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Peripheral arterial disease (PAD)

Peripheral arterial disease (PAD) is the development of fatty deposits or plaques localizing in the arteries and casing the walls of the arteries to become narrowed. As the fatty deposits grow larger, the arteries lose their elasticity and the smooth walls become rough causing more fatty deposits to grow on the arterial walls. Peripheral arterial disease is a condition of the blood vessels that leads to narrowing and hardening of the arteries that supply the legs and feet.

Causes, incidence, and risk factors

Peripheral arterial disease (PAD) is not a uniform occurrence. Once the walls of the artery become too narrow, the blood supply to the peripheral appendages lessens when exercising and causes leg pain and/or numbness, usually in the calves. Such a narrowing or stenosis can increase the chance of infection due to the lack of blood flow to the extremities. Blocked blood flow or occlusion can result in gangrene, i.e., tissue death.

PAD affects approximately 8 million individuals in the United States and one in five of the middle aged (65-75 years) population have evidence of PAD upon examination. Assessment for PAD in middle-aged adults can reduce cardiovascular event rates. Patients with clinical indications and physical symptoms of claudication (pain when walking) are up to four times more likely than normal people to have coronary artery disease and about half will die from a heart attack.

Risk factors for PAD are the same as those for atherosclerosis. These include:

  • Diabetes
  • High blood pressure
  • Smoking
  • Lack of exercise
  • Obesity
  • Family history of vascular disease


The classic symptoms are pain, achiness, fatigue, burning, or discomfort in the muscles of your feet, calves, or thighs. These symptoms usually appear during walking or exercise and go away after several minutes of rest.

At first, these symptoms may appear only when you walk uphill, walk faster, or walk for longer distances.

Slowly, these symptoms come on more quickly and with less exercise.

Your legs or feet may feel numb when you are at rest. The legs also may feel cool to the touch, and the skin may appear pale.

When peripheral artery disease becomes severe, you may have:

  • Impotence
  • Pain and cramps at night
  • Pain or tingling in the feet or toes, which can be so severe that even the weight of clothes or bed sheets is painful
  • Pain that is worse when the leg is elevated and improves when you dangle your legs over the side of the bed
  • Ulcers that do not heal​

New treatment option for PAD

Hoag introduces the new PAD Exercise Walking Program, an alternative therapy to increase pain-free walking and improve quality of life. Learn more.