If you’re dealing with peripheral arterial disease (PAD), you might be wondering if smoking is a major risk factor for your condition, given its link to numerous health issues. If you smoke, it’s crucial to understand how smoking affects those with PAD and how to seek help.
Determining if smoking causes PAD is complex, but research indicates it can contribute. PAD affects 3 to 10 percent of the population, but this rises to 15 to 20 percent among smokers, diabetics, and older individuals. Even secondhand smoke can harm your cardiovascular health if you’re exposed long enough.
PAD occurs when arteries narrow or become blocked due to plaque buildup, restricting blood, oxygen, and nutrients from reaching your legs. This can lead to atherosclerosis, which is more common in smokers. Since this condition hinders blood flow, it can cause PAD.
Smoking increases the risk of plaque buildup in those with PAD. Nicotine constricts arteries, reducing blood flow further. Continuing to smoke after developing PAD can worsen the disease, limiting mobility and causing pain even at rest.
Smoking is a significant risk factor for PAD. Besides constricting blood vessels, the chemicals in cigarettes can negatively impact the body, affecting blood flow and potentially causing or worsening PAD.
If you have or suspect PAD, quitting smoking is highly recommended. Although challenging, quitting can slow symptom progression. A study by the US National Library of Medicine found that smokers who quit didn’t develop claudication symptoms for seven years, while those who continued smoking saw an increase in PAD. Claudication, a sign of PAD, involves leg pain or weakness after exercise that stops with rest.
While quitting smoking may reduce symptoms, it won’t prevent PAD, so seeking treatment is essential. Smoking can accelerate PAD, leading to severe health issues. Nicotine tightens blood vessels and alters cholesterol levels, increasing plaque buildup risk.
According to the American Heart Association, PAD affects about 8.3 million Americans, with 12 to 20 percent prevalence in those over 65. Only a quarter of affected individuals are diagnosed and treated, with higher rates in African Americans.
The exact reason smoking affects leg arteries is unclear, but it mirrors the process in neck and heart vessels. Smoking constricts blood vessels, promoting plaque buildup. Blockages in heart vessels can cause heart attacks, while in the legs, they start with discomfort and can lead to tissue damage and amputation.
Initially, resting relieves discomfort, but as PAD progresses, pain occurs even at night. Some with vascular disease may not feel pain, but it can be diagnosed by comparing blood pressure in the arms and legs. Higher leg pressure indicates the disease.
Amputation risk is higher in those with diabetes, which affects nerves and small blood vessels. Diabetics often have unhealed foot wounds, and combining diabetes with vascular disease complications is dangerous.
Preventing PAD is similar to preventing heart disease. Those with one condition often have the other. Weight loss, exercise, and medications to lower cholesterol and blood pressure help. Statins and anticoagulants may be recommended. If you smoke, it’s crucial to quit.
PAD treatment mirrors heart disease procedures, starting with less invasive methods like balloon angioplasty or stents. Bypass surgery is another option. Recently, I treated a 57-year-old man with an aorta blockage near the arteries supplying his legs. After clearing the blockage, he resumed walking and quit smoking, realizing the risk of losing a limb.
As a public health student before surgical training, I’ve considered the work needed beyond the operating room. Advocacy groups have raised awareness about smoking, heart disease, and lung cancer, but not PAD. I’m glad this is changing, but there’s more to do.
While I enjoy saving limbs in the operating room, I know the high smoking rates mean some patients will lose mobility.
