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Piedmont Physicians Join National Effort to Screen Patients for Artery Disease

Twenty medical practices in the Piedmont have joined a national effort to screen 10,000 Americans for blood vessel disease in the legs, which can be a warning sign of future heart attacks and strokes.

The Hypertension and Vascular Disease Center at Wake Forest University Baptist Medical Center is leading the local effort to identify people with peripheral artery disease (PAD), the build-up of fatty deposits in the arteries that supply blood to the legs. It is one of 28 sites in the nation selected for the program.

The local participating practices, which are in the Winston-Salem area as well as in Elkin, High Point, Mount Airy, North Wilkesboro and Sparta, will each screen 25 of their patients for PAD. As part of the program, they received diagnostic equipment they can continue to use in their practices.

"This is an unrecognized disease," said Pavel Levy, M.D., a Medical Center specialist in vascular medicine who is leading the local screening effort. "There are undiagnosed patients who are losing their sex lives, their limbs, their jobs and even their lives from it."

PAD is more common than heart vessel disease and starts earlier, said Levy. It usually begins in the blood vessels in the abdomen, which can affect the legs as well as the colon, lower back, kidneys and sexual function.

Symptoms of PAD include cramps and other pain in the feet, legs and lower back when walking and skin ulcers on the legs that don''t heal. The pain results from an insufficient blood supply to the legs.

"Many people might ignore the pain and take an analgesic or believe their symptoms are a natural part of aging," said Levy. "But the pain could be ‘angina in the leg.''"

PAD is a major cause of disability because leg pain can limit mobility and affect quality of life. In more severe cases, amputation is a major risk. If PAD is not diagnosed and treated, it can progress and affect the heart and brain arteries, causing heart attacks and stroke. Someone with PAD is six times more likely to die from heart artery disease than someone who doesn''t have PAD.

Risk factors for PAD include smoking, diabetes, high blood pressure, high cholesterol, and a family history of vessel disease. An estimated 18 million Americans have the disease. It is most common among older adults, but can affect younger people as well.

Treatment for PAD includes controlling risk factors, such as smoking cessation and lowering cholesterol, a supervised exercise program and drugs to improve walking.

The physicians participating in the screening program have received portable ultrasound equipment to diagnose PAD in their offices. The equipment is used to compare blood pressure in the arms with pressure in the legs. Physicians who do not have the ultrasound equipment can make a preliminary diagnosis by checking the strength of pulses in the legs.

The program is sponsored by the Society for Vascular Medicine and Biology and Bristol-Myers/Sanafi.

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