Peripheral Artery Disease Causes and Risk Factors
What causes PAD?
Atherosclerosis is the main cause of PAD.
Atherosclerosis is a disease in which a waxy substance called plaque builds up on the inner lining of arteries. Plaque is made up of fat, cholesterol, fibrous tissue, and calcium. In PAD, plaque may reduce or fully block the flow of oxygen-rich blood through arteries to the body’s vital organs and the limbs.
This health topic focuses on PAD in the legs and feet, but other types of PAD block blood flow to the brain, kidneys, or the intestines. A person may have atherosclerosis in just a single artery or in many.
What raises the risk of PAD?
You may have a higher risk of lower extremity PAD because of your age, family history and , lifestyle habits, other medical conditions, race, ethnicity, and sex. The risk factors for PAD are mostly the same as those for coronary heart disease and carotid artery disease, which are also caused by atherosclerosis.
You can develop PAD at any age, but your risk goes up as you get older. Most people in the United States who have PAD are age 65 or older.
Worldwide, the age group for PAD is younger (ages 45 to 49) in countries with lower incomes when compared with high-income countries.
Family history and genetics
A family history of PAD, heart disease, stroke, or blood vessel disease, such as some types of vasculitis, raises your risk of PAD. Researchers are studying variations that seem to increase the risk of PAD or could make the disease worse.
Genetic studies have found that certain gene variations are found in different types of atherosclerotic diseases, such as PAD, carotid artery disease, and coronary heart disease. An example is the gene variation that is found in factor V Leiden disorder, a specific gene mutation that leads to an increased risk of .
Over time, unhealthy lifestyle habits can lead to plaque buildup in the leg and foot arteries, causing PAD. These habits may include the following:
- Smoking or regularly breathing in secondhand smoke damages your blood vessels, raises your blood pressure, and causes unhealthy cholesterol levels. The nicotine in tobacco also makes your blood vessels tighten and reduces blood flow in your legs. Quitting smoking is a very important step in lowering your risk of PAD.
- Not getting enough physical activity can make other PAD risk factors worse.
- Stress can make your arteries tighten and narrow.
- Eating foods high in saturated fats and following other unhealthy eating patterns can also increase your risk of PAD. Butter, palm and coconut oils, cheese, and red meat have high amounts of saturated fat.
Other medical conditions
Medical conditions that raise your risk of developing PAD include:
- Disorders that cause blood clots, such as thrombocytosis or antiphospholipid syndrome
- Fibromuscular dysplasia, a condition that occurs when cells in the artery walls grow too much, making the artery narrow
- High blood pressure
- Metabolic syndrome
- Unhealthy blood cholesterol levels or high blood triglycerides
Race or ethnicity
African American people have a higher risk of PAD than people of other races or ethnicities. African Americans are also more likely to have complications of PAD, such as problems walking or loss of a limb.
Additionally, American Indian women have a higher risk of PAD than white or Asian American women do. Hispanic or Latino people and white people have similar risk levels. However, NHLBI research found that rates of lower extremity PAD are higher among Hispanic and Latino adults who have highly sedentary lifestyles, even when they do not have any other risk factors.
Men and women have a similar risk of developing PAD, but PAD affects men and women differently.
Women are more likely than men to have PAD without symptoms. However, women also frequently have more PAD complications, such as problems walking.
How can you prevent PAD?
To help you prevent PAD, your provider may talk to you about heart-healthy lifestyle changes and managing conditions that may lead to PAD.
Heart-healthy lifestyle changes include quitting smoking, choosing a heart-healthy eating pattern (such as the DASH eating plan), being physically active, aiming for a healthy weight, and managing stress.