Peripheral arterial disease (PAD) is a common circulatory problem in which arteries narrow and blood flow to a person’s limbs is reduced.

Some 8.5 million people in the United States have PAD, including about 20 percent of people older than 60, according to the Centers for Disease Control and Prevention. 

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Dr. Nestor Cruz

It’s primarily caused by the buildup of fatty plaque in the arteries, which is called atherosclerosis. PAD can occur in any blood vessel, but it is more common in the legs than the arms.

When someone develops PAD, their extremities don't receive enough blood flow to keep up with demand. This causes symptoms, most notably leg pain when walking (the medical term is claudication).

“There’s often pain or a feeling of heaviness whenever there’s activity,” said Dr. Nestor Cruz, a vascular surgeon at Novant Health Heart & Vascular Institute. “It can be very painful in the lower extremities.”

Common PAD symptoms:

  • Pain in thighs, hips and calf muscles after movement such as walking or climbing stairs
  • Fatigue or pain in the leg
  • Sores on your legs or feet that don’t heal
  • A cold feeling in a foot, compared to the other foot
  • A change in the color of your leg, hair loss on your legs and feet and slower growth of toenails

What are risk factors for PAD?

“There often is a correlation between smoking, diabetes, hypertension and high cholesterol and PAD,” Cruz said. “About 50 percent or more of patients with PAD have coronary disease.”

The main risk factor for PAD is smoking. Other risk factors include older age and diseases like diabetes, high blood cholesterol, high blood pressure, heart disease, and stroke. If you’re obese or have limited physical activity, that increases your risk for PAD, too.

Taking control of risk factors, and eliminating as many as possible, can decrease the risk of developing PAD.

Treatment and prevention of PAD

Dr. Kobina Wilmot, a cardiologist at Novant Health Heart & Vascular Institute, said patients can control the risk factors to limit their chances of developing PAD.

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Dr. Kobina Wilmot

If it’s been diagnosed, options include:

  • A supervised exercise program to improve overall health.
  • Medications: You could be prescribed high blood pressure medications and/or medications to lower your cholesterol. Sometimes, medications to help prevent blood clots are prescribed.
  • Balloon angioplasty: This minimally invasive procedure opens a clogged heart artery by inflating a tiny balloon in it. It’s often combined with a stent to keep the artery open and decrease the chance of another blockage.
  • Stents: A minimally invasive procedure in which a wire mesh tube is used to prop open an artery. It will improve blood flow to the heart muscle.
  • Bypass grafting: A surgical procedure in which a vein from another part of your body can be used to “bypass” and reroute blood around a closed artery.

 “You can stabilize PAD,” Wilmot said. “We have a lifestyle modification discussion with the patient. They have to re-assess what they’re doing right and wrong. It comes down to us recognizing patients making changes. We can slow down the process.”

Cruz and Wilmot agreed that immediately stopping smoking is a key step to treating PAD. Exercising and a healthy diet are important to reduce the effects, too.

“PAD is a big warning sign to the patient,” Cruz said. “They have to think `If I keep this up, I’m going to be in trouble within the next five years. That’s when it becomes time for them to examine their risk factors and make good lifestyle changes.”

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