NIH - What Is Peripheral Arterial Disease? “Peripheral arterial disease (PAD) occurs when a fatty material called plaque (plak) builds up on the inside walls of the arteries that carry blood from the heart to the head, internal organs, and limbs. PAD is also known as atherosclerotic peripheral arterial disease. The buildup of plaque on the artery walls is called atherosclerosis (ath-er-o-skler-O-sis), or hardening of the arteries. Atherosclerosis causes the arteries to narrow or become blocked, which can reduce or block blood flow. PAD most commonly affects blood flow to the legs. Blocked blood flow can cause pain and numbness. It also can increase a person's chance of getting an infection, and it can make it difficult for the person's body to fight the infection. If severe enough, blocked blood flow can cause tissue death (gangrene). PAD is the leading cause of leg amputation. … A person with PAD has a six to seven times greater risk of CAD, heart attack, stroke, or transient ischemic attack ("mini stroke") than the rest of the population. If a person has heart disease, he or she has a 1 in 3 chance of having blocked arteries in the legs. Early diagnosis and treatment of PAD, including screening high-risk individuals, are important to prevent disability and save lives. PAD treatment may stop the disease from progressing and reduce the risk of heart attack, heart disease, and stroke. Although PAD is serious, it is treatable. The buildup of plaque in the arteries can often be stopped or reversed with dietary changes, exercise, and efforts to lower high cholesterol levels and high blood pressure. In some patients, blood flow in the vessels may be improved by medicines or surgery. “

NIH - Arteriosclerosis of the extremities "Arteriosclerosis of the extremities is a disease of the blood vessels characterized by narrowing and hardening of the arteries that supply the legs and feet. This causes a decrease in blood flow that can injure nerves and other tissues. Arteriosclerosis, or "hardening of the arteries," commonly shows its effects first in the legs and feet. The narrowing of the arteries may progress to total closure (occlusion) of the vessel. The vessel walls become less elastic and cannot dilate to allow greater blood flow when needed (such as during exercise). Calcium deposits in the walls of the arteries contribute to the narrowing and stiffness. The effects of these deposits may be seen on ordinary X-rays. This is a common disorder, usually affecting men over age 50. People are at higher risk if they have a personal or family history of: Diabetes Heart disease (coronary artery disease) High blood pressure (hypertension) Kidney disease involving hemodialysis Smoking Stroke (cerebrovascular disease) Symptoms Return to top Often, symptoms affect one limb. If arteriosclerosis is in both limbs, the intensity is usually different in each. Change of color of the legs Cold legs or feet Leg pain (intermittent claudication) Occurs with exercise (such as walking) Relieved with rest Loss of hair on the legs and/or feet Muscle pain in the thighs, calves, or feet Numbness of the legs or feet at rest Paleness or blueness (cyanosis) Walking/gait abnormalities Weak or absent pulse in the limb"

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Association between ankle - brachial index and risk factor profile in patients newly diagnosed with intermittent claudication. (Circ J. 2008) “Peripheral arterial disease (PAD) affects up to 20% of adults older than 55 years and is associated with silent or symptomatic arterial disease in other vascular beds.1–3 Although the majority of PAD patients are asymptomatic with a low rate of local symptoms and complications, both symptomatic and asymptomatic PAD patients carry a higher risk for vascular events. PAD is considered as a coronary heart disease (CHD) equivalent and is characterized by high mortality rates (approximately 25–30% within 5 years for patients with symptomatic PAD), mainly from stroke and myocardial infarction.”

Peripheral Arterial Disease -- A Cardiovascular Time Bomb (Br J Diabetes Vasc Dis. 2007) “People with PAD are six times more likely to die from cardiovascular disease within 10 years than people without PAD. Evidence suggests that aggressive risk factor management will prevent many premature deaths and associated morbidity. Therefore, it is vital to identify patients and initiate effective management strategies swiftly. However, whilst 40% of PAD patients have symptomatic disease ranging from intermittent claudication to critical limb ischaemia, around 60% are asymptomatic. As a result of the low rates of detection PAD is underdiagnosed and undertreated in the UK.”

Medical treatment of peripheral arterial disease. "CONTEXT: Peripheral arterial disease (PAD) affects approximately 20% of adults older than 55 years and is a powerful predictor of myocardial infarction, stroke, and death due to vascular causes. The goals of treatment are to prevent future major coronary and cerebrovascular events and improve leg symptoms. … CONCLUSION: The substantial and increasing burden of PAD, and its local and systemic complications, can be reduced by lifestyle modification (smoking cessation, exercise) and medical therapies (nicotine replacement therapy, bupropion, antihypertensive drugs, statins, and antiplatelet drugs)."

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NIH - Peripheral Arterial Disease