What causes peripheral arterial disease (PAD)?

Joshua I. Greenberg, MD
Vascular Surgery
Peripheral arterial disease (PAD) is caused by a number of factors that also predispose a person to heart disease. Importantly, all of these conditions can be either prevented or treated. These include:
  • smoking
  • diabetes
  • high blood pressure
  • high cholesterol
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Peripheral arterial disease (PAD) is generally the result of a narrowing of the arteries in the pelvis and legs. Like arteriosclerosis (also called atherosclerosis), or narrowed arteries in the heart, PAD involves narrowed or blocked arteries to the lower body or extremities and has many of the same causes as its counterpart in the heart. Arterial disease often occurs as part of the aging process and affects mainly people over age 65, but younger people who have history of diabetes, high blood pressure, smoking and a family history of arteriosclerosis are at a higher risk of developing PAD.

There are other relatively uncommon causes of arterial disease, such as popliteal entrapment syndrome, in which the calf muscle tendon impinges on the artery. This uncommon syndrome tends to affect younger people.

Factors that raise the risk of PAD include:
- Smoking (the most common cause of PAD)
- High cholesterol in the blood
- High blood pressure
- Diabetes, which results in high blood sugar levels
- Age
Diabetes (especially the type II variety) is rising in prevalence in the United States. In October 2010, the U.S. Centers for Disease Control and Prevention released a report predicting that as many as one in three adults could have diabetes by the year 2050, leading to a potentially dramatic rise in PAD and its complications. It is important for people with diabetes to control their blood sugar to manage their risk of PAD.

The most common cause of peripheral arterial disease (P.A.D.) is atherosclerosis. The exact cause of atherosclerosis isn't known.

The disease may start when certain factors damage the inner layers of the arteries. These factors include:

  • Smoking
  • High amounts of certain fats and cholesterol in the blood
  • High blood pressure
  • High amounts of sugar in the blood due to insulin resistance or diabetes

When damage occurs, your body starts a healing process. The healing may cause plaque to build up where the arteries are damaged.

Over time, the plaque may crack. Blood cell fragments called platelets stick to the injured lining of the artery and may clump together to form blood clots.

The buildup of plaque or blood clots can severely narrow or block the arteries and limit the flow of oxygen-rich blood to your body.

This answer from the National Heart, Lung and Blood Institute has been reviewed and/or edited by Dr. William D. Knopf.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.