Peripheral Artery Disease (PAD)
Learn about PAD, a common circulatory problem where narrowed arteries reduce blood flow to your limbs, and how it can be treated.
What is Peripheral Artery Disease?
Peripheral artery disease (PAD) is a common circulatory condition in which narrowed arteries reduce blood flow to the limbs, most commonly the legs. Like coronary artery disease, PAD is caused by atherosclerosis—the buildup of fatty plaque in the artery walls.
When you have PAD, your legs don't receive enough blood flow to keep up with demand. This typically causes leg pain when walking (claudication), which goes away with rest. In severe cases, PAD can lead to leg ulcers, infections, and even limb loss.
Important Facts about PAD
- PAD affects approximately 8-12 million Americans - People with PAD are at higher risk for heart attack and stroke - Many people with PAD don't know they have it - PAD is often underdiagnosed and undertreated - Early detection and treatment can improve quality of life and prevent complications
Signs and Symptoms
Many people with PAD have mild or no symptoms. When symptoms do occur, they often include:
Claudication (Leg Pain with Walking)
- Muscle pain or cramping in legs or hips during activity - Pain typically stops after a few minutes of rest - May occur in one or both legs - Location of pain depends on where arteries are narrowed
Other Common Symptoms
- Leg numbness or weakness - Coldness in lower leg or foot - Sores on toes, feet, or legs that don't heal - Changes in leg color (pale or bluish) - Hair loss or slower hair growth on legs - Slower toenail growth - Shiny skin on legs - Weak or absent pulse in legs or feet - Erectile dysfunction in men
Stages of PAD
1. **Mild PAD**: Minimal or no symptoms 2. **Moderate PAD**: Claudication - pain with walking 3. **Severe PAD**: Pain at rest, especially at night 4. **Critical Limb Ischemia**: Tissue loss, wounds, gangrene
When to See a Doctor
Don't dismiss leg pain as a normal sign of aging. If you experience leg pain when walking that goes away with rest, talk to your doctor about PAD screening.
Risk Factors
The risk factors for PAD are similar to those for heart disease and stroke:
Major Risk Factors
- **Smoking**: The single most important risk factor. Smokers are 4 times more likely to develop PAD. - **Diabetes**: Significantly increases PAD risk and complication rates - **High Blood Pressure**: Damages artery walls over time - **High Cholesterol**: Contributes to plaque buildup - **Age**: Risk increases after age 50
Other Risk Factors
- Personal or family history of cardiovascular disease - Obesity - Physical inactivity - Chronic kidney disease - High levels of homocysteine - African American ethnicity
The Connection to Heart Disease
PAD is a sign of widespread atherosclerosis. If you have PAD, you likely have plaque buildup in other arteries too. This means: - Higher risk of heart attack - Higher risk of stroke - Importance of comprehensive cardiovascular care
Diagnosis and Treatment
Diagnosis
PAD is often diagnosed with a simple, painless test:
- **Ultrasound**: Images blood flow in the arteries
- **Angiography**: Uses dye and X-rays to visualize blood flow
- **CT or MR Angiography**: Detailed images of arteries
Treatment Approaches
Lifestyle Changes
- Quit smoking (essential) - Regular walking program (supervised exercise therapy) - Heart-healthy diet - Weight management - Foot care to prevent injuries and infections
Medications
- Blood thinners to prevent clots - Cholesterol-lowering medications - Blood pressure medications - Diabetes management medications - Cilostazol to reduce claudication symptoms
Procedures
- **Angioplasty and Stenting**: A balloon is used to open blocked arteries, and a stent may be placed to keep them open - **Atherectomy**: Removal of plaque from the artery - **Bypass Surgery**: Creating a new pathway for blood flow around the blocked artery
Early treatment can relieve symptoms, improve quality of life, and reduce the risk of complications including amputation.
Key Takeaways
- PAD is caused by plaque buildup in leg arteries
- Leg pain when walking is the most common symptom
- PAD significantly increases heart attack and stroke risk
- Smoking is the biggest controllable risk factor
- Treatment can relieve symptoms and prevent complications
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Medical Disclaimer: This information is provided for educational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.