Conditions InDepth: Peripheral Artery Disease (PAD)

Arteries carry blood to all the organs of your body. Therefore, any condition that damages arteries can damage the organs to which they supply blood, such as the heart or brain.

When the affected arteries are the ones that carry blood to the legs and arms, the resulting condition is called peripheral artery disease (PAD).

Peripheral artery disease is similar to coronary artery disease and carotid artery disease. In PAD, fatty deposits ( atherosclerosis ) build up along artery walls and affect blood circulation, mainly in arteries leading to the legs and feet. In its early stages, a common symptom is cramping or fatigue in the legs and buttocks during activity. Such cramping subsides with standing still. This is called "intermittent claudication." People with PAD have a higher risk of death from stroke and heart attack due to generalized atherosclerosis (narrowing of the arteries) and, to a lesser degree, an increase risk of blood clots.

Atherosclerosis

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Atherosclerosis begins in the teen years as deposits of fat and cholesterol in the walls of large arteries. Over decades these deposits (plaques) enlarge, break down, and calcify, narrowing or completely clogging the artery. The deposits can also produce fragments that break off, travel down the artery, and cause an obstruction to blood flow. If the artery is a coronary artery supplying the heart, a heart attack may result. If the artery supplies the brain, a stroke can occur. If the artery supplies the legs and feet, this may result in claudication or other signs of lack of blood supply to the extremities.

Claudication affects 2% of people over 65. Of these, only 25% will have the disease severe enough to require a procedure to reopen clogged arteries. Those at greatest risk include people with diabetes , high blood pressure , or hyperlipidemia ; smokers; and people who don’t get enough exercise.

What are the risk factors for peripheral artery disease?
What are the symptoms of peripheral artery disease?
How is peripheral artery disease diagnosed?
What are the treatments for peripheral artery disease?
Are there screening tests for peripheral artery disease?
How can I reduce my risk of peripheral artery disease?
What questions should I ask my doctor?
What is it like to live with peripheral artery disease?
Where can I get more information about peripheral artery disease?

References:

American Heart Association website. Available at: http://www.americanheart.org/ . Accessed August 14, 2008.

Braunwald E, Fauci AS, eds. Harrison's Principles of Internal Medicine. 16th ed. McGraw-Hill Professional;2004.

The Merck Manual website. Available at: http://www.merck.com/mmpe/index.html .

Rask-Nissila L, Jokinen E, Terho P, et al. Neurological development of 5-year-old children receiving a low-saturated fat, low-cholesterol diet since infancy. JAMA . 2000;284:993-1000.

Textbook of Clinical Neurology. 2nd ed. W.B. Saunders; 2003.



Last reviewed July 2008 by Michael J. Fucci, DO

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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