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Peripheral Artery Disease

Learn how to treat and prevent PAD through diet, exercise, and controlling your risk factors for heart disease.
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Written by
Sourav Bose, MD.
2019-Present - Postdoctoral Research Fellow, Children's Hospital of Philadelphia
Medically reviewed by
Last updated April 1, 2021

Peripheral artery disease questionnaire

Use our free symptom checker to find out if you have peripheral artery disease.

What is peripheral artery disease?

Your body has arteries that carry blood from your heart to the arms, legs, and various organs. Peripheral artery disease is the narrowing of arteries that carry blood from your heart to the outer parts of your body, such as your legs.

The narrowed arteries are caused by a build-up of calcium deposits and fatty plaque. Peripheral artery disease (PAD) causes less blood to circulate to your limbs, and is most likely to happen in the legs.

Most common symptoms

Pro Tip

A diagnosis of PAD means you are at significantly increased risk for heart disease. It is important that you make lifestyle changes to decrease your risk of heart attack—as well as further progression of your PAD. —Dr. Benjamin Ranard

PAD usually develops gradually. Symptoms start when your extremities (usually legs) aren’t getting enough blood. Often, pain is felt first when walking long distances. It may become worse over time. Eventually—a sign that the PAD is really bad—you may notice pain even when you’re not moving.

The most common symptoms are leg pain, discomfort, and weakness. These will all start or get worse when you’re moving, like during a walk. Depending on where arteries are narrowed, the cramping and aching may travel up into the butt muscles. Some people may feel off-balance from muscle weakness.

There are several other diseases that have similar symptoms, such as nerve compression, arthritis, and problems with the veins or lymphatics.

Main symptoms

  • Leg pain that worsens when you move or exercise. Pain may be in the calf, thigh, or butt.
  • Cramping and aching in legs when you move or exercise.

Other symptoms you may have

People with PAD often have blockages in the blood vessels of the heart, also known as coronary artery disease. Sometimes, you’ll notice chest pain along with leg pain during movement and exercise.

Next steps

Pro Tip

Ask your doctor: What can I do to help prevent my PAD from becoming worse and to reduce my risk of heart disease? Are there any new medications that I can take? —Dr. Ranard

You may have temporary numbness, tingling, or weakness in your legs during or after an activity such as walking or climbing stairs. If so, make an appointment with your primary care doctor.

If you have severe leg pain, cannot move your toes or feet, or if your feet are suddenly cold to the touch, go to the ER immediately. This could mean you’ve completely lost blood flow to your legs, which requires emergency treatment to open up the blocked artery.

Your doctor will ask you questions to figure out your risks that are contributing to your PAD. They will also assess how severe your PAD is.

They will take your blood pressure from different places on your body. This lets them calculate the ankle-brachial index (ABI), which shows how narrowed your blood vessels are.

You will need to get imaging tests like an ultrasound or CT scan to see the blood vessels of your legs. You will also have a blood test for certain markers of PAD.

Can you reverse peripheral artery disease?

If you have PAD, there are things you can do to slow or stop the progression of the disease and to improve symptoms. The goal is to reduce symptoms and avoid the need for emergency surgery if the PAD progresses.

  • Improve your diet.
  • Exercise. You may be prescribed an exercise program to increase blood flow to your legs.
  • Lose weight.
  • Manage diabetes with lifestyle changes and medications.
  • Quit smoking (and refrain from tobacco products).
  • Take medicines to lower your blood pressure, cholesterol levels, and other risks of heart and blood vessel diseases. You may need to take blood thinners to reduce your risk of blood clots.
  • In emergency situations, where little blood is flowing to your legs, you’ll need surgery. This will involve removing any blood clots out and clearing the blood vessels to improve flow.

Follow up

If not treated, PAD is a life-long disease. But with changes to diet and exercise as well as taking medications (such as aspirin and cholesterol medications), symptoms may go away completely.

Follow up with your primary care doctor and/or vascular surgeon (specialists who treat blood vessels) for regular ultrasounds and exams of your blood vessels. This will help your doctor know whether there is more you can do to lower your risk.

Dr. Rx

There are three types of specialist physicians who perform interventions for PAD: Cardiologists, Vascular Surgeons, and Interventional Radiologists. Some specialists do specific types of procedures but not others. Cardiologists also specialize in medications that can help treat PAD and prevent it from becoming worse. —Dr. Ranard

What is the main cause of peripheral artery disease?

If fatty material accumulates in the walls of your arteries (known as atherosclerosis), your arteries have less room for blood to flow. Symptoms become noticeable when your muscles need more blood, like when walking or climbing stairs.

High blood pressure, smoking, diabetes, obesity, and chronic kidney disease create system-wide inflammation. Inflammation changes the way your blood vessels carry oxygen to muscles during exercise, which can make symptoms worse.

What makes you more likely to have it?

High blood pressure, high cholesterol, kidney disease, diabetes, and obesity make you more likely to develop PAD. If you smoke or used to smoke tobacco, you’re also at a higher risk. If you have problems with clots in your heart, carotid arteries (in your neck), or abdominal arteries (in your torso), you’re more likely to develop PAD affecting your legs.

Preventative tips

Lower your chances of developing PAD by controlling your blood pressure, diabetes, and high cholesterol. Quitting smoking will help as well. Losing weight, if needed, and exercising regularly will help blood vessels function better, which can also reduce your risk.

Share your story
2019-Present - Postdoctoral Research Fellow, Children's Hospital of Philadelphia

Sourav Bose is a postdoctoral research fellow at the Center for Fetal Research in the Department of Surgery at the Children’s Hospital of Philadelphia and is a general surgery resident at the Brigham and Women’s Hospital affiliated with Harvard Medical School.

His current clinical investigation is in care programs for children with congenital anomalies and he is particularly interested in understanding how organizational structure and management influence patient outcomes and access to advanced precision care. He is also actively engaged in translational work investigating the efficacy of in utero gene therapy for congenital metabolic diseases. Previously, Sourav conducted and published research on pricing of healthcare services in Guatemala and Mongolia and on pediatric trauma outcomes.

Sourav received a BSc Economics from the Wharton School and a BA Biology from the School of Arts and Sciences through the Roy & Diana Vagelos Program in Life Sciences and Management at the University of Pennsylvania. He subsequently was awarded the Thouron Fellowship to pursue an MSc Public Health at the London School of Hygiene and Tropical Medicine. His master’s thesis evaluated the organizational and human resources investments necessary to conduct global clinical trials focusing on the Crash-2 investigative group. He returned to Penn where he received his MD from the Perelman School of Medicine and his MBA in Healthcare Management from the Wharton School.

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