Peripheral Artery Disease (PAD)
Peripheral artery disease (PAD) is a progressive disease that is the result of plaque buildup in the arteries that supply nutrient rich blood to the limbs – usually the lower extremities. Plaque can build up inside arteries around the groin, knee, or calf, causing painful symptoms.
Peripheral artery disease is also related to coronary artery disease (CAD). Not only do PAD and CAD share similar risk factors, but they are also both caused by atherosclerosis which is the buildup of plaque inside arteries. Atherosclerosis can lead to blood clots that can have serious consequences. People who have both PAD and CAD have a significantly higher risk for blood clot–related events like heart attack and stroke, so it’s important to ask your doctor about getting screened for CAD and PAD.
Peripheral artery disease affects up to 8.5 million people in the US alone. But studies have shown only about 25% of adults have any awareness of PAD.
Peripheral artery disease is the end result of atherosclerosis, or hardening of the arteries. This is the process by which the arteries become damaged and inflamed because of certain health conditions and risk factors. Once inflammation begins, cholesterol, white blood cells, and other substances build up inside the damaged walls, forming plaque.
Plaque can start forming as early as childhood and builds up slowly, over many years. Imagine plaque as a sticky substance, like sludge on the inside of pipes. However, an important difference is that plaque doesn’t just build up on the interior surface of artery walls—it also builds up inside the walls themselves, causing the arteries to thicken and harden over time. As atherosclerosis progresses and the areas of plaque grow larger. This reduced blood flow is what causes symptoms like intermittent claudication (pain or cramping in the hips, thighs, or calf muscles after walking or being physically active.
PAD Risk Factors
- Older age
As you get older, your risk PAD increases. Other risk factors can cause plaque to build up in your arteries as you age. Over time, there may be enough plaque in your arteries to cause symptoms. For men, risk increases after age 45, while in women, risk increases after age 55.
Other than advanced age, smoking is the biggest contributing factor to whether or not a person will develop PAD. The risk of developing PAD is even higher when a person smokes and also has other risk factors.
- High cholesterol
High cholesterol by itself isn’t necessarily a cause for concern, but when you have too little of the “good” kind (high-density lipoprotein or HDL) and too much of the “bad” (low-density lipoprotein or LDL), you should take steps to lower your LDL or “bad” cholesterol levels.
- High triglyceride levels
Triglycerides are the most common type of fat in the body. However, having high triglyceride levels with low HDL or high LDL is associated with atherosclerosis, the buildup of plaque inside arteries that can cause serious blockages in the limbs and increases the risk of heart attack and stroke.
- High blood pressure
High blood pressure can damage the arteries that supply blood to the heart. This damage can promote the buildup of plaque inside the arteries that supply blood to your limbs, causing the arteries to stiffen and narrow over time, limiting blood flow to your muscles.
- A sedentary lifestyle
Too little physical activity is a risk factor for PAD. Regular physical activity, like walking, helps reduce the risk of cardiovascular disease. Other benefits of being active include better control of blood cholesterol, reduced risk of diabetes, weight loss, and lower blood pressure.
- Being overweight
People with excess body fat—especially around the waist—are at a higher risk for cardiovascular disease even without other risk factors. Lifestyle changes, like a heart-healthy diet and regular physical activity, can often result in weight loss as well as improved blood pressure, cholesterol, and blood sugar.
Diabetes is a major contributor to PAD. Even if your glucose levels are in a healthy range, you are still at increased risk for cardiovascular disease if you have diabetes. The risk is even greater if your blood sugar is not under control. That’s why it’s essential to work with your healthcare professional to get your diabetes under control and reduce your risk for PAD.
The connection between stress and cardiovascular disease requires more research, but many healthcare professionals agree that managing stress is beneficial for overall health. Stress releases hormones that elevate heart rate and blood pressure. Some people may respond to stress by engaging in behaviors that may harm their health, including drinking, smoking, or overeating.
Peripheral artery disease (PAD) and deep vein thrombosis (DVT) are such a serious health condition because it involves your cardiovascular system. Your cardiovascular system is also known as your circulatory system, and it connects everything from your brain to your toes. Your heart, arteries, veins, and lungs all work together to move nutrients and oxygen-rich blood to every single part of your body. If you have plaque buildup in your legs, there is a high likelihood that it could occur in other arteries of your body, so it’s important to do everything you can to keep your cardiovascular system healthy.