Peripheral artery disease (PAD)
Narrowing of the arteries that supply the legs (and sometimes arms) with blood, from the same plaque process behind heart disease. Its hallmark is leg pain on walking that eases with rest (claudication). It also signals high risk of heart attack and stroke.
What it is
Peripheral artery disease is the narrowing of the arteries that carry blood to the limbs — most often the legs — caused by the same cholesterol-plaque process, atherosclerosis, that affects the heart's arteries. As the leg arteries narrow, the muscles cannot get enough blood during exertion, and the classic symptom is intermittent claudication: a cramping, aching or tiring pain in the calf, thigh or buttock that comes on with walking and eases within minutes of rest. In more advanced disease, pain can occur at rest (often in the foot at night), and blood supply can become so poor that wounds fail to heal or tissue is threatened (critical limb ischaemia). PAD shares its risk factors with coronary disease — smoking (a particularly strong driver), diabetes, high cholesterol, high blood pressure and age — and its presence is an important marker that the same disease is likely in the heart and brain arteries, so people with PAD are at high risk of heart attack and stroke. It is assessed by symptoms, examination of pulses, and the ankle-brachial index (comparing blood pressure at the ankle and arm), with imaging when needed. Management centres on stopping smoking, supervised walking exercise, and treating cholesterol, blood pressure, diabetes and clotting risk, with procedures to restore flow in severe cases.
Key lab markers
- LDL cholesterol and related lipids (apoB, non-HDL) — central drivers; lowering LDL reduces risk.
- HbA1c / glucose — diabetes is a major contributor and worsens outcomes.
- hs-CRP — reflects the inflammatory component of atherosclerosis.
- Blood pressure and smoking status — key modifiable risks.
- Kidney function — often affected and relevant to risk.
- Note: PAD is diagnosed clinically and with the ankle-brachial index, not by a blood test; markers define and manage the underlying atherosclerotic risk.
Symptoms
- Cramping, aching or tiring pain in the calf, thigh or buttock on walking, easing with rest (intermittent claudication)
- Leg or foot pain at rest in more advanced disease, often worse at night
- Cold, pale legs or feet
- Slow-healing wounds or ulcers on the feet or legs
- Weak or absent pulses in the feet
- Hair loss or shiny skin on the legs
- In some, few symptoms despite significant disease
Related symptoms
Related lab panels
When to discuss with a doctor
Peripheral artery disease often first shows as leg pain on walking that eases with rest, which should be assessed — it can be mistaken for a joint or muscle problem. Beyond the leg symptoms, its real importance is as a red flag: PAD signals a high risk of heart attack and stroke, so finding it is a prompt to control cardiovascular risk firmly. Stopping smoking is the single most powerful step, alongside supervised walking exercise, and treating cholesterol, blood pressure and diabetes. Warning signs that need urgent assessment include leg or foot pain at rest, a sudden cold, pale, painful leg (which can mean an acute blockage — an emergency), or a foot wound that will not heal. Mediora.AI can surface the high-risk lipid, glucose and inflammatory pattern that underlies PAD and shared cardiovascular risk, but diagnosing and managing it belongs with your doctor.