Peripheral arterial disease (PAD) is narrowing of one or more arteries (blood vessels) and can occur in any artery of the body, but mainly affects the arteries that take blood to the legs.
Prevalence It's estimated that around one in every five people over the age of 60 are affected by the condition to some degree and is commonly associated with other conditions such as diabetes, obesity, stroke, and increases in prevalence as we get older.
Causes PAD usually happens when fatty deposits (plaques) build up in the walls of your arteries, causing them to narrow and restrict blood flow. This is called atherosclerosis. You are more likely to develop atherosclerosis if you are older than 50, are male, are a smoker, have diabetes, have high blood pressure, have high cholesterol, are obese, are physically inactive.
PAD Symptoms Many people who have PAD don't even know they have it. Half of those with the disease don't have any symptoms. However, you may notice the following:
- Pain in the lower leg, which comes on after walking or other exercise and goes away after rest (this is the most common symptom and is called intermittent claudication)
- An ache, cramp, numbness or sense of fatigue in the muscles
- Pain in the thigh or buttock
- Walking more slowly than normal
- Finding walking difficult
- Not being able to walk very far
If your condition gets worse and there isn't enough blood getting to your legs, you may also develop:
- Cold and numb feet and toes, especially after you have been lying down for some time
- Pain in your legs coming on even when you are resting
- Losing hair from your feet, toes or legs
Treatments aim to reduce the risk of heart attack and stroke, as well as easing the symptoms of leg pain. GP's will also discuss lifestyle changes as part of a treatment regime.
- Coronary heart disease and stroke - If the arteries to your legs have become narrowed due to a build-up of fatty deposits, then it is possible that the same thing could be happening in other arteries throughout your body. This can cause more serious problems such as heart failure, heart attack or stroke
- Amputation - In most people with PAD, symptoms such as leg pain don't get any worse, but just stay about the same. However in a few people, the condition can worsen, causing ulceration and even gangrene as the blood supply to the lower limbs is cut off altogether. When this happens, amputation may be necessary. However, this only happens in around five in 100 people with peripheral arterial disease
- Quit smoking - Smoking greatly increases the chances of your peripheral arterial disease getting worse
- Be more active - This may include walking every day as far as you can before you feel any pain, and gradually increasing the amount you walk. This can be a very effective way of reducing pain and helping you to walk further
- Lose weight - This reduces the demands on the heart and leg muscles and reduces the risk of forming atheroma
- Eat a healthy diet - This is the same as advised to prevent heart disease. This reduces the chance of atheroma forming
- Reduce alcohol consumption - Drinking a small or moderate amount of alcohol helps to reduce the risk of developing cardiovascular diseases such as PAD
- Take care of your feet - Try not to injure your feet. An injury may lead to an ulcer or infection developing more easily if the blood supply to the feet is reduced
Further Help & Support (click through hyperlinks are highlighted in light blue)
British Heart Foundation