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CardiovascularICD-10: I73.9Affects about 8.5 million people in the United States; 200+ million worldwide

Peripheral Artery Disease

Also known as: PAD, Peripheral Vascular Disease, PVD

Peripheral artery disease (PAD) is a circulatory condition in which narrowed arteries, usually due to atherosclerosis, reduce blood flow to the limbs, most commonly the legs. PAD is a strong marker for systemic atherosclerosis and significantly increases the risk of heart attack, stroke, and limb amputation. Many people with PAD are asymptomatic, making screening important in high-risk populations.

Symptoms

Intermittent claudication (leg pain or cramping when walking that resolves with rest)
Leg numbness, weakness, or coldness
Weak or absent pulses in the feet
Shiny skin on the legs
Slow-healing sores or wounds on the feet or legs
Hair loss on the legs
Color changes in the legs (pale or bluish)
Erectile dysfunction in men

Causes

  • Atherosclerosis (plaque buildup in the arterial walls)
  • Inflammation of the blood vessels (vasculitis) — rare
  • Injury to the limbs or radiation exposure

Risk Factors

  • Smoking (strongest modifiable risk factor)
  • Diabetes mellitus
  • Hypertension
  • High cholesterol
  • Age over 65 (or over 50 with additional risk factors)
  • Obesity and sedentary lifestyle

Diagnosis

  • Ankle-brachial index (ABI) — ratio of ankle to arm blood pressure (PAD if ABI ≤0.9)
  • Duplex ultrasound of lower extremity arteries
  • CT angiography or MR angiography for detailed vascular imaging
  • Treadmill exercise test with ABI

Treatment

  • Supervised exercise therapy (walking programs — first-line treatment)
  • Antiplatelet therapy (aspirin or clopidogrel)
  • Statin therapy for cholesterol management and plaque stabilization
  • Cilostazol for symptom relief from claudication
  • Blood pressure and diabetes management
  • Revascularization (angioplasty with stenting or bypass surgery) for severe disease

Prevention

  • Quit smoking — the single most important intervention
  • Maintain healthy blood pressure, cholesterol, and blood sugar levels
  • Exercise regularly
  • Eat a heart-healthy diet low in saturated fats
  • Maintain a healthy weight

When to See a Doctor

  • Leg pain when walking that consistently resolves with rest
  • Non-healing wounds or sores on the feet or toes
  • Sudden leg pain, coldness, or color change (acute limb ischemia — emergency)
  • Numbness or weakness in the legs

Frequently Asked Questions

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Medical Disclaimer: This content is for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider.

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