Off the Charts is a series where experts answer your questions about heart and brain health. This week’s question is about peripheral artery disease, a problem that affects more than 8.5 million Americans.

Q: “I am contacting you from Scotland to ask if you have any further information in relation to cyclodextrin and how it might be used in treating PAD. My sister has peripheral arterial disease, which has rendered her disabled. I have researched as far as I can, but can find no further information. Many thanks in advance.” —Catherine Diamond

A: Peripheral artery disease, often called PAD, is a narrowing of arteries to the legs, stomach, arms and head. PAD, like coronary artery disease (CAD), is caused by atherosclerosis — which some call “hardening of the arteries.” Fatty deposits narrow and block arteries going to critical parts of the body.

Diamond’s question was prompted by an American Heart Association News story about a woman whose twin daughters take cyclodextrin to treat a rare genetic cholesterol-metabolism disorder. The story explored how the mother was prompting potential new research that could someday lead to cyclodextrin’s use in heart patients.

The quick answer, according to Mark Creager, M.D., a renowned PAD expert and the director of the Dartmouth-Hitchcock Heart and Vascular Center in Boston:

“To our knowledge there are no clinical trials looking at this particular drug for peripheral artery disease.” But Creager, a former AHA president, said there is research being done in areas with other “novel therapies.”

“We haven’t found any major game-changer yet, but people are experimenting with cell-based therapies to see if that increases blood supply,” he said. “Also, the American Heart Association will be funding a Strategically Focused Research Network (SFRN) in vascular disease that includes [PAD].”

These networks are a way to fund groups of researchers at different hospitals, labs and universities who are working to come up with innovative ideas to tackle heart and stroke conditions.

In general, PAD patients are counseled on how to avoid stroke and heart attacks, to stop the progression of the disease and to improve mobility. New guidelines on PAD released last year recommended people with PAD take statins and blood thinners.

Creager said often patients are prescribed an aspirin and antiplatelet medicine, such as clopidogrel, whose brand name is Plavix, and a statin, to reduce the risk of having a heart attack or stroke. He said there also have been promising results with a drug called vorapaxar, which, like clopidogrel, keeps blood platelets from making clots.

[Catherine’s story]

PAD affects more than 8.5 million Americans and becomes more common as we age. But diagnosis can sometimes be a challenge because many people don’t recognize the symptoms or think they are something else.

[Printable list of symptoms and risk factors]

Lifestyle changes – stopping smoking, eating healthier and an exercise program – can improve symptoms or keep them from getting worse. When those changes and medication aren’t enough, some patients need angioplasty or bypass surgery.

Angioplasty is a non-surgical procedure that widens narrowed or blocked arteries using a thin tube. In bypass surgery, a vein from another part of the body or a synthetic vessel is attached above and below the blocked area to provide a detour for the blood.

Have a question for Off the Charts? Contact For specific answers about your condition, diagnosis and treatment, always seek help from your doctor.