Peripheral Artery Disease
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Peripheral Artery Disease

Peripheral Artery Disease Causes and Risk Factors

What causes PAD?

Atherosclerosis is the main cause of PAD.

Atherosclerosis in the leg arteries. The image shows how PAD affects the arteries in the legs. Figure A shows a normal artery with normal blood flow. The inset image shows a cross section of the normal artery. Figure B shows an artery with plaque buildup that is partially blocking blood flow. The inset image shows a cross section of the narrowed artery.
Atherosclerosis in the leg arteries. The image shows how PAD affects the arteries in the legs. Figure A shows a normal artery with normal blood flow. The inset image shows a cross section of the normal artery. Figure B shows an artery with plaque buildup that is partially blocking blood flow. The inset image shows a cross section of the narrowed artery.

 

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.

This video shows how buildup of cholesterol and other waste can lead to plaque buildup (atherosclerosis). Medical Animation Copyright © 2022 Nucleus Medical Media Inc. All rights reserved

What raises the risk of PAD?

You may have a higher risk of lower extremity PAD because of your age, family history and  genetic , 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.

Age

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  gene  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 blood clot .

Lifestyle habits

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:

Also, if you had preeclampsia or gestational diabetes during pregnancy, you have a higher risk of developing PAD later in life.

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.

Sex

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.

Facts About Peripheral Arterial Disease fact sheet
fact sheet

Facts About Peripheral Arterial Disease (P.A.D.)

Learn what PAD is, the steps you can take to reduce your risk of PAD, PAD symptoms, diagnosis and treatment.

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 activeaiming for a healthy weight, and managing stress

Follow your provider’s advice about preventing and treating conditions that raise your risk of PAD, such as diabetes, high blood pressure, and high blood cholesterol.

This video can give you some ideas to increase your physical activity level. Try to be active for 30 minutes a day to protect your heart health. If you can’t fit that in, do what you can! Even 5 minutes of physical activity has real health benefits.

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