Peripheral Arterial Disease(PAD) is a condition in which the arteries that carry blood to the legs and arms get clogged or blocked by the build up of a fatty material called plaque (plak), on the inside walls of these blood vessels. PAD affects over 9 million Americans. 1 in every 4 people 65 and older, even if otherwise healthy, may be affected by this disease. For those with "risk factors" (conditions or family history that make them prone to develop vascular disease) PAD may present as early as in their 50's.

The buildup of plaque on the artery walls is called atherosclerosis (ath-er-o-skler-O-sis) or hardening of the arteries. Arterial plaque may cause narrowing of the blood vessels effectively reducing blood flow supply to the legs and sometimes even the arms. PAD is associated with a 5-fold increased risk of heart attack and 2-3 fold greater risk of stroke and total mortality.

PAD also fosters major disability on its own by causing pain and sometimes numbness and weakness of the legs that typically occurs with walking. It also can increase the chances of infection and make it difficult for the body to fight infection, therefore one of the symptoms of PAD may be slow or non-healing ulcers in the legs. In severe cases, lack of blood flow may lead to tissue death (called "gangrene") with the subsequent need for limb amputation. In fact, PAD is the leading cause of leg amputation in North America.

Both men and women can develop the disease. PAD may impair physical health and diminish the ability to walk. Despite its seriousness and prevalence, PAD is often undiagnosed, under-treated and unknown to most Americans. The good news is that you can lower your risk by taking steps to learn about PAD, including asking your doctor to check your risk and if appropriate, perform simple, noninvasive screening test that can help save your life.

Signs and symptoms of PAD

• Lower extremity discomfort that is exertional but does not consistently resolve with rest or consistently limits exercise.


• Cramping in the calves and thighs


• Skin color changes in the limbs such as excessive paleness or blueness of skin


• Poor nail growth and loss of hair on toes and legs


• A weak or absent pulse in the legs or feet


• Lower temperature in one leg compared to the other


• Sores or wounds on legs, feet or toes that do not heal or heal slowly or poorly

Risk factors for PAD

• Age over 50 years.


• Tobacco exposure.
  – Smokers have up to four times higher risk of developing PAD


• Diabetes
  – One in every 3 diabetics over the age of 50 years is likely to have PAD


• High blood pressure
  – High blood pressure increases the stress on the blood vessel wall making it more prone to accumulate plaque


• High blood cholesterol
  – Excess cholesterol is deposited in the artery walls in the form of plaque


• Personal or family history of cardiovascular disease
  – If you or a close family member (especially parents and siblings) have vascular disease, history of heart attack or stroke you have a higher chance of also having PAD


• African-American origin
  – African Americans are more than twice as likely to have PAD as their white counterparts

Prevention and treatment of PAD

• Quit smoking
  Your health care provider may be able to help design an effective tobacco cessation program

Lower your numbers
Work with your physician to lower your cholesterol, blood pressure and blood sugar levels either with diet, exercise and medicines or a combination thereof

• Follow healthy eating habits
  Make sure to eat plenty of fresh fruits and vegetables. Prefer whole grains. Baked, grilled or broiled foods are better than fried. Choose foods that are low in saturated fat, "trans" fat and cholesterol.


• Be more physically active
  Try to incorporate 30 minutes of moderate-intensity activity to your daily schedule. What works over time is consistency and long-term commitment to exercise.


• Aim for a healthy weight
  The healthiest way to do it is through diet and exercise. Do not get discouraged if you do not lose weight fast. Once again, a life-long commitment to healthy diet and a good level of physical activity is efficacious to decrease your risk of cardiovascular disease, even if you do not lose that much weight.


• Talk to your doctor about PAD
  The best treatment for PAD is prevention. Adopt a healthy lifestyle, and ask your health care provider to check periodically your blood pressure, cholesterol and blood sugar levels. If you have risk factors for PAD, ask your doctor which screening test is right for you.