Peripheral arterial disease. Medical management in primary care practice.

Peripheral arterial disease (PAD) is caused by atherosclerosis, the leading cause of death and disability in patients age 50 and older. PAD progresses gradually and silently over many years, occluding the lumen of arteries that supply blood to the extremities. Symptoms of peripheral arterial insufficiency include intermittent claudication, rest pain, and impotence. Nonoperative management--including the control of risk factors such as hypertension, diabetes, hyperlipidemia, and smoking--is the most effective method to lower the risk of morbidity from PAD. Diagnostic technologies such as color duplex imaging, MRI, and MRA complement the clinical assessment of PAD and provide a stronger foundation for treatment decisions in the primary care setting.