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Peripheral artery disease (PAD) is a circulatory condition where narrowed arteries reduce blood flow to the limbs, most commonly the legs. It is caused by atherosclerosis, the buildup of fatty plaque deposits containing LDL cholesterol in the peripheral arteries. The Direct LDL test is the most important test for assessing PAD risk factors and guiding treatment strategies.
Peripheral artery disease is caused by atherosclerosis, a condition where fatty plaque deposits build up inside the arteries that carry blood to your legs and arms. These plaques contain LDL cholesterol, calcium, and other substances that narrow the arteries over time. Risk factors that accelerate this plaque buildup include smoking, diabetes, high blood pressure, high cholesterol, obesity, and lack of physical activity. As the arteries narrow, less oxygen-rich blood reaches your leg muscles, causing pain and cramping, especially when walking or exercising.
The Direct LDL test is the most important blood test for peripheral artery disease because it directly measures low-density lipoprotein cholesterol levels, which are the primary contributor to plaque formation in peripheral arteries. High LDL cholesterol drives the atherosclerosis process that narrows arteries in your legs and reduces blood flow. Regular monitoring of LDL levels helps your healthcare provider adjust medications like statins and lifestyle recommendations to slow disease progression. While PAD itself is diagnosed through physical examination and specialized tests like the ankle-brachial index (ABI), the Direct LDL test is essential for managing the underlying cause and preventing serious complications like heart attack and stroke.
You should get tested if you experience leg pain or cramping when walking that goes away with rest (claudication), numbness or weakness in your legs, coldness in your lower leg or foot, slow-healing wounds on your feet or legs, or changes in leg color. People over 65, smokers over 50, or anyone with diabetes, high blood pressure, or high cholesterol should consider testing even without symptoms. If you have a family history of heart disease or PAD, getting your Direct LDL cholesterol checked regularly helps catch problems early. Early detection and treatment can prevent disease progression and reduce your risk of limb complications.
What this means
Your LDL cholesterol is elevated above the optimal range, which means you have more bad cholesterol circulating than ideal. This increases your risk of plaque buildup in your arteries over time, which can lead to heart disease. The good news is that LDL responds well to dietary changes and increased physical activity.
Recommended actions
Reduce saturated fats by limiting red meat, butter, and full-fat dairy products
Add more fiber-rich foods like oats, beans, lentils, and vegetables to your daily meals
Incorporate 30 minutes of aerobic exercise like brisk walking or cycling at least 5 days per week
Retest in 3-6 months to track improvement from lifestyle changes
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