DEAR DR. DONOHUE: When I walk – and I try to walk every day – I get terrific pain in my calves, the right more than the left. It goes away if I stop and rest, but it comes back again once I start walking. Could this be a circulation problem? – K.P.

ANSWER: It could be and probably is. It has all the markings of intermittent claudication – leg pain that comes on when walking and goes away when a person stops to rest. It’s a sign of atherosclerosis – artery hardening, meaning that the leg arteries have become filled with a buildup that obstructs blood flow to muscles. The name of this condition is peripheral (the legs being the body’s periphery – outer boundary) vascular disease.

The causes are the same causes that lead to heart artery clogging – high blood cholesterol, high blood pressure, diabetes, inactivity and obesity.

Pain occurs downstream of the blockage. Calf pain indicates that the obstruction is in thigh arteries, and the obstruction rarely is the same on both sides. That’s why your right calf hurts more than your left.

Doctors establish the diagnosis of peripheral vascular disease by assessing the strength of the pulses at the ankles and the feet. One excellent test to confirm the diagnosis is comparing the blood pressure at the ankle with the blood pressure in the arm. The two should be equal. A lower ankle blood pressure indicates artery obstruction.

Treatment is similar to treatment for heart artery blockage. Strict control of blood pressure is an absolute necessity. Weight loss, if needed, is another essential. Lowering blood cholesterol is usually necessary. Exercise is most important. Do just as you are. Walk to the point of pain, rest until it goes away and then resume walking. The eventual goal is 30 to 45 minutes of daily walking.

Medicines such as Pletal and Plavix can help. Flattening the obstruction with a balloon-tipped catheter and bypassing the obstruction with an artery graft are two other procedures used to rid a person of peripheral vascular disease.

The booklet on peripheral vascular disease goes into its causes and treatments. Readers can obtain a copy by writing: Dr. Donohue – No. 109, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.50 U.S./$6.50 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: Sixteen years ago my mother passed away from heart angina. She was only 54. The doctor told us that the angina caused her heart muscle to deteriorate. Recently I saw an article that said angina is caused by lack of blood flow through heart arteries. Would you clarify this disease for me? Is it hereditary? – M.E.

ANSWER: The profusion of names for heart disease causes understandable confusion. Coronary (heart) artery disease, CAD, is the No. 1 heart condition. It also goes by the names of arteriosclerotic (hardened artery) heart disease – ASHD – and ischemic (deficient blood flow) heart disease, IHD. The underlying process is a buildup of plaque (a mound of cholesterol, triglycerides, protein and platelets) clinging to the wall of an artery and obstructing blood flow through it to heart muscle.

A complete obstruction causes a heart attack.

A partial obstruction causes angina – chest pain that comes on when a person is active – because activity demands a greater flow of blood to heart muscle, and a blocked artery will not permit that.

Heredity does have a major influence on blocked heart arteries, especially prematurely blocked arteries.

DEAR DR. DONOHUE: My granddaughter gained 20 pounds this past summer. Then I saw an article about a moon face. She has one. What is the significance? – L.J.

ANSWER: A face that is as round as a full moon and that has become so somewhat rapidly can be a sign of too much cortisone produced by the adrenal glands. Cushing’s disease is the name of the illness. It is a rare illness. Weight gain is a more common cause of a moon face.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.