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Understanding Peripheral Artery Disease (PAD): Symptoms, Causes, and Treatment Options

Oghenefejiro Okifo | MD

Medically reviewed by Oghenefejiro Okifo | MD, Harvard Medical School | Henry Ford Hospital - Detroit, MI on March 27th, 2024.

Key Takeaways

  • Atherosclerotic plaque buildup narrows arteries by 50% or more before symptoms appear, reducing oxygen delivery to leg muscles and creating the characteristic cramping pain during walking (claudication).
  • Smoking multiplies risk by 400% and is the single strongest modifiable risk factor—even former smokers have double the risk of never-smokers, making cessation critical for prevention.
  • The ankle-brachial index (ABI) test compares blood pressure in your ankle versus arm; readings below 0.9 indicate blockages, while severe disease shows readings under 0.4.
  • Supervised exercise therapy for 30-45 minutes, 3 times weekly can increase walking distance by 150-200% within 3-6 months by improving muscle efficiency and developing collateral circulation.
  • Antiplatelet medications like clopidogrel reduce cardiovascular events by 25% in PAD patients, while statins lower both cholesterol and inflammation regardless of baseline cholesterol levels.

Peripheral artery disease (PAD) is a condition in which your arteries become narrowed, reducing blood flow to your limbs. It's a form of peripheral vascular disease that can affect your arms, legs, head, stomach, and kidneys. If left untreated, PAD can lead to serious complications, such as heart attack, stroke, or amputation.

Symptoms of PAD

The most common symptom of PAD is muscle pain or cramping in your legs, particularly when walking or climbing stairs. This pain, called claudication, usually subsides with rest. Other symptoms may include:

  • Changes in leg color

  • Numbness or burning sensation in your legs or feet

  • Weakness or fatigue in your legs

  • Slow-healing sores on your toes or feet

  • Shiny or pale skin on your legs

  • Loss of hair on your legs

  • Erectile dysfunction (in men with diabetes)

If you experience any of these symptoms, consult your doctor for an accurate diagnosis and appropriate treatment plan.

Causes and Risk Factors of PAD

The primary cause of PAD is atherosclerosis, a condition in which fatty deposits (plaques) build up in your arteries, reducing blood flow. Over time, these plaques harden and narrow your arteries, leading to PAD. While the exact cause of plaque buildup is unknown, several risk factors can increase your likelihood of developing PAD:

  • Smoking

  • Diabetes

  • High blood pressure

  • High cholesterol

  • Age (over 50)

  • Obesity

  • Lack of physical activity

  • Family history of PAD, heart attack, or stroke

Smoking is the single most significant controllable risk factor for PAD, increasing your risk by 400% compared to non-smokers. If you smoke, talk to your doctor about strategies to help you quit.

Understanding Peripheral Artery Disease (PAD): Symptoms, Causes, and Treatment Options

Diagnosing PAD

To diagnose PAD, your doctor will perform a physical exam and may order additional tests, such as:

  • Ankle-brachial index (ABI) to compare blood pressure in your legs and arms

  • Ultrasound to assess blood flow and identify blocked arteries

  • Angiogram to visualize blocked arteries using X-ray and contrast dye

  • Blood tests to check for risk factors like diabetes or high cholesterol

Treatment Options for PAD

Treatment for PAD aims to manage symptoms, improve blood flow, and prevent complications. Your doctor may recommend lifestyle changes, medications, or surgical procedures, depending on the severity of your condition.

Lifestyle Changes

  • Quit smoking

  • Exercise regularly

  • Eat a healthy diet

  • Manage stress

  • Control blood sugar, blood pressure, and cholesterol levels

Medications

  • Cilostazol or pentoxifylline to improve blood flow

  • Aspirin or other anti-clotting drugs to prevent blood clots

  • Cholesterol-lowering medications (statins)

  • Blood pressure medications

  • Diabetes medications

Surgical Procedures

  • Angioplasty and stenting to widen narrowed arteries

  • Bypass surgery to redirect blood flow around blocked arteries

Preventing PAD

Adopting a healthy lifestyle is the best way to prevent PAD. This includes regular exercise, a balanced diet, stress management, and controlling conditions like high blood pressure, diabetes, and high cholesterol. If you smoke, quitting is the most significant step you can take to reduce your risk of developing PAD.

Regular checkups with your doctor can help detect PAD early, allowing for prompt treatment and prevention of complications. If you have concerns about your risk factors or experience symptoms of PAD, don't hesitate to consult your healthcare provider.

For more information on peripheral artery disease, visit:

The Bottom Line

Early detection through simple blood pressure measurements in your legs can identify blockages before they progress to tissue damage or amputation risk. The most effective treatment combines smoking cessation, supervised walking programs, and medications to prevent clots and reduce inflammation. If you're experiencing leg pain during activity or have risk factors like diabetes and smoking history, Doctronic can help evaluate your symptoms quickly.

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