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Medical Author:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Medical Editor:

Daniel Lee Kulick, MD, FACC, FSCAI

Daniel Lee Kulick, MD, FACC, FSCAI

Dr. Kulick received his undergraduate and medical degrees from the University of Southern California, School of Medicine. He performed his residency in internal medicine at the Harbor-University of California Los Angeles Medical Center and a fellowship in the section of cardiology at the Los Angeles County-University of Southern California Medical Center. He is board certified in Internal Medicine and Cardiology.

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In this Article

• Peripheral vascular disease facts
• What is peripheral vascular disease?
• What is atherosclerosis?
• How does atherosclerosis cause disease?
• What are potential complications of peripheral artery disease?
• What are the other causes of peripheral vascular diseases?
• Who is at risk for peripheral artery disease?
• What are the symptoms and signs of peripheral artery disease?
• How is peripheral artery disease diagnosed?
• What are the treatments for peripheral artery disease?
• Lifestyle changes
• Supervised exercise
• Medications
• Angioplasty
• Surgery
• Patient Comments: Peripheral Vascular Disease - Experience
• Find a local Cardiologist in your town
• Peripheral Vascular Disease Index

Peripheral artery disease (or peripheral arterial disease) is a common condition that affects approximately ten million adults in the U.S. About 5% of people over the age of 50 are believed to suffer from peripheral artery disease. Peripheral artery disease is slightly more common in men than in women and most often occurs in older persons (over the age of 50). The known risk factors for peripheral artery disease are those that predispose to the development of atherosclerosis. Risk factors for peripheral artery disease include:

• High blood levels of the bad LDL cholesterol and triglycerides
• Low blood levels of the good HDL cholesterol
• Cigarette smoking
• Diabetes mellitus (both type 1 and type 2 diabetes)
• High blood pressure (hypertension) or a family history of hypertension
• A family history of atherosclerotic disease
• Chronic renal failure
• Overweight or obesity
• Physical inactivity

In peripheral artery disease, the risk factors are additive, so that a person with a combination of two risk factors -- diabetes and smoking, for example -- has an increased likelihood of developing more severe peripheral artery disease than a person with only one risk factor.

Approximately half of people with peripheral artery disease do not experience any symptoms. For patients with symptoms, the most common symptoms are intermittent claudication and rest pain.

• Intermittent claudication refers to arm or leg pain or cramping in the arms or legs that occurs with exercise and subsides with rest. The severity and location of the pain of intermittent claudication vary depending upon the location and extent of blockage of the involved artery. The most common location of intermittent claudication is the calf muscle of the leg, leading to leg pain while walking. The pain in the calf muscle occurs only during exercise such as walking, and the pain steadily increases with continued walking until the patient has to stop due to intolerable pain. Then the pain quickly subsides during rest. Intermittent claudication can affect one or both legs.
• Rest pain occurs when the artery occlusion is so critical that there is not enough blood and oxygen supply to the lower extremities even at rest and represents a more serious form of the condition. The pain typically affects the feet, is usually severe, and occurs at night when the patient assumes a supine position (lying down, face up).

Other symptoms and signs of peripheral artery disease include:

• Numbness of the extremities
• Weakness and atrophy (diminished size and strength) of the calf muscle
• A feeling of coldness in the legs or feet
• Changes in color of the feet; feet turn pale when they are elevated, and turn dusky red in dependent position
• Hair loss over the dorsum of the feet and thickening of the toenails
• Painful ulcers and/or gangrene in tissue where there is critical ischemia; typically in the toes