DEAR DR. DONOHUE: Please explain peripheral vascular disease. I have never heard of it, and neither have people I have asked. — C.D.

ANSWER: Peripheral vascular disease also goes by the name peripheral artery disease. Have you seen the TV ad where the young boy and his grandmother are walking through a store where there’s a display on peripheral artery disease? The boy asks his grandmother if she has it. It’s extremely common. It’s the leg’s equivalent of heart artery disease. Both have to do with arteries clogged with plaque — a buildup of cholesterol, fat and other materials.

Pain on walking is the prominent symptom of this illness. The pain occurs because the working leg muscles aren’t getting enough blood. They complain by sending pain signals. Calf pain is common when the obstruction to blood flow is in a thigh artery. Stopping and resting relieves the pain.

High blood pressure, a family history of this condition, a family history of heart disease, smoking, diabetes and increased cholesterol all contribute to it. The most important contributor is aging.

The family doctor can detect peripheral artery disease by noting a decreased pulse at the ankle. Greater evidence is obtained by comparing ankle blood pressure to arm blood pressure. The two should be equal. If ankle pressure is lower than arm pressure, the reason is a blockage in leg artery blood flow.

Treatment is similar to treatment for obstructed heart arteries. Affected people have to lower their cholesterol, lower their body weight, lower their blood pressure, stop smoking, control blood sugar and stay active by walking to the point of pain, resting and then continuing to walk. Doctors usually also must prescribe medicines to lower cholesterol and to facilitate the passage of blood through narrowed arteries.

Sometimes an operation on the clogged artery is necessary. Often this can be done with a catheter that has a balloon tip. The catheter is threaded to the point of obstruction and inflated to open up the artery. Then a stent — a metal device — is placed to keep the artery dilated.

The booklet on peripheral vascular disease gives the details of the illness and its 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 $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I am on two blood pressure medicines, monitored by my kidney doctor because at one time I had only 40 percent kidney function. Now it is normal for my age. I check my own blood pressure. During the past couple of months I had readings of 124/59, 107/54, 121/51 and other slightly higher ones. I have had ultrasounds of my legs and am told I have poor circulation. Could the low blood pressure cause the poor circulation? I also have an aortic aneurysm. When I take my pressure, the instrument initially goes to 185 mm. Does taking blood pressure cause aneurysms? — B.W.

ANSWER: Your blood pressure readings are fine. There’s more than enough pressure to push blood through your arteries. A more likely explanation of poor circulation is buildup of cholesterol in the arteries.

The momentary high pressure on your arm from the blood pressure cuff did not lead to the formation of an aneurysm.

DEAR DR. DONOHUE: A number of us paramedics are anxiously awaiting your thoughts on the attached letter that was sent some time ago. Can one safely venture outdoors in chilly or cold weather after showering, or does one need to wait for a period of time. In the old days, our mothers told us that our pores need to close up before going out. — R.G.

ANSWER: Honestly, I thought I had answered your question. I’ll do so again. I don’t want paramedics mad at me. I might need them soon. You can go outside after a shower when you have dried yourself and put on clothes. You can do this even in midwinter, when the temperature is below freezing.

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. Readers may also order health newsletters from www.rbmamall.com.

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