Understanding Peripheral Arterial Disease

Peripheral arteries deliver oxygen-rich blood to the tissues outside the heart. As you age, your arteries become stiffer and thicker. In addition, risk factors, such as smoking and high cholesterol, can damage the artery lining. This allows plaque (a buildup of fat and other materials) to form within the artery walls. The buildup of plaque narrows the space inside the artery and sometimes blocks blood flow. Peripheral arterial disease (PAD) occurs when blood flow through the arteries is reduced due to plaque buildup. It often happens in the legs and feet, but can also occur elsewhere in the body. If this buildup occurs in the carotid artery (a large artery in the neck), it can be a major contributor to stroke.



Peripheral arteries deliver oxygen-rich blood to the tissues outside the heart. As you age, your arteries become stiffer and thicker. In addition, risk factors, such as smoking and high cholesterol, can damage the artery lining. This allows plaque (a buildup of fat and other materials) to form within the artery walls. The buildup of plaque narrows the space inside the artery and sometimes blocks blood flow. Peripheral arterial disease (PAD) occurs when blood flow through the arteries is reduced due to plaque buildup. It often happens in the legs and feet, but can also occur elsewhere in the body. If this buildup occurs in the carotid artery (a large artery in the neck), it can be a major contributor to stroke.

A Healthy Artery

An artery is a muscular tube. It has a smooth lining and flexible walls that allow blood to pass freely. When active, muscles need more oxygen, requiring increased blood flow. Healthy arteries can adapt to meet this need.



A Damaged Artery

PAD begins when the lining of an artery is damaged. This is often due to a risk factor such as smoking or diabetes. Plaque then starts to form within the artery wall. At this stage, blood flows normally, so you’re not likely to have symptoms.


A Narrowed Artery

If plaque continues to build up, the space inside the artery narrows. The artery walls become less able to expand. The artery still provides enough blood and oxygen to your muscles during rest. But when you’re active, the increased demand for blood can’t be met. As a result, your leg may cramp or ache when you walk.


A Blocked Artery

An artery can become blocked by plaque or by a blood clot lodged in a narrowed section. When this happens, oxygen can’t reach the muscle below the blockage. Then you may feel pain when lying down (rest pain). This type of pain is especially common at night when you’re lying flat. In time, the affected tissue can die. This can lead to the loss of a toe or foot.

High Blood Pressure and Peripheral Arterial Disease (PAD)

Blood pressure measures the force of blood against artery walls. High blood pressure (hypertension) can damage arteries and put you at risk of peripheral arterial disease (PAD). PAD is a disease of arteries in the legs. If you have PAD, it’s likely that arteries in other parts of the body are diseased, too. That puts you at high risk of heart attack and other heart diseases. Read on to learn how high blood pressure can lead to PAD and affect your health.

How Can High Blood Pressure Lead to Peripheral Arterial Disease?

High blood pressure promotes plaque formation. Plaque is waxy material made up of cholesterol and other particles that can build up in artery walls. When there is too much plaque, the arteries can become narrowed and restrict blood flow. If high blood pressure isn’t controlled, this makes it more likely for you to develop PAD and other heart problems. But high blood pressure can be controlled with exercise, weight loss, dietary changes, and medication.

What Happens If Blood Pressure Isn’t Controlled?
  • For every 20 mmHg systolic or 10mmHg diastolic increase in your blood pressure, your risk of death from heart disease or stroke doubles.
  • If you have diabetes, high blood pressure increases your risk of diabetes complications.
What Happens If Blood Pressure Is Controlled?

Lowering your blood pressure and keeping it low can:
  • Reduce your risk of stroke by 35 to 40%.
  • Reduce your risk of heart attack by 20 to 25%.
  • Reduce your risk of dying of heart disease by 25%.
  • Reduce your risk of diabetes complications.
High Blood Pressure and Peripheral Arterial Disease (PAD)

Cholesterol is a fatty substance that builds up in your bloodstream. High cholesterol can damage arteries. This puts you at higher risk of peripheral arterial disease (PAD). PAD is a disease of arteries in the legs. If you have PAD, it’s likely that arteries in other parts of the body are diseased, too. That puts you at high risk of heart attack and other heart diseases. Read on to learn how high cholesterol can lead to PAD and affect your health.

What Is Cholesterol?

Your total cholesterol can be measured by a blood test. There are two kinds of cholesterol:
  • LDL (low-density lipoprotein) is a particle that carries cholesterol in the bloodstream and deposits it in artery walls. It’s known as “bad cholesterol.”
  • HDL (high-density lipoprotein) is a particle that picks up excess cholesterol from artery walls. HDL is known as “good cholesterol.”
How Can High Cholesterol Lead to Peripheral Arterial Disease?

Having high cholesterol (or a high LDL level) promotes buildup of plaque in the arteries. Plaque is waxy material made up cholesterol and other particles. When there is too much plaque, the arteries can become narrowed and restrict blood flow. High levels of triglycerides (fats that travel in the blood to be used for energy) also increase risk of blockage. If high cholesterol isn’t controlled, this makes it more likely for you to develop PAD and other heart problems. But high cholesterol can be controlled with diet changes, exercise, and medication.

What Happens If High Cholesterol Isn’t Controlled?
  • The higher your LDL and triglyceride levels, the higher your risk of heart attack, stroke, and worsened PAD.
  • Even if your LDL is normal, a low HDL puts you at risk of all types of vascular disease.
What Happens If High Cholesterol Is Controlled?
  • Lowering LDL reduces the risk of heart attack, stroke, heart or artery surgery, and worsened PAD.
  • Raising HDL may also help improve these risks.
Smoking and Peripheral Arterial Disease (PAD)

Smoking is the greatest single danger to the health of your arteries. It puts you at higher risk of peripheral arterial disease (PAD). PAD is a disease of arteries in the legs. If you have PAD, it’s likely that other parts of the body are diseased, too. That puts you at high risk of heart attack or stroke. Read on to learn how smoking can lead to PAD and affect your health.

How Can Smoking Lead to Peripheral Arterial Disease?

Smoking causes inflammation that leads to plaque formation. Plaque is waxy material made up of cholesterol and other particles that can build up in artery walls. When there is too much plaque, the arteries can become narrowed and restrict blood flow. This then increases the risk of PAD and blood clots. It also worsens other risk factors such as high blood pressure and high cholesterol. These are things that make you more likely to develop arterial disease.

What Happens If You Don’t Quit Smoking?
  • You have 2 to 4 times the risk of dying of a heart attack or stroke as a nonsmoker does.
  • You have an increased risk of developing severe PAD, claudication, gangrene, or needing to have a leg or foot amputated.
  • You have an increased risk of developing an abdominal aortic aneurysm (AAA). This is a bulge in the aorta, a major artery. It can rupture suddenly and be fatal.
What Happens If You Quit Smoking?
  • Your risk of heart attack and stroke drops as soon as you quit smoking. After 1 year of not smoking, your risk of heart attack will fall by 50%. In 5 to 15 years after you quit, risk of heart attack or stroke is similar to that of someone who never smoked.
  • Your risk of amputation and other complications of PAD is reduced.
  • Your risk of developing AAA decreases.



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