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Peripheral Arterial Disease (PAD)


Peripheral arterial disease (PAD) happens when buildup on the walls of blood vessels causes them to narrow. It commonly affects people with type 2 diabetes, who are also prone to high cholesterol and heart disease. According to the American Diabetes Association, about 1 in 3 people with diabetes over the age of 50 have PAD. Doctors most often diagnose PAD when it’s causing leg or foot problems.

Since buildup and narrowing of the arteries occur in all arteries in the body, people with PAD are at high risk of heart attack and stroke. If you suspect you have PAD, it’s important to talk to your doctor. They can help you take steps to treat your symptoms and protect your heart and blood vessels.

Symptoms of PAD

PAD affects millions of Americans, reports the National Heart, Lung, and Blood Institute. However, people often don’t notice it. Many doctors and patients overlook subtle signs of the condition.

Possible signs of PAD include:

  • a pain in your calves when you’re walking or exercising that goes away with rest, which is called "claudication"
  • numbness, tingling, or a feeling of pins and needles in your lower legs or feet
  • cuts or sores on your legs or feet that don’t heal or heal slowly

Sometimes, the symptoms of PAD are so subtle that you may not suspect you have a problem. In some cases, you may dismiss mild leg pain from PAD as a sign of aging and nothing more. That’s why it’s so important to pay attention to your body and take potential symptoms of PAD seriously. Early treatment is essential to protecting your vascular system.

Causes of PAD

If you have PAD, plaque builds up on your blood vessel walls and restricts the flow of blood and oxygen to your legs and feet. Depending on its severity, this can cause pain in your lower legs when you’re walking. It can also cause numbness, tingling, and coldness while you’re at rest.

Risk factors for PAD

Diabetes greatly increases your risk of PAD. You may also be at higher risk of PAD if you:

  • have a family history of heart disease
  • have high blood pressure
  • have high cholesterol
  • have had a previous heart attack or stroke
  • are overweight or obese
  • are physically inactive
  • are a smoker
  • are over the age of 50

Talk to your doctor about your risk factors. If you’re at high risk of developing PAD, they may check you for signs of PAD. They may also recommend lifestyle changes or other measures to lower your risk of PAD.

Diagnosing PAD

Your doctor can use the ankle-brachial index to diagnose PAD, which compares the blood pressure in your arm to the blood pressure in your ankle. If the blood pressure in your ankle is lower than the pressure in your arm, you may have PAD. If your doctor can’t make a clear diagnosis of PAD by taking your blood pressure alone, they may recommend other diagnostic measures. For example, they may order magnetic resonance angiography or a Doppler ultrasound.

Treating PAD

In most cases, you can manage PAD through a combination of medication and lifestyle changes. This can reduce your symptoms and lower your chances of having a heart attack or stroke.

For example, your doctor may advise you to do the following.

  • Quit smoking if you smoke.
  • Eat a well-balanced diet to help manage your blood glucose levels and weight.
  • Lower the cholesterol, saturated fat, and sodium in your diet to lower your blood pressure and cholesterol levels.
  • Follow a moderate and supervised exercise program, in which you rest when you feel pain in your legs. Most doctors recommend walking three times per week for roughly 30 minutes per day.
  • Monitor your blood pressure and take medication for it as prescribed.
  • Take any other medications, such as those for diabetes or cholesterol, as prescribed.
  • Take antiplatelet drugs or aspirin to thin your blood. This can help your blood flow through narrow or restricted arteries.

In serious cases of PAD, your doctor may recommend surgery. Your surgeon can use balloon angioplasty or arterial bypass to help open or reroute restricted blood vessels.

Outlook for people with PAD

If you have PAD, your chances of having a heart attack or stroke are increased. According to research reported in the Journal of the American Medical Association, PAD is "a powerful predictor of [heart attack], stroke, and death due to vascular causes." That’s why it’s so important to diagnose and treat PAD early. Following your doctor’s prescribed treatment plan can help you lower your risk of heart attack and stroke.

Preventing PAD

If you’re at risk of PAD and you smoke, you should stop smoking immediately. Smoking narrows the blood vessels in your heart over time. This can make it more difficult for your heart to pump blood throughout your body, especially to your lower limbs.

It’s also important to:

  • eat a well-balanced diet
  • get regular exercise
  • maintain a healthy weight
  • take steps to monitor and manage your blood glucose levels, blood cholesterol levels, and blood pressure
  • follow your doctor’s prescribed treatment plan for diabetes or other diagnosed health conditions

Content licensed from:

Written by: Joann Jovinelly
Medically reviewed on: May 31, 2016: Peggy Pletcher, MS, RD, LD, CDE

This feature is for informational purposes only and should not be used to replace the care and information received from your health care provider. Please consult a health care professional with any health concerns you may have.
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