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The Heart of the Matter

Courtesy of the American Heart Association.

Earlier this year, the American Heart Association (AHA) issued a policy statement aimed at reducing nontraumatic leg amputations by 20 percent over the next decade. Titled “Time to Get to Our Feet,” the statement urges primary care doctors to educate themselves and their patients about one of the key causes of leg amputations, peripheral artery disease (PAD).

As the AHA notes, many doctors don’t screen vigilantly for PAD (which is commonly associated with diabetes) and don’t consistently use treatments that might prevent limb loss, heart attacks, strokes, and other severe outcomes. This pattern of inattention helps explain why PAD-related amputations increased 50 percent between 2009 and 2015.

It also explains why the AHA’s strategy for decreasing limb loss is built around more routine PAD monitoring and more aggressive treatment. The AHA’s statement lists several PAD-management strategies that doctors should implement. You should know them, too, even if you’ve already lost a limb. Discuss them with your physician, and make sure these recommendations are being applied on your behalf. If they aren’t, advocate for yourself and switch doctors if you need to.

PAD-related amputations are especially high among certain demographic groups, including Black, Latinx, rural, and low-income populations. If you fall into one of those categories, it’s all the more reason to demand the best PAD treatments.

Managing Your Own PAD Case

DIAGNOSIS

If you still have one or both of your anatomical legs:

1. Insist on a comprehensive foot exam as part of your annual checkup
2. Request Ankle-Brachial Index (ABI) testing to detect impaired blood flow to lower limbs

TREATMENT

If you’re at high risk of PAD or have already been diagnosed:

1. Get PAD-specific anti-smoking counseling to help you kick the habit
2. Request new-generation drugs to control diabetes, such as liraglutide
3. Ask your doctor to prescribe statins, such as simvastatin
4. Discuss the pros and cons of lipid-lowering medications, such as rivaroxaban
5. Request a referral to a vascular specialist if you’re showing PAD symptoms

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