Dear Dr. Roach: Some months ago, my doctor used a QuantaFlo test to measure circulation in my legs. My result was low — 0.69 versus the normal range of 0.9-1.40. I was not surprised, as poor circulation runs in the family. She recommended I wear compression socks. I am 70 and have never had symptoms, such as leg aches. What noticeable benefit would come from wearing them?
T.S.
There are two major types of circulation problems: restrictions in the blood flow going to an area (arterial), and away from it (venous). The QuantaFlo device measures arterial blood flow to the legs. Compression stockings are used to treat swelling, the major symptom of venous insufficiency. I am worried these two have been confused here.
The traditional method of determining arterial blood flow involves measuring blood pressures and the wave formed by Doppler imaging of the legs. A manufacturer study of QuantaFlo suggested it has good accuracy compared with the traditional method. Before making any decisions, consider getting a test confirming your low result, which is usually done by a vascular laboratory.
If confirmed, a level of 0.69 indicates mild to moderate obstruction in the arteries serving the area that was tested. (Normally each leg gets its own reading, so I suspect 0.69 was the worse leg.) In a person without symptoms, the most important next step is not compression socks. Rather, a blockage or series of blockages in the legs should make your doctor suspect blockages in other places, including the arteries going to your brain and to your heart. People with low blood flow to the leg are at higher risk for heart attack and stroke, and you and your doctor should be actively working to lower your risk. That means improvement in diet if at all possible, regular moderate exercise if your doctor says it is safe, and management of any medical risk factors. Smoking is probably the single most important modifiable risk factor, so if you are a smoker, quit. Today, if you can.
Most people with blockages in arteries to the legs benefit from a cholesterol-lowering drug, such as a statin and an aspirin. Many benefit from lowering their blood pressure.
People with symptoms of arterial blockages, especially pain with exercise, usually start with lifestyle and medication treatment as well, but they might benefit from consultation to consider a procedure to improve blood flow if lifestyle treatment is inadequate. Very severe blockages could require surgery.
This result is a red flag. Given your family history, I recommend you make as many healthy changes as you can.
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