Arteries carry blood from the heart to all areas of the body and, when healthy, have a smooth lining that promotes blood flow and helps to prevent blood clots. Peripheral arterial disease (PAD) is a condition in which fatty deposits (called plaque) build up along the walls of the arteries that carry blood to the arms and legs. This is also known as atherosclerosis or hardening of the arteries. The arteries slowly narrow and may even become blocked, affecting blood circulation, especially in the legs and feet. The February 1, 2006, issue of JAMA includes 2 articles about PAD. This Patient Page is based on one previously published in the September 19, 2001, issue of JAMA.
Painful cramping of the leg or hip muscles during walking, in some cases severe enough to hinder walking, that stops during rest; or numbness, weakness, or a feeling of heaviness in the legs with no pain
Cooling of the skin in specific areas of the legs or feet
Color changes in the skin, particularly in the arms or legs
Toe and foot sores that do not heal promptly
Burning or aching in the feet and toes while at rest and particularly while lying flat (this is a sign of more severe PAD)
Smoking is the number one risk factor for PAD and will interfere with treatment of the disease. Individuals with PAD should stop smoking completely because even 1 or 2 cigarettes daily can affect treatment.
Older age is a predictor for PAD—it occurs more frequently in those individuals 60 years of age or older.
Diabetes is a significant risk factor for PAD. Individuals with diabetes should keep strict control of their blood sugar to avoid serious problems resulting from PAD.
High blood pressure
High cholesterol levels
Tests for PAD include comparing the blood pressure in the ankle with the blood pressure in the arm. Measurement of ankle blood pressure is assisted by a Doppler device, which amplifies the sound of blood flow.
Your doctor can test you for PAD and recommend the best treatment to stop or even reverse the buildup of plaque in the arteries. Individuals with PAD should quit smoking, exercise regularly, and eat a healthy diet low in fat and salt. Medications to control high blood pressure, high cholesterol, high blood sugar, and blood clotting are often important.
American Heart Associationhttp://www.americanheart.org
Vascular Disease Foundationhttp://www.vdf.org
To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA's Web site at http://www.jama.com. Many are available in English and Spanish.
Sources: American Heart Association, Centers for Disease Control and Prevention, National Institutes of Health, Society of Cardiovascular & Interventional Radiology, Vascular Disease Foundation, World Health Organization
The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 203/259-8724.
TOPIC: VASCULAR DISEASE
Stevens LM, Lymn C, Glass RM. Peripheral Arterial Disease. JAMA. 2006;295(5):584. doi:10.1001/jama.295.5.584