What is Peripheral Artery Disease?
By Deanna Stephens, FNP
Peripheral artery disease (PAD) happens when fatty buildup (“plaque”) slowly clogs the blood vessels that carry blood to your legs and feet. This reduces blood flow to the muscles and skin, which can cause pain, weakness, or slow healing. PAD is not just a leg problem. It is a sign of blood vessel disease throughout the body and increases the risk of heart attack and stroke.
What causes PAD?
PAD develops over many years as cholesterol and fatty material collect inside the arteries, making them narrow and stiff. Common risk factors include smoking, diabetes, high blood pressure, high cholesterol, kidney disease, older age, and family history of heart or blood vessel disease.
What are the common symptoms?
- Leg pain, cramping, or tightness when walking that improves with rest
- Heavy, tired, or weak legs
- Pain in the feet or toes while resting or lying down
- Slow-healing sores or wounds
- Cool skin, color changes, or hair loss on the legs
- Some people have no symptoms even when PAD is present
How is PAD diagnosed?
Your provider may check pulses in your legs and feet, examine your skin, and review your health history. A simple test called the Ankle–Brachial Index (ABI) compares blood pressure in your ankle to your arm: Normal 1.00–1.40, Borderline 0.91–0.99, PAD 0.90 or lower. Ultrasound or CT scans may be used if procedures are being considered.
What medications are used?
- Aspirin or clopidogrel to prevent blood clots
- Cholesterol-lowering statins
- Blood pressure medicines
- Diabetes control
- Cilostazol to improve walking distance (not used in heart failure)
- In some higher-risk patients, low-dose rivaroxaban plus aspirin may be used.
Is exercise important?
Yes. Walking is one of the best treatments for PAD. Aim for 30–45 minutes of walking at least three days per week. Walk until moderate discomfort, rest, and then continue.
When are procedures needed?
Procedures to open blocked arteries may be recommended when symptoms limit daily activities or when wounds do not heal.
What lifestyle changes help?
- Stop smoking.
- Walk regularly.
- Eat a heart-healthy diet.
- Maintain a healthy weight.
- Check your feet daily for cuts or sores.
What complications can occur?
Without treatment, PAD can lead to worsening pain, slow-healing wounds, infection, amputation, and increased risk of heart attack or stroke.
Deanne Stephens is a board-certified nurse practitioner with UNC Health Southeastern Cardiology and Cardiovascular Care. To learn more about health services available through UNC Health Southeastern, visit Heart & Vascular Care | Lumberton, NC | UNC Health Southeastern.
