index (ABI) screening and monofilament testing.

ABI screening is a patient-friendly, inexpensive technique that compares blood pressures between the patient’s arms and ankles.

The ABI test is a useful tool, as it not only provides clinicians with a means of identifying PAD, but also with information regarding the severity of PAD that can assist in guiding a treatment approach.

For more information about PAD and the i-PAD Awareness Club, call the i-PAD Connect hotline at 811-i-PAD (811-4-723) for Metro Manila, or toll-free 1-800-1888-i-PAD (1-800-1888-4-723) for provincial areas.