PAD and exercise: 8 facts you need to know

Peripheral artery disease (PAD) affects millions of Americans. PAD is a narrowing or blockage of the arteries that carry blood from your heart to your limbs. The blockages are most commonly found in your legs and are caused by the accumulation of fatty plaque.

The symptoms of PAD are:

• Pain, cramping, heaviness or aching in your legs or arms, especially when you are moving
• Fatigue
• Hair loss on your skin
• Pain while sleeping
• Sores or cuts that won’t heal
• Erectile dysfunction

You are in danger of developing PAD if you:

• Smoke
• Eat a lot of processed or fast food
• Have high blood pressure
• Have high cholesterol
• Have diabetes
• Are not physically active
• Are older than 50

PAD is treatable with medication, proper diet and regular physical activity. Anne R. Albers, MD, PhD, RVT, FACC, FASE, FAHA, FSVM, a cardiologist at OhioHealth Heart and Vascular Physicians and OhioHealth Vascular Institute, is an expert in PAD. She recently discussed how essential physical activity – also known as exercise – is for PAD patients so they can continue their activities of daily living without symptoms. Here are eight facts she wants you to know.

Fact #1: Supervised exercise is the best way to treat PAD

Research has shown that supervised exercise is similar in improving walking ability to a balloon and stent medical procedure, also called angioplasty. Notice the word “supervised.” Because PAD is painful when you move, maintaining an exercise program can be difficult. With an outpatient supervised exercise therapy (SET) plan, you are monitored by a medical professional, take breaks when needed and benefit from having a cheering section to power you through.

Fact #2: SET is a commitment

The typical SET program requires you to visit an exercise therapist three times a week for 12 weeks. You will use a treadmill, recumbent cycle or arm exerciser. Each workout is between 30 to 60 minutes. If you are progressing, more time may be added to your workout. The goal is to maximize your strength and endurance. After 12 weeks, you are discharged from the SET program with a prescription for continued physical activity to continue your workouts on your own.

Fact #3: SET does not cure PAD

PAD blockages do not go away with SET. However, as you strengthen your muscles, your body creates bypasses around the blockages that keep your blood and oxygen flowing. Dr. Albers says, “We know exercise encourages bypass formation and helps your muscles work better. However, it’s a use-it-or-lose-it situation. You must keep moving and using your muscles for the bypasses to work.”

Fact #4: SET improves your health in other ways

Dr. Albers says, “Exercise for peripheral artery disease is a great way to multitask. Not only are you treating PAD, but you are also improving your blood pressure and your cholesterol levels and keeping your heart strong.”

Fact #5: Raising your blood pressure during SET is not a bad thing

It’s OK to raise your blood pressure when you are active. That means your heart is beating, and your blood is flowing. Exercise for peripheral artery disease decreases your blood pressure over time. But it’s why SET is critical for PAD patients. You will be supervised while exercising in case your blood pressure becomes too high. 

Fact #6: SET is not easy, and it takes time to see results

PAD patients experience a lot of discomfort while moving. SET requires you to move. You will exercise to the point of pain, take a break and start again. The ultimate goal is to increase the distance and the duration you can walk without pain. Just as blockages in your arteries develop over the years, it will take time to get relief from them.

Fact #7: SET is covered by Medicare

The Centers for Medicare & Medicaid Services (CMS) covers SET, up to 36 sessions over 12 weeks, if certain criteria are met. In addition, many private insurance plans cover SET.

Fact #8: OhioHealth offers SET at multiple locations

SET is just one of the many heart and vascular therapies available as a part of OhioHealth’s Cardiac Rehabilitation Program. There are locations at the McConnell Heart Health Center, Doctor’s Hospital, Dublin Methodist and Grady Memorial. Any PAD patient can take advantage of the program with a doctor’s referral. Smoking cessation and nutrition planning programs are also available if you need them.

Exercise for peripheral artery disease is a highly effective treatment. Dr. Albers says, “SET is the most effective way for patients with PAD to improve their mobility and avoid disability. You’ll be able to do the activities of daily living without pain and live a healthier life overall.”