“Most of the time, atherosclerosis is asymptomatic,” says Dr. José Gómez Rivera

The medical literature reports that patients with peripheral arterial disease have a mortality of more than 50% in the next five years if they are not treated.

By: Luisa Ochoa


According to the National Heart, Lung, and Blood Institute (NIH), heart-related diseases atherosclerosis They are the leading cause of death in the United States. About half of citizens between the ages of 45 and 84 have atherosclerosis and they don’t know it.

This condition is usually asymptomatic and progressively progresses over years until it begins to manifest symptoms in patients, which generally occur in the legs and feet, peripheral areas of the human body.

Regarding peripheral arterial disease, Dr. José Gómez Rivera, director of Cardiology at Hospital Damas, explained that this condition most times does not present symptoms, until a strong obstruction occurs in the arteries which occurs progressively.

The presence of symptoms usually occurs in more advanced stages

“Most of the time the atherosclerosis it is asymptomatic, this is a process and we can see it as literally tubes that carry circulation to different parts of the body, they begin with a large caliber and are gradually reduced”, indicated the cardiologist.

In addition, he explained that the decrease in blood flow is what ultimately ends up generating pain symptoms in patients, this decrease is caused precisely by the obstruction of the arterial pathways.

“When it becomes obstructed, it is a process of years without any symptoms. Symptoms begin when the obstruction is significant and is reducing the amount of blood going to those tissues. The decrease in flow is what begins to produce symptoms, ”she clarified.

Patients often feel intermittent claudication

According to the information provided by the specialist and the medical literature, patients usually present with claudication, which is when they have pain when making a movement such as walking, and this may be the first sign that they have arterial disease.

“The first thing we are going to see are pain symptoms. Initially, the patient has no pain symptoms, except when he exercises. It is what we call intermittent claudication because usually the symptom appears when the patient begins to be physically active. In the foot it is the most common”, explained the doctor in an interview for the Medicine and Public Health Magazine.

Another of the manifestations that can be felt are leg cramps due to lack of circulation. For specialists in vascular surgery, the pain that patients report when they do physical activity is an indication of this condition, which not only affects the area where discomfort is felt, but the entire circulatory system.

Arterial disease is a problem of the entire circulatory system.

“That is the same thing that is happening to me throughout my body, not just where I have the symptoms. The atherosclerosis it is the deposit of cholesterol, triglycerides, etc., which is caused by many factors. The lifestyle helps a lot because the conditions that lead me to it are age, genetics, smoking, diabetes, high blood pressure and high cholesterol levels”, explained Dr. Gómez Rivera.

Factors such as age and genetics cannot be changed, but patients do have the option to choose what lifestyle they want to lead to avoid or worsen their risk of peripheral arterial disease.

“The better lifestyle you have, the better control you have of your high blood pressure condition, diabetes. These are conditions that eventually lead us to atherosclerosis and peripheral arterial disease”, pointed out the cardiologist.

Overview of peripheral arterial disease in Puerto Rico

Regarding the impact of peripheral arterial disease in Puerto Rico, the doctor expressed that the panorama is not encouraging, because they are seeing patients between 40 and 50 years old with notable changes in the arteries and these manifestations used to appear in people of more advanced ages years ago.

“Puerto Ricans are very bad. What is our problem? Mainly diabetes. The percentage of diabetics in our population is extremely high compared to society, and if we add to this undiagnosed hypertension, being overweight, all this leads to uncontrolled diabetes, cholesterol, and triglycerides, which accelerates the process of atherosclerosissometimes to a severe degree,” the expert warned.

Finally, he concluded by stating that the mortality of patients with peripheral arterial disease is very high when patients are not treated, since they can present heart attacks or cerebrovascular accidents.

“When we see a problem at the peripheral level, we know that the patient may have serious complications. The literature tells us that the patient is going to have a mortality of more than 50% in the next 5 years if he is not treated”, he stated.

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