Peripheral Arterial Disease (PAD)
What is Peripheral Arterial Disease (PAD)?
Peripheral arterial disease is a circulation problem where narrowed arteries reduce blood flow to your limbs. It most often affects the legs and feet. The condition happens when fatty deposits build up in artery walls, a process called atherosclerosis. These deposits make arteries stiff and narrow, limiting oxygen-rich blood from reaching your muscles and tissues.
PAD affects over 8 million Americans, but many people do not know they have it. The reduced blood flow can cause pain when walking and increases your risk of heart attack and stroke. Early detection through blood testing helps identify risk factors before symptoms appear. This gives you time to make changes that slow or stop disease progression.
Your arteries are like highways carrying blood throughout your body. When these highways get clogged with fatty buildup, tissues downstream do not get enough oxygen. This is especially noticeable in your legs during physical activity. With proper testing and lifestyle changes, many people manage PAD successfully and maintain active lives.
Symptoms
- Leg pain or cramping during walking that stops with rest, called claudication
- Numbness or weakness in your legs or feet
- Coldness in one lower leg or foot compared to the other side
- Sores or wounds on toes, feet, or legs that heal slowly or not at all
- Color changes in your legs or feet, appearing pale or bluish
- Shiny skin on your legs with hair loss on feet and legs
- Weak or absent pulse in legs or feet
- Erectile dysfunction in men
- Pain in legs or feet that wakes you at night
Many people with early PAD have no symptoms at all. The disease can progress silently for years before causing noticeable problems. This makes regular blood testing important for detecting risk factors early, especially if you smoke, have diabetes, or are over age 65.
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Causes and risk factors
PAD develops when fatty deposits containing cholesterol accumulate inside artery walls. These deposits form plaques that narrow arteries and restrict blood flow. The main cause is atherosclerosis, the same process that leads to heart disease and stroke. Smoking is the single biggest risk factor, damaging artery walls and accelerating plaque buildup. Diabetes also dramatically increases risk by damaging blood vessels and promoting inflammation. High cholesterol levels provide raw material for plaque formation, especially elevated LDL cholesterol and apolipoprotein B particles.
Other risk factors include high blood pressure, being over age 50, family history of PAD or heart disease, and chronic kidney disease. Obesity and physical inactivity contribute by promoting metabolic problems that damage arteries. Elevated lipoprotein(a) is an inherited cholesterol particle that strongly increases PAD risk. Black Americans face twice the risk compared to white Americans. The good news is that many of these risk factors can be identified through blood testing and addressed through lifestyle changes before PAD develops.
How it's diagnosed
Doctors diagnose PAD using a combination of physical examination and specialized tests. During an exam, your doctor checks pulses in your legs and feet, listens to arteries with a stethoscope, and looks for signs of poor circulation. The ankle-brachial index test compares blood pressure in your ankle to blood pressure in your arm. A lower pressure in your ankle suggests blocked arteries. Ultrasound imaging can show blood flow patterns and identify narrowed areas in arteries.
Blood testing plays a critical role in identifying PAD risk factors and guiding treatment. Rite Aid tests measure LDL cholesterol, LDL particle number, small dense LDL, apolipoprotein B, apolipoprotein A1, and lipoprotein(a). These markers reveal your atherosclerosis risk and help your doctor create a targeted treatment plan. Testing twice yearly lets you track whether lifestyle changes and medications are working. Getting tested at over 2,000 Quest Diagnostics locations makes regular monitoring convenient and affordable.
Treatment options
- Quit smoking immediately, the single most important step you can take
- Start a supervised walking program to improve circulation and reduce symptoms
- Adopt a Mediterranean-style diet rich in vegetables, fruits, fish, and healthy fats
- Lose weight if overweight to reduce stress on your cardiovascular system
- Control blood sugar levels if you have diabetes through diet and medication
- Take statins or other cholesterol-lowering medications as prescribed
- Use antiplatelet medications like aspirin or clopidogrel to prevent blood clots
- Manage blood pressure with medication and lifestyle changes
- Practice good foot care, inspecting daily for wounds or changes
- Consider angioplasty or bypass surgery for severe blockages causing significant symptoms
Concerned about Peripheral Arterial Disease (PAD)? Get tested at Rite Aid.
- Simple blood draw at your nearest lab
- Results in days, not weeks
- Share results with your doctor
Frequently asked questions
PAD affects arteries that carry oxygen-rich blood to your limbs, while varicose veins involve veins that return blood to your heart. PAD is caused by blocked arteries and can lead to serious complications like heart attack and stroke. Varicose veins are primarily a cosmetic concern, though they can cause discomfort. PAD requires immediate medical attention and lifestyle changes to prevent progression.
While you cannot completely reverse artery damage, you can slow or stop PAD progression with lifestyle changes. A healthy diet and regular walking program improve circulation and reduce symptoms in many people. Some research shows that intensive lifestyle changes may reduce plaque buildup over time. The key is catching PAD early through blood testing and starting treatment before severe artery damage occurs.
Most doctors recommend blood testing every 3 to 6 months when managing PAD. Rite Aid offers 2 tests per year, which aligns well with monitoring your cholesterol and lipid markers. More frequent testing helps you see whether medications and lifestyle changes are working. Your doctor may adjust your treatment based on these results to better control your risk factors.
LDL particle number counts the actual number of cholesterol-carrying particles in your blood. You can have normal LDL cholesterol but still have too many particles, each one capable of entering artery walls and forming plaque. Small dense LDL particles are especially dangerous because they penetrate artery walls more easily. Testing particle number gives a more accurate picture of your atherosclerosis risk than cholesterol levels alone.
Lipoprotein(a) is an inherited cholesterol particle that strongly increases PAD risk. Unlike other cholesterol markers, lifestyle changes do not lower lipoprotein(a) much. High levels mean you need more aggressive treatment of other risk factors like LDL cholesterol and blood pressure. Knowing your lipoprotein(a) level helps your doctor understand why you developed PAD and create a more targeted treatment plan.
Yes, supervised walking programs are actually a primary treatment for PAD. Walking until you feel pain, resting, then walking again helps your body grow new small blood vessels. This process improves circulation over time and reduces symptoms. Start slowly and gradually increase distance. Talk to your doctor before starting any exercise program to ensure it is safe for your specific situation.
Severe untreated PAD can lead to critical limb ischemia, where tissues do not get enough oxygen to survive. This can result in tissue death and amputation. However, this outcome is preventable with early detection and proper treatment. Regular blood testing, lifestyle changes, medications, and sometimes procedures to restore blood flow can prevent PAD from reaching this advanced stage.
Diabetes damages blood vessels through multiple mechanisms, making PAD develop faster and more severely. High blood sugar injures artery linings, promotes inflammation, and accelerates plaque buildup. Diabetes also damages nerves, so you may not feel pain from reduced blood flow until damage is severe. People with diabetes need especially careful blood sugar control and regular blood testing to monitor cholesterol and other PAD risk factors.
Apolipoprotein B is a protein found on the surface of cholesterol particles that cause atherosclerosis. Each harmful particle contains exactly one apolipoprotein B molecule, making it an accurate count of artery-clogging particles. High apolipoprotein B levels indicate increased risk of PAD progression even when standard cholesterol tests look normal. This marker helps identify people who need more intensive treatment.
Quitting smoking will not make existing artery damage disappear, but it stops further damage immediately. Most people notice symptom improvement within weeks to months as circulation gradually improves. Smoking cessation is the single most effective thing you can do to slow PAD progression. Combined with walking exercise and medications, many former smokers experience significant symptom reduction and avoid serious complications.