Peripheral Artery Disease

Sometimes cramping and leg pain are more than signs of aging, especially for people who smoke or have high cholesterol, diabetes and obesity. If you feel heaviness, aching or cramping in your feet, legs or buttocks when you walk or climb stairs, you may be one of more than eight million people in the United States, ages 40 and older, with peripheral artery disease or PAD.

What Is Peripheral Artery Disease?

Peripheral artery disease, also called peripheral arterial disease, is a common form of peripheral vascular disease that occurs when plaque builds up in the peripheral arteries, preventing blood flow to other parts of the body. PAD most commonly affects the lower extremities, like the legs and feet. It can also be used interchangeably with peripheral vascular disease.

Atherosclerosis is the leading cause of peripheral artery disease. It is a condition characterized by plaque buildup of fat, cholesterol, calcium and other substances in the blood. Too much plaque eventually narrows or hardens the peripheral arteries. Pieces of plaque can break off and flow into the bloodstream, slowing or blocking blood flow throughout the body, including the heart, brain, arms, pelvis and kidneys. However, some factors can also increase a person's risk of developing peripheral artery disease, such as:

• Aging
• Personal or family history of PAD, cardiovascular disease or stroke
• High blood pressure
• High blood cholesterol
• Smoking
• Type 2 diabetes

Peripheral artery disease symptoms are usually dismissed as signs of arthritis. But while arthritis pain centers in the joints, such as the knees or hips, peripheral artery disease pain is more general and felt in more areas of the body.

What Are the Warning Signs of Peripheral Vascular Disease?

Although symptoms vary from one person to another, watch for the following most common symptoms of peripheral artery disease:

• Pain, aching, heaviness or cramping in the legs when walking or climbing stairs that goes away after rest (also called intermittent claudication).
• Toenails and leg hair stop growing.
• One foot feels colder than the other.
• A foot or leg turns pale, discolored or blue.
• Leg weakness or numbness.
• A feeling of pins and needles in the leg or foot.
• Pain in the leg and foot when at rest (also called critical limb ischemia).
• Sores or wounds on the toes, feet or legs that may appear to have healed slowly or may not heal at all.

If you have symptoms of peripheral artery disease, your doctor will ask you about your medical and family history, conduct a physical exam and order tests and procedures, which may include the following:

• Ankle-brachial index – a painless exam that compares the blood pressure in your lower legs to the blood pressure in your arms.
• Duplex ultrasonography – a noninvasive test that produces images of the artery through sound waves and measures the blood flow in the artery to indicate the presence of blockage.
• Computed tomographic (CT) angiography – a noninvasive test that uses X-rays and a contrast agent (dye) to visualize the blood vessels in the arteries in your abdomen, pelvis and legs.
• Magnetic resonance angiography – a test that provides cross-sectional images like a CT without using X-rays.
• Angiography – a test that uses a contrast dye that is injected into the arteries and X-rays to show blood flow in the leg arteries.

Undiagnosed peripheral artery disease can lead to painful symptoms or complications, such as loss of a leg, coronary artery disease, stroke or heart attack. If you believe you are at risk, consult a healthcare professional to help you understand your condition.

Can Peripheral Artery Disease Be Treated?

Fortunately, some peripheral artery disease cases are treatable with healthy lifestyle changes and medication. Peripheral artery disease treatment depends on its severity, existing conditions and other conditions that may develop. PAD treatment will be designed to help you reach the following goals:

• Reducing your risk of major heart events, such as a stroke or heart attack
• Reducing symptoms of peripheral artery disease
• Improving your mobility, including walking, climbing stairs as well as performing other daily activities
• Lowering your risk of losing a limb
• Improving your quality of life

Your doctor may include heart-healthy lifestyle changes, an exercise program, medicine or a procedure in your treatment plan. The procedure aims to open or bypass blockages in your arteries.

Recommendations

The success of the treatment plan will also depend on your lifelong lifestyle choices. Some lifestyle modifications to consider are:

• Quit smoking.
• Choose a heart-healthy eating plan that includes fruits, vegetables and whole grains while avoiding foods rich in saturated fats, sodium, added sugars and alcohol.
• Maintain a healthy weight or lose 3-5% of your current weight if you are overweight or have obesity.
• Aim for 30 minutes of moderate exercise a day.
• Learn relaxation techniques to counter stress-related complications.
• Get good-quality sleep daily to help improve your emotional and physical health.