"Hidden" Disease Causing Disability, Death

July 13, 1999

Jim Pennell first noticed the pain when he was working part-time as a golf instructor. As he walked from hole to hole, he had terrible cramps in his calves. Pennell, now 48, eventually had to give up the job.

"It hurt so bad I couldn''t walk the 18 holes."

Pennell, of State Road, consulted several doctors before getting a definite diagnosis: the arteries supplying blood to his legs were severely blocked. Pennell had hardening of the arteries (atherosclerosis), the same disease that blocks arteries to the heart and brain and causes heart attacks and strokes. Without bypass surgery, he was in danger of losing his legs.

"This is an unrecognized disease," said Pavel Levy, M.D., a specialist in vascular medicine at Wake Forest University Baptist Medical Center. "There are undiagnosed patients who are losing their sex lives, their limbs, their jobs and even their lives from it."

Atherosclerosis, the buildup of fatty deposits in the blood vessels, usually begins in the abdomen, where it can affect the legs as well as the colon, kidneys and sexual function, said Levy.

When the blood supply to the legs is affected, it is known as peripheral artery disease (PAD). Symptoms of PAD include skin ulcers on the legs that don''t heal and cramps and other pain in the feet, legs and lower back when walking.

"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.

Pennell, who was in his twenties when he first developed symptoms, said leg pain is not something to ignore. After his diagnosis, he had successful surgery to bypass the blocked arteries in his legs.

"Your legs are your lifeline. It''s something everyone should think about, regardless of your age."

Twenty medical practices in the Piedmont have joined a national effort to screen 10,000 Americans for PAD. They have received special training and equipment to screen their patients for the disease. PAD is diagnosed by using ultrasound to compare blood pressure in the arms with pressure in the legs. The Medical Center, one of 28 sites in the nation selected for the program, in leading the local effort.

Treatment for PAD includes controlling risk factors, such as smoking cessation and lowering cholesterol, a supervised exercise program and drugs to improve walking. In more severe cases, like Pennell''s, surgery to bypass the blocked arteries may be required.


Media Contacts: Karen Richardson, (336) 716-4453 or Jim Steele, (336) 716-3487.

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