Understanding peripheral arterial disease

That leg cramp may be a sign of something serious

Peripheral arterial disease (PAD) is a common, yet often overlooked, circulatory condition that affects more than 12 million Americans and 200 million people worldwide. ¹

Despite its prevalence, many individuals don’t know they have it because they have either mild or no symptoms.

Here’s what you need to know about PAD.

What is peripheral arterial disease?

PAD happens when narrowed or blocked arteries reduce blood flow to the limbs, most commonly the legs. This narrowing is typically caused by atherosclerosis, a condition that develops when fatty plaque builds up in the arteries. As a result, affected individuals may experience symptoms such as leg pain, numbness, weakness and difficulty walking, especially during physical activity.

We often focus on our heart when we think about plaque buildup, but the arteries of the legs and feet are the second most common area of concern. PAD raises your risk for developing coronary artery disease and cerebrovascular disease, which can ultimately lead to heart attack or stroke.

Peripheral arterial disease symptoms

One of the hallmark symptoms of PAD is leg cramping, usually in the first few minutes while walking, which subsides with rest. Some people experience aches or cramps in their buttocks, hips, thighs or calves. However, PAD can manifest in various ways, and some people may not experience noticeable symptoms until the condition has progressed significantly.

Other potential PAD symptoms to watch for include coldness or discoloration of the legs, slow-healing wounds or ulcers on the feet or legs, weakened or absent pulse in the affected limb, muscle atrophy, hair loss, smooth, shiny skin that’s cool to the touch, or cold or numb toes.

Identifying risk factors of peripheral arterial disease

Several factors can increase the risk of developing PAD, but the most significant risk factor is smoking. Those who smoke are three to four times more at risk for developing PAD than those who don’t smoke.²

Other PAD risk factors include:

• Diabetes. Individuals with diabetes are at a higher risk of developing PAD due to elevated blood sugar levels that can damage blood vessels.
• High blood pressure and/or cholesterol. Hypertension (high blood pressure) and high cholesterol levels contribute to the buildup of plaque in the arteries — narrowing blood vessels and restricting blood flow.
• Age. Individuals older than 60 are more likely to develop PAD.
• Family history. A family history of vascular disease is associated with an increased risk of PAD.

Diagnosing peripheral arterial disease

Early diagnosis and intervention are crucial for PAD management and preventing complications. Healthcare providers may perform a variety of diagnostic tests, including ankle-brachial index (ABI) measurement, ultrasound, and CT or MRI angiography, to assess blood flow and identify blockages in the arteries.

Peripheral arterial disease treatment

Treatment for PAD aims to relieve symptoms, improve blood flow and reduce the risk of complications such as heart attack or stroke. Lifestyle modifications such as quitting smoking, getting regular exercise and eating a heart healthy diet are important components of PAD management.

In addition, your doctor may prescribe medications such as antiplatelet agents (aspirin, Plavix^®), statins (Lipitor^®, Crestor^®, Zocor^®) and medications to control blood pressure or blood sugar to manage underlying risk factors.

In some cases, more invasive intervention such as angioplasty or stenting, atherectomy or bypass surgery may be recommended to restore blood flow to the affected limb.

Preventing peripheral arterial disease

While certain risk factors of PAD like age and family history are outside your control, there are several proactive steps individuals can take to reduce their risk and prevent the progression of PAD. These include:

• Quitting smoking
• Maintaining a healthy weight
• Managing stress
• Exercising regularly, particularly walking
• Following a balanced diet low in saturated fats and cholesterol
• Managing underlying conditions such as diabetes, high blood pressure and high cholesterol through medication and/or lifestyle modifications

Our pharmacists are here for you

At Express Scripts^® Pharmacy, we understand the challenges of managing a chronic condition such as PAD. That’s why our pharmacists are available 24/7 to answer any of your questions or concerns by phone. From guidance on lifestyle changes to medication management, our dedicated pharmacists are committed to providing you with personalized care.

1 American Heart Association, Circulation: Health Disparities in Peripheral Artery Disease: A Scientific Statement From the American Heart Association (June 15, 2023): ahajournals.org.
2 National Library of Medicine: A modern day perspective on smoking in peripheral artery disease (April 28, 2023): ncbi.nlm.nih.gov/pmc/articles/PMC10175606/.