Experts urge regular screening to prevent complications in people with peripheral artery disease

An international group of cardiologists, angiologists and vascular surgeons is urging regular screening to help prevent complications in people with Peripheral Arterial Disease (PAD).

PAD is a common condition where a build-up of plaque in the arteries restricts the blood supply to the leg muscles. While many people with PAD have no symptoms, some may experience a sharp pain in their legs when they walk, which usually goes away after a few minutes of rest. While PAD is caused by blocked arteries in the legs, it is often an early sign of blocked arteries in the brain and heart. Early detection and treatment of PAD greatly reduces the risk of serious conditions such as amputations, heart attacks and stroke.

The new European Society of Cardiology (ESC) guidelines, written by researchers from the University of Surrey, also highlight that personalized treatment plans, which can include a simple walking program and a healthy diet, could benefit the nearly 300 million people living with PAD globally. The guidelines also recommend a new and more reliable method for detecting PAD developed in Surrey called the estimated brachial ankle pressure index.

The guidelines further encourage the use of mobile apps to manage PAD and ensure patients adhere to their individualized treatment plans.

Professor Christian Heiss, co-author and chair-elect of the ESC Working Group on Aorta and Peripheral Vascular Disease from the University of Surrey’s School of Life Sciences, said:

“These updated guidelines are important because they provide a road map for the prevention and management of serious complications in people with peripheral artery disease. By focusing on early diagnosis, individualized treatment plans, lifestyle changes, and early revascularization if needed, we can significantly improve patient outcomes and quality of life. Combined with advances in diagnostic methods, medical applications and wearable monitoring devices, our work equips patients and their caregivers with the tools and knowledge to take control of their health and prevent future problems.”

The guidelines also emphasize the use of lipid-lowering therapies designed to reduce the amount of “bad” cholesterol (LDL) in the blood. These treatments help prevent fatty buildup in the arteries, which can block blood flow. The guidelines recommend aiming for very low LDL cholesterol levels to provide better protection for the heart and blood vessels.

If lifestyle changes such as diet and exercise, along with standard drugs such as statins, do not lower cholesterol enough, the guidelines recommend additional treatments. These include PCSK9 inhibitors, which can significantly lower LDL cholesterol for people struggling to reach their goals with statins alone, and bempedoic acid, an alternative for those who cannot tolerate statins or need extra support to lower their cholesterol levels.

In addition, the guidelines emphasize the important role of early and effective treatment of blockages, which in most cases can be achieved with catheters and therefore does not require surgery.

The guidelines have been published in the European Heart Journal.