What Is Peripheral Artery Disease (PAD) – Causes, Symptoms & Diagnosis
Peripheral artery disease (also called peripheral arterial disease, or PAD), is a rather common circulatory problem in which restricted arteries reduce the blood flow to your limbs.
When you develop PAD, your extremities, usually your legs, don’t receive enough blood to keep up with your muscle’s demands. When this happens, you may develop symptoms, often leg pain when you walk (claudication).
Causes of PAD
PAD is usually caused by atherosclerosis. In atherosclerosis, fatty deposits (plaques) begin to build up in the walls of your artery and reduce the amount of blood flow. Plaque consists of fat, fibrous tissue calcium, cholesterol, and other substances in your blood.
Less common causes of PAD are blood clots in the arteries, injured limbs, and unusual anatomy of the ligaments and muscles.
Major risk factors
It is estimated that 8.5 million people in the U.S. have PAD, affecting approximately 12–20% of Americans over age 60.
PAD is a major risk factor for heart attacks and strokes.
• PAD is more common in African-Americans than other racial groups, and men are slightly more likely than women to develop PAD.
• PAD is also more common in smokers.
• People who smoke or have diabetes have the greatest risk of developing PAD due to reduced blood flow.
• Other risk factors that contribute to PAD are high blood pressure, obesity, increasing age, family history of heart disease, high cholesterol, and excessive levels of C-reactive protein or homocysteine.
Symptoms of PAD
• Painful cramping in your hip, thigh or calf muscles after certain activities, such as walking or climbing stairs (claudication)
• Leg numbness or weakness
• Coldness in your lower leg or foot, especially when compared with the other side
• Sores on your toes, feet or legs that won’t heal
• A change in the color of your legs
• Hair loss or slower hair growth on your feet and legs
• Slower growth of your toenails
• Shiny skin on your legs
• No pulse or a weak pulse in your legs or feet
• Erectile dysfunction in men
If PAD progresses, pain may occur even when you’re resting or lying down (ischemic rest pain). It may be bad enough to disrupt your sleep. Hanging your legs over the edge of your bed or walking around your room may temporarily relieve the pain.
When to see your doctor
If you have leg pain, numbness or other symptoms, don’t dismiss them as a normal part of aging. Call your doctor and make an appointment.
Even if you don’t have symptoms of PAD, you may need to be screened if you are:
• Over age 70
• Over age 50 and have a history of diabetes or smoking
• Under age 50, but have diabetes and other peripheral artery disease risk factors, such as obesity or high blood pressure
Treatment for peripheral artery disease has two major goals:
1. Manage symptoms, such as leg pain, so that you can resume physical activities.
2. Stop the progression of atherosclerosis throughout your body to reduce your risk of heart attack and stroke.
You may be able to achieve these goals with lifestyle changes. If you are a smoker, quitting is the single most important thing you can do to help reduce your risk of complications.
If changes in your lifestyle are not enough, you will need to seek additional medical treatment.
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