Peripheral artery disease
disease (PAD) is a disorder that causes abnormal narrowing of other than those that supply the heart or brain. PAD can happen in any blood , but it is more common in the legs than the arms.
Underlined words are explained — tap any of them.
Symptoms — what it feels like
- ·Leg pain when walking that resolves with rest, skin , bluish skin, cold skin, loss of hair, unusually smooth or shiny skin
Causes — why it happens
- ·,
How it's found
- ·Ankle-brachial index < 0.90, duplex ,
Treatment
- ·Stopping smoking, supervised exercise therapy,
Complications
- ·,
The sections below are general education drawn from public guidelines (NHS, Mayo, CPIC, WHO, ICMR). They are not individually reviewed by a clinician and are not medical advice — always talk to a doctor about your own health.
Genes that change how certain drugs work — and that differ in South Asians. This is education, not a dosing tool; genotype-guided prescribing is a clinician decision.
is a 'switched-off' medicine that your body has to switch on using an called . Many South Asians carry a gene version that makes a weaker enzyme, so the drug never fully turns on and does less to stop dangerous - which is why a doctor may pick a different blood thinner instead.
South Asian signal: The loss-of-function alleles CYP2C19*2 (c.681G>A, rs4244285) and *3 (c.636G>A, rs4986893) are common in South Asians. In a British-South Asian clopidogrel cohort, ~13% were poor metabolisers (two LOF alleles) and ~57% carried at least one LOF allele (intermediate or poor) - higher than European (~2.4% PM) reference (JACC Advances 2023, PMC10550831). CYP2C19*2 allele frequency in South Asians is reported around 30-34% (Ionova et al., Clin Transl Sci 2020).
Prescriber note: In a South Asian ACS/PCI patient, a poor response to clopidogrel is more likely than European data suggest; where CYP2C19 genotype or a validated point-of-care test is available, an intermediate/poor metaboliser result supports switching to prasugrel or ticagrelor rather than escalating clopidogrel. For CYP2C19 intermediate or poor metabolisers with ACS/PCI, CPIC recommends avoiding clopidogrel and using an alternative antiplatelet (e.g. prasugrel or ticagrelor) where not contraindicated, because reduced clopidogrel activation raises the risk of major adverse cardiovascular events.
Not a dosing tool. Genotype-guided prescribing is a clinician decision; genotyping access in India is limited.