Causes of Peripheral Artery Disease

Atherosclerosis is a disease process that occurs throughout the arteries of the body. Common causes include high blood pressure, high cholesterol, cigarette smoking and lack of exercise.

Over years, plaques made of cholesterol and debris gradually obstruct the arteries.

When atherosclerosis narrows the long arteries of the legs, blood flow to the leg muscles becomes inadequate when the muscles are working. Muscle pain, called intermittent claudication, can result. Claudication typically comes on with exercise, and relieved with rest.

Depending on the arteries that are affected and where the blockage is, different muscle groups can be affected:

• Buttock and hip
• Thigh
• Calf (most common)
• Foot (less common)

But pain can be atypical and occasionally attributed to something else. Some patients describe burning or numbness. There also can be severe blockages with no pain at all. Often this is because the body grows blood vessels that “bypass” the blockages, called collateral circulation.

Other signs and symptoms include:

• Wounds that heal poorly
• Legs are cooler than the arms
• Shiny skin over the legs
• Loss of hair on the legs
• Decreased pulses in the feet

Atherosclerosis causes peripheral artery disease, coronary arter disease, and strokes through the same general process. For this reason, the risk factors are the same as for heart attacks and strokes:

• Diabetes
• Abnormal cholesterol
• Cigarette smoking
• High blood pressure

Diabetes seems to be particularly important in the development of peripheral artery disease. People with diabetes have worse peripheral artery disease, and tend to improve less with treatment.