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Heart Smart Living
Heart Smart Living

Cardiologist, author, and heart health expert Dr. Sarah Samaan offers advice on how to live a heart smart life.

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What is Peripheral Arterial Disease and How Do You Know if You Have It?

You may have heard about peripheral arterial disease (PAD), also known as peripheral vascular disease, from television commercials promoting the latest treatments for the condition, but the signs and symptoms of this close relative to coronary heart disease (CHD) are often overlooked.

Just like CHD, PAD involves hardening of the arteries due to buildup of cholesterol plaque, or atherosclerosis. In PAD, however, it is the blood vessels feeding the legs, arms, and organs of the body (other than the heart) that are affected. Carotid artery disease is a form of PAD that affects the blood vessels to the brain. I’ll tell you more about that in a later post. Erectile dysfunction may also be caused by PAD.

People with PAD affecting the blood vessels to the legs will typically feel a hard, tight cramping in the calves or thighs when they walk for more than short distances, or when they climb stairs. Stopping and resting will relieve the symptoms very quickly. Often people confuse cold hands or feet with “poor circulation” and blockage in the arteries, but when those are the only symptoms, PAD is less likely.

Since PAD limits blood flow, people with the condition are more likely to develop infections in their feet that are slow to heal. That is because blood carries oxygen, nutrition, and disease-fighting white blood cells. Without these vital nutrients, injured tissue can eventually die, leading to gangrene.

PAD is much more common than many people realize. As many as 5 percent of Americans over age 50 are affected. Smokers are up to 20 times more likely to develop PAD than non-smokers. Diabetes alone will triple or quadruple the risk, so the likelihood of PAD in diabetic smokers is astronomical. The majority of patients that I have cared for who required amputations due to PAD had this deadly duo of risk factors. High blood pressure and high cholesterol are also risk factors.

Testing for PAD is generally fairly simple. Your doctor can order a test called an ankle-brachial index, which measures the pressure in the legs. CT scans can be used to confirm the diagnosis.

Although PAD can be devastating, it is often treatable. A stent can be inserted into a blockage to open it up and restore blood flow, although a blood vessel that is riddled with PAD may not be a good candidate for the procedure. There are several medical therapies available as well. In many cases, an exercise program can help strengthen smaller blood vessels, enabling them to take over some of the work of the larger blocked arteries. Most importantly, stop smoking, treat cholesterol and other risk factors, and choose a healthy way of life.

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About the Author


Dr. Samaan is an acclaimed cardiologist, writer, and heart health educator.