Peripheral Artery Disease

Peripheral artery disease is a narrowing or hardening of the arteries that supply blood to your extremities, the areas of your body beyond the chest or abdomen. One in 20 Americans over age 50 experiences the disease, which increases the risk of heart attack and stroke.

In its most common form, peripheral artery disease affects circulation in the legs, even though the peripheral vascular system also includes the arms, stomach and head. It’s easy to identify and often easy to treat: Quit smoking, exercise regularly and follow a nutritional diet.


If you have peripheral artery disease, you might feel pain or cramping in a leg when walking or climbing stairs. The location of the pain also tells you the general location of the artery that’s narrowed or hardened. Unfortunately, many people dismiss the pain as insignificant or attribute it to aging.

Pain in the leg, hip, thigh or calf muscles (called claudication) is one of many possible signs of peripheral artery disease:

  • Numbness or weakness in the leg.
  • Weak (or no) pulse in the legs or feet.
  • Sores on legs, toes or feet that don’t heal as usual.
  • Cramping with exercise.
  • Discoloration in legs.
  • Temperature in one leg lower than the other.
  • Hair loss (or slower growth) on legs and feet.
  • Poor toenail growth.
  • Coldness in lower leg or foot.

Because symptoms can be mild or barely noticeable, it’s best to check with your doctor if you’re over age 50 with a history of smoking or diabetes or over age 70. Also check with your doctor, even if you have no symptoms, if you’re under age 50 with diabetes and at least one risk factor for atherosclerosis.

Causes/Risk Factors

It’s clear that atherosclerosis – an accumulation of plaque, with its mixture of cholesterol, fat and other substances, in the blood – can cause peripheral artery disease.

Here are some contributors to atherosclerosis:

  • Smoking.
  • Diabetes.
  • High blood pressure.
  • Family history of heart disease.
  • Previous heart attack or stroke.
  • Elevated levels of certain fats and cholesterol in the blood.
  • Overweight or obese.
  • Sedentary lifestyle.
  • Over age 50.
  • Your race. African Americans are twice as likely as whites to get the disease.


Smoking and diabetes are the two greatest risk factors for peripheral artery disease. Each damages the inner layers of the arteries. During healing, plaque can build up at the site of the damage.

For some people, quitting smoking can be more effective than any medical treatment. If you have diabetes, talk with your doctor about controlling your blood sugar (glucose) levels. Exercise, such as a daily walking program, and a nutritional health plan can also help 

Your doctor will consider your symptoms, medical and family history, the results of diagnostic tests and a physical exam. An ankle-brachial index, a simple test that compares blood-pressure readings in your ankles with readings in your arms, can also help determine if you have peripheral artery disease. (It cannot pinpoint, however, which arteries are narrowed or blocked.) 

Those who ignore treatment risk serious tissue damage, evident as sores or gangrene caused by reduced blood flow. In rare cases, complications might require amputation of part of the leg or foot. 

Your doctor might also prescribe medication, as appropriate, to: 

  • Lower blood pressure.
  • Reduce cholesterol.
  • Increase blood flow to the limbs.
  • Prevent blood clots.
  • Reduce leg pain when walking or climbing stairs. 


Angioplasty/stenting: A tiny balloon inserted into the narrowed artery, then inflated, widens the artery. A stent, a wire mesh coil, often is used to keep the artery open.

Atherectomy: An alternative to angioplasty that removes plaque buildup (atherosclerosis) from the walls of blood vessels.

Bypass surgery: A healthy blood vessel from another part of your body (arm, chest or leg), connected to heart arteries, bypasses the blocked or narrowed artery.

Note: Artery blockages that are not causing sympstoms do not require intervention.