What is Peripheral Artery Disease?
Peripheral Artery Disease (PAD) is a common circulatory condition where narrowed arteries reduce blood flow to your limbs, particularly your legs. When arteries become narrowed or blocked by fatty deposits (plaque), your legs don't receive enough blood flow to keep up with demand.
PAD affects more than 200 million people worldwide and is a serious warning sign that fat deposits are building up in your arteries. This same process can affect arteries throughout your body, including those that supply blood to your heart and brain.
Common Symptoms and Warning Signs
Many people with PAD have mild symptoms or no symptoms at all. However, some people experience leg pain when walking, which is called claudication. Other signs and symptoms include:
- Painful cramping in your hip, thigh, or calf muscles after certain activities like walking or climbing stairs
- Leg numbness or weakness that persists
- Coldness in your lower leg or foot, especially when compared to the other side
- Sores on your toes, feet, or legs that won't heal
- Color changes in the skin of your legs or feet
- Hair loss or slower hair growth on your legs
- Slower nail growth on your toenails
- Shiny skin on your legs
- No pulse or weak pulse in your legs or feet
- Erectile dysfunction in men
Causes and Risk Factors
PAD is most commonly caused by atherosclerosis—the buildup of fatty plaque in your arteries. While atherosclerosis is a disease of blood vessels throughout the body, it can particularly affect the legs.
Several factors increase your risk of developing PAD:
- Smoking: The single most important risk factor—smokers have up to four times the risk
- Diabetes: High blood sugar damages blood vessels and increases plaque buildup
- Age: Risk increases after age 50 (or 40 if you have diabetes or smoke)
- High blood pressure: Can damage artery walls over time
- High cholesterol: Contributes to plaque buildup in arteries
- Family history: PAD can run in families
- Obesity: Excess weight increases strain on your cardiovascular system
- Sedentary lifestyle: Lack of physical activity increases risk
Diagnosis and Testing
If your doctor suspects PAD, several tests can help confirm the diagnosis and determine its severity:
Common Diagnostic Tests
- Ankle-Brachial Index (ABI): Compares blood pressure in your ankle with blood pressure in your arm
- Doppler ultrasound: Uses sound waves to view blood flow through arteries
- Angiography: Uses contrast dye and X-rays to see inside your arteries
- Blood tests: Check cholesterol levels, blood sugar, and other risk factors
- CT or MR angiography: Provides detailed images of blood vessels
Treatment Options
Treatment for PAD has two primary goals: managing symptoms and stopping the progression of atherosclerosis throughout your body to reduce risk of heart attack and stroke.
Lifestyle Changes
- Quit smoking: The most important step you can take
- Exercise regularly: Walking programs can significantly reduce symptoms
- Eat a healthy diet: Focus on fruits, vegetables, whole grains, and lean proteins
- Manage diabetes: Keep blood sugar levels under control
- Maintain healthy weight: Even modest weight loss can help
Medications
- Cholesterol-lowering medications: Statins to reduce plaque buildup
- Blood pressure medications: To manage hypertension
- Blood thinners: To prevent blood clots
- Symptom relief medications: To improve walking distance and reduce leg pain
Surgical Procedures
- Angioplasty: Opening narrowed arteries with a balloon catheter
- Stent placement: Supporting artery walls with a small mesh tube
- Bypass surgery: Creating a detour around blocked arteries
- Thrombolytic therapy: Dissolving blood clots in arteries
Living with PAD
Managing PAD requires ongoing commitment to treatment and lifestyle changes. With proper care, many people with PAD can maintain an active lifestyle and prevent the condition from worsening.
Regular follow-up appointments with your healthcare provider are essential to monitor your condition and adjust treatment as needed. Taking care of your feet is also crucial—inspect them daily for sores or injuries, wear comfortable shoes, and see a podiatrist regularly.
When to Seek Immediate Help
Seek emergency medical care if you experience sudden, severe leg pain, coldness, or numbness that doesn't improve. These could be signs of acute limb ischemia, a serious complication requiring immediate treatment.
Also contact your doctor promptly if you develop sores or wounds on your legs or feet that won't heal, as these can lead to serious infections.