I wrote a piece on peripheral arterial disease (PAD) last year, drawing attention to "the most dangerous disease you've never heard of". A new article in the Archives of Internal Medicine brings the risk into closer focus. The simple diagnostic measure is to determine the difference in blood pressure between that at the usual position (the brachial artery in the arm) and that in the ankle (the posterior tibial artery).

Over 2,600 patients with the ankle-brachial index (or ratio) 0.9 or lower were used to create a predictor of mortality, based on the severity of their PAD. Points were allocated for the following risks: impaired kidney function, heart failure, ECG changes, age over 65, high cholesterol, ankle brachial index below 0.6, diabetes, stroke or lung disease, statin, aspirin, or beta-blocker use. Depending on their points total, it was possible to accurately predict the likelihood of death, which ranged from 22% to 70% over the next 10 years.

The underlying pathology of Pad is atherosclerosis, and it's possible to arrest, or, in some cases, reverse this condition, using statins, physical activity, weight control, and good nutrition. Now you know . . .