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Are You at Risk for Peripheral Artery Disease?

Are You at Risk for Peripheral Artery Disease?

This article is for people who would like to learn more about peripheral artery disease (PAD), including those who may be at risk for it, such as people with diabetes or heart disease. The goal is to educate patients on the importance of engaging with their doctor and healthcare team about ways they can recognize PAD and who's at risk for it.

You will learn about:

  • What PAD is

  • What causes PAD and who's at risk for getting it

  • How PAD is recognized

  • PAD treatment

  • How to lower your chances of getting PAD

  • Questions to ask your doctor

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What Is Peripheral Artery Disease?

Peripheral artery disease -- or PAD -- happens when fatty deposits (plaque) in your bloodstream block the blood vessels in your legs. These vessels become narrow and not enough blood reaches your legs and feet. PAD can also happen in the neck, arms, and stomach.

PAD can cause pain, especially when walking, and foot problems, such as wounds that won't heal. PAD may even stop blood from reaching your legs and feet completely, causing the tissue there to die (gangrene). In severe cases, it may be necessary to remove (amputate) the foot or leg.

What Causes PAD and Who's at Risk?

Atherosclerosis (plaque in your vessels) is the main cause of PAD, and having diabetes or heart disease increases your chance of developing atherosclerosis.

Atherosclerosis that causes PAD doesn't happen in just your legs. It can also happen in blood vessels to your heart and brain. In fact, atherosclerosis is the main cause of heart attacks and strokes.

If you have diabetes, heart disease, or any of the risk factors below, you have a bigger chance of developing PAD:

  • Overweight/obesity

  • Not physically active

  • Smoking

  • High blood pressure

  • High blood cholesterol

  • Over age 50

  • Someone in your family has heart or vessel disease (heart attack, stroke, or PAD)

What Are the Symptoms of PAD?

Many people don't know they have PAD because they don't have symptoms, but some may have these symptoms in the legs or feet:

  • Numbness, weakness, or tingling

  • Coldness, especially when compared to the other side

  • Leg pain, especially when walking or exercising

  • Trouble walking

  • Cramps in hips, thighs, or calves after walking or using stairs

  • Sores or wounds that heal slowly or won't heal

  • Skin that's shiny or has changed color

  • Slow toenail growth

If PAD progresses, pain can happen when you're resting and even cause you to wake up.

How Will You Know If You Have PAD?

If you have diabetes, heart disease, or other risk factors and you have leg pain, numbness, or other PAD symptoms, call your doctor to get checked for PAD.

Even if you don't have PAD symptoms, you should get tested if you:

  • Have diabetes or heart disease

  • Are over age 50

  • Are under age 50 and have other risk factors, such as obesity or high blood pressure

Tests your doctor may do include:

  • Physical exam

  • Ankle-brachial index (ABI) to check the blood pressure in your legs and feet

  • Ultrasound or magnetic resonance imaging (MRI) to find narrow or blocked vessels

  • Angiography to check your blood flow

  • Blood tests for glucose (sugar) and cholesterol

How Can You Lower Your Chances of Getting PAD?

The best way to lower your chances of developing PAD is to learn about and lower your risk factors, keep a healthy lifestyle, and take your medicines as directed to help achieve your goals. You should also visit your doctor regularly and be aware of PAD symptoms.

Tips for a healthy lifestyle include:

  • Quit smoking

  • Keep your glucose, cholesterol, and blood pressure under control

  • Follow the meal plan recommended by your doctor

  • Stay physically active

  • Maintain a healthy weight

  • Get enough sleep -- 7 to 8 hours each night

  • Develop coping strategies to help reduce stress

How Is PAD Treated?

The 2 main goals of PAD treatment are managing PAD symptoms and stopping atherosclerosis from getting worse.

If you have PAD your doctor may prescribe medicines to help:

  • Control high blood glucose (if you have diabetes)

  • Control high blood pressure

  • Lower high blood cholesterol

  • Prevent blood clots and improve blood flow

  • Relieve PAD symptoms, like leg pain

In some cases, invasive or surgical procedures may be necessary. Your doctor will discuss those with you.

Good Foot Care Is Important

It's important to take good care of your feet. With PAD -- especially if you have diabetes -- you can get foot injuries or sores that won't heal. This increases your chance of getting an infection.

Ways you can take care of your feet include:

  • Wash and dry them thoroughly every day

  • Moisturize -- but not between your toes -- to prevent cracks

  • Wear shoes that fit properly and thick, dry socks

  • Treat athlete's foot promptly

  • Be careful when trimming your toenails

  • Check your feet daily and call your doctor right away if you see a sore or injury

  • Visit a foot doctor (podiatrist)

Questions to Ask Your Doctor

Visit your doctor regularly so they can review your treatment; check your glucose, cholesterol, and blood pressure; and test for PAD.

Questions to ask your doctor include:

  • Am I at risk for PAD?

  • How can I recognize PAD?

  • Are there any tests I should have?

  • What medicines are available and what are their side effects?

  • What type of diet or meal plan should I follow?

  • What changes to my lifestyle should I make?

  • What type of physical activity should I do?

  • What should I do if I start to feel stressed?

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Authors and Disclosures

Clinician Reviewer

Susan L. Smith, MN, PhD

Senior Medical Education Strategic Director, Medscape, LLC

Disclosure: Susan L. Smith, MN, PhD, has disclosed no relevant financial relationships.


Anita A. Galdieri, RPh, PharmD

Senior Scientific Content Manager, Medscape, LLC

Disclosure: Anita A. Galdieri, RPh, PharmD, has disclosed no relevant financial relationships.

Peer Reviewer

Amy Hess Fischl, MS, RDN, LDN, BC-ADM, CDE

University of Chicago Medicine

Disclosure: Amy Hess Fischl, MS, RDN, LDN, BC-ADM, CDE has disclosed the following relevant financial relationships:Served as an advisor or consultant for:Xeris Pharmaceuticals, Inc.Served as a speaker or a member of a speakers bureau for:Abbott Diabetes Care; Xeris Pharmaceuticals, Inc


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