Peripheral arterial disease (PAD) is a common but often overlooked condition in which a build-up of fatty deposits (atheroma) in the arteries restricts the blood supply to leg muscles. It is also known as peripheral vascular disease.
The most common symptom of PAD is painful cramping in the legs brought on by walking. Cramps then disappear after 5–10 minutes of resting.
However, it is estimated that up to two-thirds of people with PAD have no noticeable symptoms. See Peripheral arterial disease – Symptoms for more information.
PAD, atherosclerosis and cardiovascular disease
PAD is a cardiovascular disease, meaning that it affects the blood vessels.
While it is not immediately life-threatening, the fact the PAD has developed (even if it does not cause any noticeable symptoms) suggests that you have a high degree of atherosclerosis. This is a potentially serious and progressive (gets worse over time) condition where the body’s medium and large arteries become clogged up by fatty substances, such as cholesterol.
Having a high degree of atherosclerosis means you have a much higher risk of developing another, more serious cardiovascular disease, such as:
Receiving a diagnosis of PAD should therefore be taken as a serious warning sign that you need to make significant lifestyle changes (see below) to reduce your risk of disability and possibly death.
Also, if the symptoms of PAD worsen, there is a risk that the tissue of the lower leg will begin to die (this is known as gangrene), which in the most severe of cases requires the lower leg to be amputated.
How common is PAD?
Rates of cases of PAD are strongly associated with older age. It is estimated that it develops in:
- 2.5% of people under 60
- 8.3% of people aged 60–69
- 19% of people over 70
Men are more likely to develop the symptoms of PAD earlier in life than women.
Risk factors for PAD are the same as for other cardiovascular diseases and include:
PAD is treated through medication and making certain lifestyle changes. The two most important lifestyle changes are to quit smoking if you are a smoker and to exercise daily. See Peripheral arterial disease – Treatment for more information.
Surgery may be used in the more serious cases of PAD.
Outlook
The outlook for PAD depends to a large extent on whether you are willing to make, and then stick to, the recommended lifestyle changes. If you are, the outlook is moderate to good.
The outlook is less favourable if you are unable or unwilling to make lifestyle changes, especially if you are experiencing worsening symptoms of leg pain. In these circumstances, within five years of the start of symptoms, it is estimated there is a:
- one-in-four chance that symptoms will have worsened
- one-in-five chance that you will experience a non-fatal heart attack or stroke
- 5% chance that one or both of your legs will need to be amputated
- one-in-three chance that you will die
