Peripheral artery disease (PAD) affects more than 10 million Americans. It occurs when plaque, a sticky mix of fat and cholesterol, builds up inside the arteries that carry blood to your legs and feet. Over time, this narrows the blood vessels and blocks blood flow. Think of it like a clogged pipe; the more blocked it gets, the harder it is for water to get through. In your body, that means your legs aren’t getting enough oxygen and nutrients, which can cause symptoms like pain, cramping, and discomfort.Â
Who Gets PAD?
PAD is most common in people 65 and older. It doesn’t affect everyone equally, as Black adults are nearly twice as likely to develop PAD as white adults. Almost 1 in 3 Black adults are at risk of developing the disease in their lifetime, compared to about 1 in 5 Hispanic or white adults.Â
The good news is that PAD is treatable, especially when diagnosed early, and knowing the facts is the first step toward changing these numbers. We spoke with Society for Vascular Surgery ambassador and vascular surgeon Dr. Xzabia Caliste to learn what PAD really looks like and what people can do about it.Â
Causes and Risk Factors of PAD
Many people don’t notice symptoms, especially in the early stages, so it’s important to know your risk factors and family history. Risk factors include:
- Older age
- Being male
- High blood pressure
- Diabetes
- Smoking
- High cholesterol
- Obesity
- Lack of exercise
- A family history of PAD, heart disease, stroke, or amputation
Ask your primary care provider about your personal risk.
Know the Warning Signs  of PAD
The most common sign is heaviness, tiredness, pain, or cramping in the legs during walking or activity that goes away with rest and comes back when you start moving again.
Other symptoms can include:
- Pain in toes or feet while resting
- Sore toes or feet that won’t healÂ
- Leg numbness or weakness
- Cold feeling in lower leg or foot
- Changes in skin color
- Slow nail or hair growth on your legs
These symptoms tend to be mild at first, so it’s easy to write them off as normal aging. Dr. Caliste urges people not to wait: “Just because you turn a certain age does not mean that these symptoms are normal.”Â
Why Do So Many People Go Undiagnosed?
Dr. Caliste says the biggest barrier is a lack of knowledge on both sides. Most people don’t realize their leg and foot pain is caused by poor blood flow, so they can’t connect what they’re feeling to what’s happening in their body. At the same time, many primary care doctors, who are responsible for managing a patient’s entire health, don’t always feel confident recognizing PAD. Additionally, many patients have never heard of vascular surgery or know what it treats.
If you’re at higher risk for PAD, the best thing you can do is tell your healthcare provider and learn more about the disease and the specialists who treat it. Dr. Caliste added that her job as a vascular surgeon is to help “save limbs and lives”, not simply perform amputations.Â
What Happens When PAD Goes Unnoticed?
Dr. Caliste says that PAD is, “quite frankly, a global epidemic.” When it isn’t caught early, tired or crampy legs after walking can progress to open wounds and severe pain for some patients. In the most serious cases, patients face a high risk of amputation.
The Toll of PAD on Independence and Mental Health
PAD doesn’t just affect the body. Dr. Caliste explained that leg pain often causes people to slow down and pull away from loved ones, which can lead to isolation and negatively impact mental health.
Fear plays a role too. Many people delay care because they assume a diagnosis means losing a limb, when in reality doctors have many ways to help patients keep their mobility and independence.
Families feel this weight as well. Dr. Caliste has seen firsthand how much stress PAD and amputation place on caregivers, who are often juggling jobs and their own families while caring for a loved one.
Small Changes, Real Results
The encouraging part of Dr. Caliste’s message is how much is within a patient’s control. “Your vote matters, your choices matter,” she said. Diet, exercise, and quitting smoking can make a real difference, and no change has to be extreme.Â
“You don’t have to run a marathon,” she said. “You can walk, you can pick up some five-pound dumbbells, whatever suits your fancy.” These changes also help related conditions like high blood pressure, high cholesterol, and diabetes, which often occur alongside PAD.
Her message also cleared up a common myth: “having PAD does not mean you will lose a limb.” Vascular surgeons have many tools and treatments they can use to save a limb long before amputation ever becomes a conversation.Â
What to Do Next
If any of these signs sound familiar, start with your primary care doctor. Ask specifically for a test called an ABI that checks blood pressure in your ankle. To prepare for that conversation, visit yourvascularhealth.org to learn more about PAD and its warning signs before your appointment.Â
Above all, Dr. Caliste wants people to feel empowered, not afraid: “I want people to know that you have control over your body. It really starts with changing your mindset… you can do something simple like walking, then you start to see some drastic changes in your healthcare and, ultimately, in your lifestyle.”
Resources
Peripheral Artery Disease- Your Vascular Health