Signs and Prevention of Peripheral Arterial Disease | One Healthy Boston

Heart Health

Signs and Prevention of Peripheral Arterial Disease

Peripheral Arterial Disease, or PAD, is very common and occurs when the arteries that supply blood to your legs, arms, and neck become restricted due to plaque buildup. It’s mostly seen in men and women over the age of 60, and most frequently affects the legs.


Although this is a very common disease, many people don’t receive a diagnosis until symptoms are severe. This is usually due to the fact that a lot of patients aren’t aware they have PAD, so they mistake their pain for something else or accept it as a result of aging.

The most common symptom of PAD is muscle pain in the legs (usually calf, but sometimes thigh, hip, or buttocks) while walking that goes away at rest.

Some other symptoms of PAD include:

  • Discoloration of the feet
  • Thickening of toenails
  • Hair loss on lower legs
  • Very slow healing of minor cuts and wounds on legs and feet (for example, a blister from a tight shoe)
  • Pain in feet at rest, or pain that awakes you from sleep

If you are at the point where you are experiencing foot or leg pain at rest or while you sleep, you should contact your doctor immediately as this only happens when PAD becomes severe. You may also start to develop dead tissue from lack of oxygen being circulated in your blood. This is also a severe symptom and could result in the loss of a limb. That’s why it’s extremely important to understand symptoms and get tested for PAD at your annual exams.


The most common test for PAD is called the ankle-brachial index, or ABI, and should be performed by your primary doctor as part of a routine checkup after the age of 45. It’s a simple and painless exam where your primary doctor takes the blood pressure in your ankle and compares it to the blood pressure in your arm. In a healthy person, the blood pressure readings will be the same, but in someone with PAD, the blood pressure in their ankle will be lower. Since PAD has been shown to run in families, it’s important to share your family history with your doctor so he can have a heightened alert and start screenings earlier. If your doctor determines you need additional care, you’d be referred to a cardiologist or vascular surgeon to talk about your options.


You are at an increased risk of developing PAD if you:

  • Smoke
  • Are over the age of 60
  • Have diabetes
  • Have high cholesterol or blood pressure
  • Are overweight
  • Live a sedentary lifestyle
  • Have a family history of it


Treatment for PAD typically involves addressing the risk factors that apply to you. Of course some risk factors, like age and family history, are non-modifiable. But making healthy lifestyle changes can go a long way in treating and preventing PAD.

There’s a misconception that PAD is going to happen to everyone as they get older, which is why so many people feel like there’s nothing they can do to prevent it. But so much of the development and progression of PAD is controllable by the patient. The most important thing is to pay attention to your own risk factors and get an annual physical. If you treat it early with exercise and a healthy lifestyle, it’s very possible to age gracefully into your 70’s and 80’s.

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