Peripheral vascular disease (PVD) is also known as peripheral arterial disease (PAD) or atherosclerosis of the extremities. Atherosclerosis is the hardening and narrowing of the arteries, which occurs when cholesterol, fatty deposits, calcium and other waste products buildup on the inner lining of the artery wall. This buildup is referred to as plaque. Plaque makes it difficult for blood to pass through the artery and in some instances causes blood clots to form at the site or become trapped at the site of the narrowing. The result is a blockage of the blood vessel. In the case of PVD, this narrowing and potential blockage occurs in the legs or feet and more rarely involves the arteries of the arms.

If you're diagnosed with this disease, you're hardly alone. Approximately eight to 12 million Americans are diagnosed with PVD. Properly diagnosing this condition is especially important because people with PVD are six to seven times more likely to have a stroke or heart attack. In other words, the presence of plaque in one arterial territory typically means it is present throughout the body's entire circulation system. This concept of a 'systemic' distribution of plaque has alerted physicians to take aggressive measures to treat and prevent progression of this atherosclerosis process when it is found in any one organ system.

The causes of atherosclerosis, which causes PVD, are generally a variety of factors, including:

• Increasing age
• Gender (men 50 years old and older are most commonly affected)
• High fat, low fiber diet
• High cholesterol levels
• High blood pressure
• Poor lifestyle (sedentary lifestyle, obesity, poor diet, smoking, etc.)

PVD is especially in common in people who are at risk for or diagnosed with coronary artery disease (and the related controllable and uncontrollable risk factors), stroke, diabetes, high blood pressure and/or kidney disease that requires hemodialysis.

To learn more about atherosclerosis, visit the coronary artery disease section of our web site.

• Leg or foot pain (especially pain that occurs when walking or exercising)
• Muscle pain in the legs or feet
• Numbness of the feet or legs when at rest
• Foot or toe wounds that heal slowly or won't heal at all
• Cold legs or feet, especially when compared to the other leg or rest of the body
• Hair loss on legs or feet
• Gangrene

If you have diabetes, talk with your physician about how to differentiate symptoms of PVD with diabetes-related leg/foot pain and numbness.

If your physician suspects PVD, he or she will conduct a thorough physical exam that includes taking the pulse of the legs and comparing them with pressure in the arms. Your physician will likely order additional tests that may include:

• Blood test
• Doppler ultrasound of the leg(s)
• CT of the legs
• Magnet resonance angiography (MRA) of the leg arteries

If you're diagnosed with PVD, your treatment plan may include:

• Medications (pain relievers, anticoagulants, antiplatelet agents and drugs that enlarge the arteries)
• A modification of exercise and rest as recommended by your physician
• Angioplasty (similar to the heart angioplasty to treat coronary artery disease but this therapy opens blood vessels in the affected extremity, rather than the arteries of the heart muscle)
• Surgery to repair, replace or bypass affected vessels in the legs or feet
• Lifestyle changes to reduce/control atherosclerosis, such as quitting smoking, improving your diet, etc.