What is PAD?

Peripheral arterial disease, or PAD, occurs when extra cholesterol and other fats in the blood collect in the walls of the arteries that carry blood to the arms and legs. These fats, called plaque, build up and narrow the arteries, slowing down and eventually blocking blood flow. PAD most often affects the legs. One in every 50 Americans over age 50 has PAD, which increases the risk of heart attack and stroke.

What causes PAD?

Although the cause of PAD is unknown, you have a greater chance of developing it as you get older. The risk increases if you:

* are over age 50

* smoke or used to smoke

* have diabetes

* have high blood pressure

* have high cholesterol levels

* have had a heart attack or stroke, or have vascular disease

* have a family history of heart attack, stroke, or PAD

* are Black.

What are the signs and symptoms of PAD?

Many people with PAD don't have any signs or symptoms. Others may notice tiredness, numbness, heaviness, or pain in their calf, thigh, or buttock muscles when walking that goes away when resting. This is called claudication. Some people with PAD have foot or toe pain that wakes them up, sores on their feet that don't heal, a "cooling" feeling in the legs or feet, color changes in the feet, and less hair on toes and legs.

How will my healthcare provider know I have PAD?

If you have risk factors or signs and symptoms of PAD, your healthcare provider will take your history, examine you, and perform certain tests. He or she will check the pulses in your legs and feet to see if enough blood is flowing to these areas. Your healthcare provider may also perform a simple, painless test called an ankle-brachial index. Comparing the blood pressure in your ankles with the blood pressure in your arms is part of this test. You may also have a Doppler ultrasound test to find out if a specific artery is blocked. Your healthcare provider may take blood to check your cholesterol and blood sugar levels.

How is PAD treated?

PAD is treated with lifestyle changes, medicines, and special procedures or surgeries, if needed. Your healthcare provider will determine which is the best treatment for your condition.

Lifestyle changes that can help treat PAD include:

* quitting smoking, if you smoke

* lowering your blood pressure

* lowering your cholesterol levels

* managing your blood sugar levels

* following a healthy eating plan

* getting regular exercise, such as 30 minutes of brisk walking, every day

* losing weight if you're too heavy.

Your healthcare provider may also prescribe medicines to lower high blood pressure, prevent blood clots, and reduce leg pain.

If the blood flow in one of your legs is completely blocked, you may have a procedure or surgery, such as angioplasty or bypass graft surgery, to clear the blockage. These won't cure PAD, but they can improve blood flow to the areas that are blocked.