As the holiday season arrives, our homes are filled with joy, warmth, and delectable meals. While we savor these festive dishes, our own “life-highway” vessels quietly bear the weight of the fats and sugars we ingest. Alongside the joy of the season comes a strain on our arteries that often goes unnoticed. What concerns me even more, as a specialist in vascular health, is a recent study from the University Hospital at Downstate in Brooklyn, New York. Despite swift advancements in medical technology and vascular treatments, the amputation rate continues to climb by nearly 9 percent annually since 2010, increasingly impacting younger individuals. This group experiencing amputations is primarily due to peripheral artery disease (PAD), a condition that resembles the mechanisms responsible for coronary and cerebrovascular diseases. As the arteries in the limbs slowly narrow and become obstructed, patients suffer from claudication (pain or cramping during physical activity), non-healing ulcerative wounds, and in the most serious instances, amputation.
Several factors drive this disturbing increase, but two primary ones stand out to me. Initially, PAD is largely underdiagnosed in its earlier stages, leading to a lack of early preventive measures. Limited public recognition, nonspecific screening tests, and a tendency for both patients and primary care providers to adopt a “wait-and-see” approach all hinder timely diagnosis and prevention. By the time many patients seek help from vascular specialists, their condition is frequently well advanced, rendering intervention more complicated and less effective. Secondly, socioeconomic and demographic disparities continue to exacerbate the burden of PAD. Amputation rates are considerably elevated in lower-income ZIP codes as opposed to more affluent areas, indicating unequal access to early preventive care and primary health services. PAD also disproportionately impacts Black Americans, Hispanic/Latino communities, and Asian and Pacific Islander populations, affecting awareness, diagnosis, treatment, and the likelihood of amputation.
The unfortunate reality is that prevention should be straightforward and available at every phase, from raising patient awareness to prompt evaluation by a vascular specialist. If you smoke, have diabetes, high cholesterol, chronic kidney disease, or are a male over 50 or a female post-menopause, especially those over 65, you should discuss PAD screening with your physician. Primary care facilities, podiatrists, and wound-care clinics must stay alert for obesity, hypertension, non-healing wounds, and limb neuropathy. Early referral to a vascular specialist enables a more precise evaluation and timely intervention. A cohesive approach necessitates systematic awareness and coordinated action to prevent individuals from getting lost in a fragmented system until it is too late.
Significantly, early prevention alleviates financial strain, both for the healthcare system and individuals, which is also a critical factor in racial and regional disparities. Each year, over 100,000 Americans lose a limb due to diabetes and PAD, costing more than $11 billion annually. Established prevention programs can cut amputation rates by nearly 40 percent, saving upwards of $4 billion each year. This figure doesn’t even take into account costs related to prosthetics, rehabilitation, lost earnings, and the lifelong expenses associated with disability. For individuals, simple preventive care can slash personal medical costs by more than half.
The financial toll is substantial, but the human cost is equally significant. Early prevention is crucial for maintaining mobility, independence, and dignity. Each amputation that is prevented allows someone to retain the ability to walk, work, and live life to the fullest. Raising public awareness, conducting primary screenings, and ensuring equitable access to care can diminish the need for aggressive treatments and drastically lower long-term expenses. Focusing on communities that shoulder the greatest burden will significantly enhance overall health outcomes.
Ultimately, it is not the latest devices or sophisticated surgical practices that will dictate national limb-loss statistics. It is early prevention (timely, consistent, and fair) that will substantially decrease amputations and uphold the dignity of our citizens. And lastly, keep in mind: You are the first protector of your vessel’s health. This festive season, even a minor reduction in holiday fats and sugars, along with a bit more activity with family and friends, can be the initial step toward safeguarding the “life-highway” vessels that support you each day.
Wei Zhang is a postdoctoral researcher.