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Approximately 6.5 million people 40 and older in the United States have peripheral arterial disease. Known as PAD, the disease is the narrowing or blockage of the vessels that carry blood from the heart to the legs. It is primarily caused by the buildup of fatty plaque in the arteries, which is called atherosclerosis.

PAD can happen in any blood vessel, but it is more common in the legs than the arms.

Risk factors for PAD

• Smoking
• High blood pressure
• Atherosclerosis
• Diabetes
• High cholesterol
• Age above 60 years

Both men and woman are affected by PAD; however, African Americans have an increased risk of PAD. Hispanics may have similar to slightly higher rates of PAD compared with non-Hispanic white people.

If you have PAD, you are at risk for developing coronary artery disease and cerebrovascular disease, which could lead to a heart attack or stroke.

However, other health conditions and disorders of arteries can mimic the symptoms of PAD, and not all PAD is due to atherosclerosis.

Signs and symptoms

The classic symptom of PAD is pain in the legs with physical activity, such as walking, that gets better after rest.

However, up to 4 in 10 people with PAD have no leg pain. Symptoms of pain, aches or cramps with walking (claudication) can also occur in the buttock, hip, thigh or calf.

Physical signs in the leg that may indicate PAD include muscle atrophy (weakness); hair loss; smooth, shiny skin; skin that is cool to the touch, especially if accompanied by pain while walking (that is relieved by stopping walking); decreased or absent pulses in the feet; sores or ulcers in the legs or feet that don’t heal; and cold or numb toes.

How to prevent PAD

• Get plenty of physical activity to help prevent PAD or improve symptoms.
• Do not use tobacco. Smoking increases the risk of PAD and makes symptoms worse.
• Control high blood pressure and manage high blood cholesterol and diabetes.

If you have PAD, participating in supervised exercise training programs can improve and prolong your ability to walk longer distances.

How is PAD diagnosed?

If you have symptoms of PAD, your doctor may do an ankle brachial index (ABI), which is a noninvasive test that measures the blood pressure in the ankles and compares it with the blood pressure in the arms at rest and after exercise.

Your doctor may also do imaging tests such as ultrasound, magnetic resonance angiography (MRA), and computed tomographic (CT) angiography.

How is PAD treated?

Your doctor may recommend that you take aspirin or other similar antiplatelet medicines to prevent serious complications from PAD and associated atherosclerosis.

You may need surgery to bypass blocked arteries. You may also need to take medicine to reduce your blood cholesterol.

This information is courtesy of the National Center for Chronic Disease Prevention and Health Promotion, Division for Heart Disease and Stroke Prevention.