Learning About Peripheral Arterial Disease of the Legs

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What is peripheral arterial disease?

Leg artery narrowed by plaque

Peripheral arterial disease (PAD) is narrowing or blockage of arteries in your arms and legs.

The most common cause of PAD is the buildup of plaque on the inside of arteries. Plaque is made of extra cholesterol, calcium, and other material in your blood. Over time, plaque builds up along the inner walls of the arteries, including those that supply blood to your legs. This buildup leads to poor blood flow.

This information focuses on peripheral arterial disease of the legs, the area where it is most common.

When you have PAD of the legs and you walk or exercise, your leg muscles do not get enough blood, and you can get painful cramps. The cramps are called intermittent claudication.

Peripheral arterial disease is also called peripheral vascular disease.

What are the symptoms?

Many people who have PAD do not have any symptoms. But if you have symptoms, you may have a tight, aching, or squeezing pain in the calf, thigh, or buttock. This pain usually happens after you have walked a certain distance. The pain goes away if you stop walking.

As PAD gets worse, you may have pain in your foot or toe when you are not walking. You also may have symptoms that you can see, such as:

  • Feet and toes that become pale from exercise or when elevated.
  • Loss of hair on the feet and toes.
  • Feet that turn red when dangled.
  • Blue or purple marks on the legs, feet, or toes.
  • Sores on the feet or toes.
  • Discoloured or black skin on the legs or feet. This is a sign of gangrene (death of tissue).

How can you prevent PAD?

  • Quit smoking. Quitting smoking is one of the best things you can do to help prevent PAD. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.
  • Stay at a healthy weight.
  • If you have diabetes, control your blood sugar levels.
  • Keep your cholesterol and high blood pressure at healthy levels. Eating a heart-healthy diet and being active can help you do this. If you have high cholesterol or blood pressure, you also may need to take medicines.
  • Be physically active. Get at least 2½ hours of exercise a week. Walking is a good choice. You also may want to do other activities, such as running, swimming, cycling, or playing tennis or team sports.
  • Eat a variety of heart-healthy foods.
    • Eat fruits, vegetables, whole grains (like oatmeal), dried beans and peas, nuts and seeds, soy products (like tofu), and fat-free or low-fat dairy products.
    • Replace butter, margarine, and hydrogenated or partially hydrogenated oils with olive and canola oils. (Canola oil margarine without trans fat is fine.)
    • Replace red meat with fish, poultry, and soy protein (like tofu).
    • Limit processed and packaged foods like chips, crackers, and cookies.

How is PAD treated?

Your doctor may suggest ways to relieve symptoms and lower your risk of heart attack and stroke. These may include:

  • Quitting smoking. It's one of the most important things you can do. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.
  • Eating heart-healthy foods.
  • Staying at a healthy weight. Lose weight if you need to.
  • Regular exercise. Your doctor may suggest a program that includes walking and weight training exercises. You might try a supervised program or try it at home. Your goal is to be able to walk farther without pain.
  • Medicines that help manage other problems such as high blood pressure and high cholesterol.
  • Medicine, such as aspirin, that prevents blood clots which could cause a heart attack or stroke.
  • Procedures, such as opening narrowed or blocked arteries (angioplasty) or using healthy blood vessels to create detours around narrowed or blocked arteries (bypass surgery).

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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