Peripheral Artery Disease

Peripheral artery disease is a common condition in which the arteries supplying blood to the limbs become narrowed, most often in the legs. This narrowing is usually caused by a gradual build-up of fatty deposits in the artery walls, a process called atherosclerosis. Reduced blood flow can cause pain and other symptoms. PAD often reflects similar narrowing in arteries elsewhere in the body.

Peripheral artery disease is common, especially in people over 50, and becomes more frequent with age. It affects both men and women, with higher rates among smokers and people with diabetes, high blood pressure, or raised cholesterol. Some people have no symptoms and may not realise they have PAD, so it is sometimes detected during checks for other conditions.

The most common symptom is a cramping or aching pain in the legs, often the calves, that comes on while walking and eases with rest. Other signs include numbness, weakness, cold feet, slow-healing wounds, and changes in skin colour on the legs or feet. Some people have no symptoms. Persistent pain at rest or a non-healing sore should be assessed promptly by a doctor.

PAD is usually caused by atherosclerosis, the build-up of fatty deposits that narrow and harden the arteries. The main risk factors are smoking, diabetes, high blood pressure, high cholesterol, older age, and being overweight or inactive. A family history of heart or artery disease also increases risk. Smoking and diabetes are particularly strongly linked to developing PAD.

Diagnosis starts with a medical history and examination, including checking the pulses in your legs and feet. A common simple test compares the blood pressure in your ankle with that in your arm. Ultrasound scans can show blood flow through the arteries, and other imaging may be used if more detail is needed. Blood tests help assess related risk factors such as cholesterol and blood sugar.

Treatment focuses on relieving symptoms, improving walking ability, and lowering the risk of heart attack and stroke. Key steps are stopping smoking, exercising regularly (often through a supervised walking programme), and managing blood pressure, cholesterol, and diabetes. Medicines may be used to support blood flow and protect the heart. In more severe cases, a procedure to restore blood flow may be considered.

PAD can often be prevented or slowed by looking after your arteries. The most important steps are not smoking, staying physically active, eating a balanced diet, and keeping a healthy weight. Controlling blood pressure, cholesterol, and blood sugar is also important, particularly for people with diabetes. Regular check-ups help identify and manage risk factors before symptoms develop.