Peripheral arterial disease

Peripheral arterial disease (PAD) is a common condition, in which a build-up of fatty deposits in the arteries restricts blood supply to leg muscles. It is also known as peripheral vascular disease (PVD).

Many people with PAD have no symptoms. However, some develop a painful ache in their legs when they walk, which usually disappears after a few minutes' rest. The medical term for this is "intermittent claudication".

When to see your GP

You should see your GP if you experience recurring leg pain when exercising.

PAD is usually diagnosed through a physical examination by your GP, and by comparing the blood pressure in your arm and your ankle.

A difference between the two may indicate PAD and is called the ankle brachial pressure index (ABPI).

What causes PAD?

PAD is a form of cardiovascular disease (CVD), meaning it affects the blood vessels.

It is usually caused by a build-up of fatty deposits in the walls of the leg arteries. The fatty deposits, called atheroma, are made up of cholesterol and other waste substances.

The build-up of atheroma on the walls of the arteries makes the arteries narrower and restricts blood flow to the legs. This process is called atherosclerosis.

Who is affected

Your risk of developing PAD increases as you get older. It's estimated that around one in every five people over the age of 60 are affected by the condition to some degree.

Men tend to develop the condition more often than women.

There are certain things that can increase your chances of developing PAD and other forms of CVD, including:

smoking – the most significant risk factor
type 1 diabetes and type 2 diabetes
high blood pressure
high cholesterol

By tackling these risk factors, you may be able to reduce your chances of developing PAD and other types of CVD.

How PAD is treated

PAD is largely treated through lifestyle changes and medication.

Exercising regularly and stopping smoking, if you smoke, are the main lifestyle changes that can ease the symptoms of PAD and reduce the chances of the condition getting worse.

The underlying causes should also be treated, such as reducing high blood pressure and cholesterol, and diabetes. Medication, and in some cases surgery, can be used to improve the blood flow in your legs.

With treatment, most people's symptoms will remain relatively stable, and some people may experience an improvement in their pain.

If treatment is unsuccessful or you can't make appropriate lifestyle changes, there is a risk of potentially serious complications (see below).

Possible complications

While PAD is not immediately life-threatening, the process of atherosclerosis that causes it can lead to serious and potentially fatal problems.

Having PAD means you have a much higher risk of developing other serious forms of CVD, such as heart attack and stroke, because it is likely that blood vessels elsewhere in your body are also affected by atherosclerosis.

If the symptoms of PAD get worse, there is a risk that leg tissue will begin to die (known as gangrene). In severe cases, the lower leg may have to be amputated.

Read more about the complications of PAD.