Peripheral arterial disease (PAD) happens when fatty deposits narrow the arteries to the legs. It affects over 200 million people worldwide, and because the same process affects the heart and brain, it’s an important warning sign.
Imagine your calves cramping every time you walk to the bus stop, forcing you to stop and wait for the pain to ease. You put it down to age. A simple test comparing blood pressure in your ankles and arms reveals PAD. A walking programme, stopping smoking and the right medicines help you walk further than you have in years.
Symptoms
- Cramping pain in the calf, thigh or buttock when walking, easing with rest (intermittent claudication)
- Cold, pale or numb feet
- Hair loss and shiny skin on the legs
- Weak pulses in the feet
- Slow-healing sores on the feet or toes
Many people have no symptoms at all.
Who’s at risk?
Smoking is the biggest risk factor. Others include diabetes, high blood pressure, high cholesterol, being over 60 and kidney disease.
But how is it treated?
- Stop smoking, the single most effective step
- Supervised walking exercise, walking until the pain is moderate, resting and repeating, which improves walking distance
- Medicines such as statins, antiplatelets and blood pressure treatment to lower heart attack and stroke risk
- Good diabetes control and foot care
- Angioplasty, stents or bypass surgery for severe disease
Get emergency help for a suddenly cold, pale, painful or numb leg or foot, which may mean a blocked artery. Also seek urgent care for pain in the foot at rest, especially at night, or a foot sore that’s turning black.
Your next step: If your legs hurt when you walk and ease when you stop, ask your doctor about an ankle-brachial pressure index test.
Sources: World Heart Federation, American Heart Association (Peripheral artery disease), NHS (Peripheral arterial disease), NICE (Peripheral arterial disease guideline).
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