What Causes Peripheral Artery Disease?

Reviewed by Suzanne R. Steinbaum, MD on April 16, 2019

Peripheral artery disease, or PAD, usually affects your legs and can make it hard to walk because of pain or cramping. Naturally, you want to know why it happens.

With PAD, your limbs don’t get enough blood to keep up with your body’s needs. While most people feel it in their legs, it could also affect arteries that carry blood to your head, arms, kidneys, and stomach.

It is important to find out what is causing this condition in you or someone you love so you can begin the right treatment.

The Biggest Cause: Plaque

The most common cause of PAD is a blockage in the arteries, the vessels that carry blood away from the heart.

Over time, these blockages can collect all sorts of things in your blood, such as cholesterol, fats, calcium, and other substances. These mix together and are called plaque. It can pile up in the walls of your arteries.

When plaque builds and hardens, there’s less room for the blood to get through. This condition is called atherosclerosis.

The Problem With PAD

The blockage becomes a problem because fresh oxygen and blood can’t reach your limbs. This can create pain, weakness, or numbness in the legs.

Doctors don’t know exactly why plaque builds up in the first place. They think it’s a slow-growing disease that could have its start back in childhood.

The condition could begin if there’s damage or injury in the artery. You might have a greater chance of atherosclerosis depending on your lifestyle and whether you have another condition such as diabetes or high blood pressure, or if you smoke.

A lot of people have atherosclerosis. It’s a serious condition that can lead to other problems such as heart attack and stroke.

When your atherosclerosis is in your legs, arms, or pelvis, doctors call it PAD. You and your doctor can treat it with lifestyle changes, drugs, or if needed, surgery or other kinds of procedures.

Less Common Causes

If you don’t have atherosclerosis, your doctor may start to look for these:

● Infection or inflammation of a blood vessel

● Injury to your arms or legs

● Irregular shape of your muscles or ligaments (the tissue that connects your bones or joints together)

● Exposure to radiation

People More Likely to Get PAD

You’re more likely to get peripheral artery disease if:

If you have heart disease, you have a 1-in-3 chance of also having this condition.


You can’t control how old you are or change your family history, but you can take action on some aspects of your health. Look at your lifestyle and see if there are things you can do to lower your chances of getting PAD.

The advice is similar to what you might hear your doctor recommend even if you didn’t have PAD:


· Stop smoking

· Move and exercise

· Get to a good level with your blood pressure and cholesterol

· Stay on top of your blood sugar levels, especially if you have diabetes

WebMD Medical Reference



Mayo Clinic. “Overview: Peripheral Artery Disease,” “Symptoms and Causes Arteriosclerosis/Atherosclerosis.”

CDC: “Peripheral Arterial Disease (PAD) Fact Sheet.”

National Institutes of Health. “Facts about Peripheral Arterial Disease,” “What Is Peripheral Artery Disease?” “What Causes Atherosclerosis?” “Who Is at Risk for Atherosclerosis?” “High Blood Cholesterol: What You Need To Know.”

National Institutes of Health. National Heart, Lung, and Blood Institute. “What is Atherosclerosis?”

Johns Hopkins Medicine. “Peripheral Vascular Disease.”

NIH Senior Health. “What is P.A.D.?”

American Diabetes Association. “Peripheral Arterial Disease.”

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