Should I be screened for PAD in the legs?
Most women who do not have symptoms of PAD do not need to be screened for PAD. Even if a test detected early PAD, treatment would be focused on getting your risk factors under control—something all women should be doing anyway. To learn how you can lower your PAD risk, see Preventing PAD: The Basics.
Some women at high risk for developing PAD may benefit from a screening test so that the disease can be identified and treated early. You may benefit from PAD screening if you are:1,2
- 70 or older
- 50 or older and have other major PAD risk factors, including:
- Aged 18 to 49 and have had diabetes for more than 10 years
- Aged 18 to 49 and have diabetes and one or more of the following risk factors:
However, there is some controversy over exactly who benefits from PAD screening, and whether the benefits outweigh the risks in certain groups.3,4 You should discuss your PAD risk with your doctor and decide together whether PAD screening is appropriate for you. See Am I at Risk for PAD?
The main test used to screen for PAD is called an Ankle-Brachial Index (ABI). The ABI is a simple, painless, reliable test that uses blood pressure cuffs to compare the blood pressure in your ankles to that in your arms. If your ABI number is low (less blood flow in your legs than in your arms), PAD may be affecting blood flow in your leg arteries. Some PAD screenings may also ask you about your medical history or have you fill out a questionnaire to assess your PAD risk.
The aorta is the largest artery in the body, which runs from the heart through the chest and abdomen. The most common problem in the aorta is called an aortic aneurysm, a bulging out of the artery wall. Without treatment, an aneurysm may eventually rupture, causing massive internal bleeding that usually results in death. See disease of the aorta for more information.
Because large abdominal aortic aneurysms (AAAs) are rare in women, the US Preventive Services Task Force does not recommend that a woman receive routine screenings for aortic aneurysms, unless she has a family history of AAA.5
Medicare covers a one-time screening for women with a family history of AAA at age 65 as part of the Welcome to Medicare exam. If you are concerned about your AAA risk (even if you do not have a family history), talk to your doctor about the risks and benefits of screening.2
The most commonly used test to screen for an aortic aneurysm is an abdominal ultrasound. This fast, simple test uses sound waves (like those used to view the fetus during pregnancy) to produce images of the aorta.
Should I be screened for carotid artery disease?
Carotid artery disease is a form of peripheral artery disease that affects blood flow through the carotid arteries, the two large vessels (one on each side of your neck) that supply blood to the brain.
Healthy women should not be screened for carotid artery disease because the risks of the test outweigh the benefits.6 For more, see Should carotid Doppler ultrasound be used for stroke risk screening in healthy people?
Women at high risk for stroke (click here to calculate your risk) may benefit from screening with a carotid Doppler ultrasound test to detect carotid artery disease before it causes a stroke. See Who might have a carotid Doppler ultrasound?
How can I find a screening site?
Many health centers conduct PAD screenings during September, which is PAD Awareness Month. HeartHealthyWomen.org partner The P.A.D. Coalition has a page with links to organizations that offer PAD screenings. PAD Coalition: Find a Screening Site. Some screenings are free, while others may charge a fee. Many types of health insurance do not cover PAD screening.
To find PAD screenings year-round, ask your personal doctor or local hospital about an evaluation for PAD. Many vascular specialists offer year-round PAD screenings by appointment.
Web sites that can help you find a screening site near you:
- Peripheral Arterial Disease in People With Diabetes. Clinical Diabetes. October 2004 2004;22(4):181-189.
- Hirsch AT, Haskal ZJ, Hertzer NR, et al. ACC/AHA 2005 Practice Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic): A Collaborative Report from the American Association for Vascular Surgery/Society for Vascular Surgery,* Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Peripheral Arterial Disease): Endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation; National Heart, Lung, and Blood Institute; Society for Vascular Nursing; TransAtlantic Inter-Society Consensus; and Vascular Disease Foundation. Circulation. March 21, 2006 2006;113(11):e463-465.
- Beckman JA, Jaff MR, Creager MA. The United States preventive services task force recommendation statement on screening for peripheral arterial disease: more harm than benefit? Circulation. Aug 22 2006;114(8):861-866.
- Screening for peripheral arterial disease: recommendation statement. Am Fam Physician. Feb 1 2006;73(3):497-500.
- U.S. Preventative Services Task Force. Screening for Abdominal Aortic Aneurysm: Recommendation Statement. Rockville, MD.: Agency for Healthcare Research and Quality; 2005. AHRQ Publication No. 05-0569-A.
- Screening for carotid artery stenosis: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. Dec 18 2007;147(12):854-859.