Peripheral Artery Disease (PAD)
What is Peripheral Artery Disease (PAD)?
Peripheral artery disease is a circulation problem where narrowed arteries reduce blood flow to your limbs. It happens when fatty deposits, called plaque, build up inside the arteries that carry blood to your legs and arms. This buildup is called atherosclerosis.
PAD most often affects the legs. When your leg muscles don't get enough blood during activity, you may feel pain or cramping. The condition affects about 8 to 12 million Americans. It is most common in people over 65.
PAD is not just a leg problem. It signals that you may have similar blockages in arteries throughout your body. This increases your risk of heart attack and stroke. Catching PAD early gives you the chance to prevent serious complications.
Symptoms
Common symptoms of peripheral artery disease include:
- Painful cramping in your hips, thighs, or calves during walking or climbing stairs
- Leg pain that goes away with rest
- Leg numbness or weakness
- Coldness in your lower leg or foot, especially compared to the other side
- Sores or wounds on your toes, feet, or legs that won't heal
- Color changes in your legs or shiny skin on your legs
- Slower hair growth or hair loss on your legs and feet
- Slower toenail growth
- Weak or absent pulse in your legs or feet
- Erectile dysfunction in men
Many people with early PAD have no symptoms at all. Some people mistake leg pain for normal aging or arthritis. As the disease gets worse, you may feel pain even when resting. Severe PAD can lead to tissue death in the affected limb.
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Causes and risk factors
PAD develops when plaque builds up in your peripheral arteries. The plaque is made of cholesterol, fat, calcium, and other substances in your blood. Over time, this narrows the arteries and reduces blood flow. Smoking is the single biggest risk factor for PAD. It damages artery walls and makes plaque buildup worse.
Other major risk factors include diabetes, high blood pressure, high cholesterol, being over 65, family history of PAD or heart disease, obesity, and physical inactivity. People with diabetes are especially at risk because high blood sugar damages blood vessels. Having more than one risk factor greatly increases your chances of developing PAD. Certain types of cholesterol particles, particularly small dense LDL, increase the risk of plaque formation in peripheral arteries.
How it's diagnosed
Doctors diagnose PAD through physical exams and several tests. Your doctor will check the pulses in your legs and feet and look for signs of poor circulation. The ankle-brachial index, or ABI, compares blood pressure in your ankle to blood pressure in your arm. An ABI result below 0.90 suggests PAD. Your doctor may also use ultrasound to see blood flow in your arteries or other imaging tests.
Blood tests help identify risk factors and underlying causes of PAD. Rite Aid offers advanced cholesterol testing that measures LDL Pattern, which shows whether you have small dense LDL particles. These particles are more likely to cause plaque buildup in your peripheral arteries. Testing your cholesterol pattern helps you understand your risk and take steps to prevent PAD from getting worse. You can get this testing at Quest Diagnostics locations nationwide.
Treatment options
Treatment for PAD focuses on reducing symptoms and stopping atherosclerosis from progressing. Common approaches include:
- Quit smoking immediately, as this is the most important step you can take
- Exercise regularly, especially supervised walking programs that build circulation over time
- Eat a diet low in saturated fat and rich in vegetables, fruits, and whole grains
- Manage diabetes carefully to keep blood sugar in a healthy range
- Take medications to lower cholesterol, such as statins
- Take medications to lower blood pressure if needed
- Take medications to prevent blood clots, such as aspirin or clopidogrel
- Take medications to improve blood flow and reduce leg pain during walking
- Consider angioplasty or bypass surgery for severe blockages that limit daily activities
Work closely with your doctor to create a treatment plan. Lifestyle changes often make the biggest difference in how PAD progresses.
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Frequently asked questions
PAD is a specific medical condition where plaque narrows your arteries and blocks blood flow. Poor circulation is a general term that can describe many conditions. PAD is one of the most serious causes of poor circulation. It requires medical treatment to prevent complications like heart attack and stroke.
No, PAD does not go away without treatment. The plaque buildup in your arteries will continue to get worse over time. However, you can slow or stop PAD from progressing with lifestyle changes and medication. Early treatment prevents serious complications and improves your quality of life.
PAD typically causes cramping or fatigue in your leg muscles during activity. The pain goes away within 10 minutes of rest. Arthritis pain usually affects your joints and may feel worse when you start moving. Nerve pain from your back often includes tingling or shooting sensations. See your doctor for proper diagnosis if you have leg pain.
Family history increases your risk of PAD, but the condition itself is not directly inherited. If your parents or siblings have PAD, heart disease, or stroke, you have a higher chance of developing it. This is partly due to inherited risk factors like cholesterol levels and blood pressure. Lifestyle choices also play a major role.
Advanced cholesterol tests that measure LDL Pattern show whether you have small dense LDL particles. These particles are more likely to cause plaque in your peripheral arteries. Standard cholesterol tests may miss this important risk factor. Blood sugar tests also help because diabetes greatly increases PAD risk.
Yes, exercise is one of the best treatments for PAD. Walking programs help your body build new small blood vessels around blockages. Start slowly and stop when you feel pain. Rest until the pain goes away, then start again. Over time, you will be able to walk farther without pain.
Untreated PAD can lead to serious complications. You may develop painful sores or wounds that won't heal. Severe cases can cause tissue death that requires amputation. PAD also means you likely have blockages in other arteries, increasing your risk of heart attack and stroke significantly.
If you have risk factors like smoking, diabetes, or high cholesterol, get tested annually. People over 65 should discuss PAD screening with their doctor even without symptoms. If you already have PAD, your doctor will recommend more frequent testing to monitor your condition and treatment response.
Yes, diet plays a major role in managing PAD. Eating less saturated fat reduces new plaque formation in your arteries. A diet rich in vegetables, fruits, and whole grains helps lower cholesterol and blood pressure. Omega-3 fatty acids from fish may also improve circulation. Combine diet changes with other treatments for best results.
See your doctor right away if you have leg pain when walking that goes away with rest. Also seek care if you notice sores on your feet or legs that won't heal. Get emergency care if you have sudden severe leg pain, coldness, or color changes. These may signal a complete blockage requiring immediate treatment.