Peripheral artery disease: warning signs, risks and treatment options

Peripheral artery disease (PAD) is a silent, potentially disabling condition in which narrowed arteries limit blood flow to the legs or arms. The condition often goes undiagnosed until it worsens, yet experts say it can lead to serious complications if left untreated. Estimates from medical researchers put the number of Americans living with PAD at about 21 million, a figure tied to the buildup of fat, cholesterol and other substances in artery walls. Many people with PAD don’t have noticeable symptoms in the early stages, according to Jennifer Jones-McMeans, divisional vice president of global clinical affairs for Abbott’s vascular business, who spoke with The Post. Others may mistake symptoms like leg fatigue or discomfort for normal signs of aging.

Risk factors for PAD increase significantly with age, particularly after 50, and are shaped by genetics, certain health conditions and lifestyle habits. The condition is linked to smoking, diabetes, high blood pressure and high cholesterol, and a family history of vascular disease. Jones-McMeans notes that Black and Hispanic communities are disproportionately affected. Men and women can experience PAD differently: the No. 1 symptom is pain with walking, but men most often report this, while women frequently experience achy or tired legs or leg pain at rest. Because women are diagnosed later, often at an older age, other conditions such as arthritis or nerve damage may mask leg pain.

PAD presents a range of symptoms. In addition to leg pain or cramps, people may notice numbness or tingling in the legs or feet, or hair loss on the legs. Changes in skin color or temperature can occur, with skin turning pale or blue and becoming shiny or cool to the touch. If sores develop, they may be dry, scabbed or feature a dark or discolored center. “In some cases, the skin around the wound can look shiny, pale or feel cool to the touch,” Jones-McMeans said. These wounds are a signal that blood isn’t flowing properly to the area, which can slow or prevent healing. These signs should prompt a visit to a doctor because early diagnosis can prevent serious complications.

There are several non-invasive or minimally invasive tests used to diagnose PAD. A common test is the ankle-brachial index (ABI), which compares the blood pressure in the ankle to the pressure in the arm. Other diagnostic tests include ultrasound imaging, which looks at blood flow in the arteries, or angiography, which provides a detailed view of blood vessels. Early and accurate diagnosis helps guide treatment decisions and can slow disease progression.

PAD can worsen over time without treatment. In the most serious cases, it can progress to critical limb ischemia, a condition in which tissue dies due to lack of blood flow and may lead to amputation. Reduced blood flow also increases the risk of infections and raises the likelihood of heart attack and stroke. Treatment focuses on restoring blood flow and addressing underlying risk factors. Lifestyle changes are foundational: quitting smoking, adopting a heart-healthy diet and staying physically active. Medications may be prescribed to lower cholesterol, control blood pressure or improve circulation. In more advanced cases, procedures such as angioplasty to open narrowed arteries or bypass surgery may be required.

Jones-McMeans underscored that early detection can prevent serious complications, and health professionals encourage individuals with leg pain, non-healing sores or other PAD signs—especially older adults and those with risk factors—to seek evaluation promptly. The burden of PAD is substantial, but with timely intervention, progression can often be slowed and quality of life preserved.