What is Peripheral Arterial Disease? 

Peripheral Arterial Disease (PAD), occurs when blood vessels in the legs are narrowed or blocked by fatty deposits, and blood flow to your feet and legs decreases.  If you have PAD, you have an increased risk for heart attack and stroke.  An estimated 1 out of every 3 people with diabetes over the age of 50 have this condition. However, many of those with warning signs don’t realize that they have PAD and therefore don’t get treatment. PAD is a common condition that affects approximately 8-12 million people in the United States. PAD is an underdiagnosed and un-der-treated disease but fortunately, public and professional awareness of PAD and its diagnosis are rapidly increasing.

Risk Factors for PAD 

• Smokers - former smokers
• Obesity
• Diabetes Mellitus
• High Blood Pressure
• Physical Inactivity
• High Blood Cholesterol
• African Americans

Signs and Symptoms 

• Painful cramping of leg muscles during walking
• Burning/aching pain in the feet and toes while resting
• Toe and foot sores that do not heal
• Color changes in the skin
• Cooling of the skin in specific areas of legs or feet

How is PAD Diagnosed?

The most common test to diagnose PAD is the ankle-brachial index (ABI)  examination. The ABI exam is a simple, non-invasive test that measures the blood pressures at the lower and upper extremities.  If the ankle pressure is lower than the arm pressure, some stage of PAD may be present.

To perform the ABI exam, you will lay comfortably on an exam table.  A clinician will apply blood pressure cuffs to your arms and ankles.  Ultrasound gel and a Doppler probe is gently applied to the arterial site to locate the pulse signal. Once the signal is found, the clinician will pump up the cuff to obtain the pressure reading and wave forms will be obtained for further clinical documentation. The exam, which only takes 10-15 minutes to complete, is easy and painless. 

Facts about PAD 

PAD is more common than heart disease, cancer and stroke.

Most people who have the disease may not have any symptoms. The American Diabetes Association reports that less than 30% of PAD patients have symptoms.

If untreated, PAD can lead to critical limb is-chemia (CLI) where blood flow to the leg is significantly decreased due to atherosclerosis causing tissue loss or gangrene. As a result of this serious condition, leg amputations are commonly performed.

Annual testing of patients at risk is recom-mended by national health organizations. Undetected PAD is associated with: 

• Increase in mortality
• Increase in heart attack, stroke, amputation and death
• Severe decline in quality of life
• Leg amputation

What if I have PAD?

Treatment for PAD involves reducing symptoms and preventing further development of the disease, such as leg amputation, heart attack, or stroke. Making healthy lifestyle changes like quitting smoking, exercising, watching what you eat, and taking certain medications can decrease and possibly reverse the symptoms of the disease. For some patients, minimally invasive treatment or surgery may be necessary. Your NAPC health care provider will select a regimen that is best for you based on your current health condition and the severity of the disease. 

Peripheral Arterial Disease Checklist

• Do you suffer from claudication (fatigue, heaviness, tiredness, cramping in the leg muscles) while walking or climbing stairs?
• Do you have pain in your legs and/or feet that disturbs sleep? 
• Do you have sores or wounds on your toes, feet or legs that heal slowly, poorly or not at all?  
• Do you have a personal history of vascular disease, heart attack or stroke? If you answered “yes” to any of these questions or the questions on the cover, you have an increased risk of developing peripheral arterial disease (P.A.D.).  Early detection of P.A.D. can prevent further cardiovascular events from occurring.