February 10, 2023

Peripheral artery disease can be a warning sign for other types of cardiovascular disease.

About 8 to 10 million people in the United States have peripheral artery disease, according to the American Heart Association. PAD is the result of atherosclerosis causing a narrowing of the arteries that supply blood flow to your extremities and other parts of the body. It most often occurs in the legs. Although some people with PAD will have no pain, a common symptom is pain in the legs upon walking that resolves when you stop the activity. Other conditions commonly occur with PAD, and that’s one reason why recognizing symptoms and seeking any necessary treatment from PAD complications is important.

“PAD is a marker for systemic atherosclerotic disease,” said Tiffany Street, an acute care nurse practitioner with Vanderbilt Heart and Vascular Institute. “Patients with PAD have an increased risk of heart attacks, stroke and death.”

Risk factors for PAD

The six most common risk factors for PAD are smoking, diabetes mellitus, age, hypertension, obesity and a family history of the condition. “The strongest of these risk factors are smoking and diabetes mellitus,” Street said.

Signs of PAD complications

Inadequate wound healing is one of the most common PAD complications. Foot ulcers can occur from diabetes alone. However, PAD is more prevalent in people who also have diabetes than those who don’t, and up to half of people with diabetes-related foot ulcers are estimated to also have PAD, according to the American Heart Association. “If you can’t get adequate blood supply because of narrowing in the arteries,” Street said, “then the wounds in the leg or feet will not heal.”

It’s important to take note of any wounds that are not resolving properly and to consult your physician for vascular evaluation. “Many times,” Street said, “the non-healing ulcer is the first symptom a patient presents with, and during a formal work-up we find out the patient has PAD and other cardiovascular conditions.”

PAD complications and other cardiovascular conditions

PAD can be a tip off for more serious cardiovascular conditions, especially if a patient hasn’t previously presented with typical cardiac symptoms. Two types of heart disease that commonly present with PAD are coronary artery disease and cerebrovascular disease.

Coronary artery disease is when cholesterol deposits, or plaques, build up in the walls of the arteries that send blood to the heart. “When you have PAD, you’re more likely to have coronary artery disease,” Street said, “because it occurs in other vascular beds.” Coronary artery disease is what often causes heart attacks and strokes. And symptomatic PAD is associated with an increased risk of major cardiovascular events, according to the American Heart Association.

Cerebrovascular disease refers to a group of conditions that can impact blood flow to your brain, leading to severe issues like stroke, brain aneurism, brain hemorrhage and more. PAD and cerebrovascular disease often occur together, and PAD is associated with an increased risk of death from from cerebrovascular disease.

Watching for PAD symptoms

The most common symptoms of PAD are aching or cramping anywhere in the legs — whether the buttocks, hips, thighs, or calves — that presents during activity but then completely subsides when you’re resting. “But about 40% of patients don’t have leg pain,” Street said. That’s why it’s important to be aware of your risk factors, see your doctor regularly, and be mindful of wounds that aren’t healing.

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Need help?

If you have peripheral artery disease, you know what it’s like to have painful legs, difficulty walking or a sore that won’t heal. The vascular specialists at Vanderbilt University Medical Center can help. The Vanderbilt Peripheral Artery Disease Program offers a variety of treatments to help your legs feel better.

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