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Can Peripheral Artery Disease (PAD) Be Reversed?

Medically Reviewed by Brunilda Nazario, MD on October 20, 2021

Peripheral artery disease (PAD) happens when your arteries harden and narrow due to a buildup of plaque, made up of fats and other substances in your bloodstream. You get PAD, also called peripheral arterial disease, in the arteries that carry blood to your arms and legs.

If blood can’t get to these areas, tissue damage (and eventually tissue death) can occur. If it's not controlled, PAD can lead to a stroke, heart attack, kidney disease, or amputation of your foot, leg, or arm.

There’s no cure for the disease. But lifestyle changes, exercise, and medication can slow the progression of PAD and possibly reverse its symptoms.

What Lifestyle Changes Can You Make to Treat PAD?

Doctors say there are two lifestyle adjustments that are most important for people with PAD:

Exercise. Studies show that regular physical activity can lead to fewer and less serious PAD symptoms. Exercise can also reduce your risk for developing another cardiovascular disease (CVD) such as heart disease, stroke, or heart attack. Consistent workouts can also improve your mood, self-esteem, energy, and sleep.

Walking is a great option for those with PAD. Experts recommend that you walk as far and as long as you can before your pain gets hard to handle. Rest until your pain goes away. Walk again until the pain returns, then take another break. Repeat until you’ve walked for at least 30 minutes total. Do this several times a week.

Your doctor might recommend supervised exercise therapy to help manage your PAD. For this therapy, you walk on a treadmill under the supervision of a nurse or physical or exercise therapist.

Whichever exercise you do, remember that consistency is key. Make it a goal to get some kind of activity each day. You won't reap the benefits of exercise if you don’t do it frequently and regularly.

Quitting smoking. When you stop smoking, you reduce the risk that your PAD will get worse. It also lowers your odds of getting another CVD. Studies show that people who keep smoking after learning they have PAD are much more likely to die from a complication of heart disease than those who quit after their diagnosis.

Try a behavior modification program, nicotine replacement therapy, or stop-smoking support group if you need help kicking the habit.

Beyond these two lifestyle changes, several other health habits can help stabilize your PAD:

Eat a healthy diet. Many people with PAD also have high cholesterol levels. Diets low in saturated and trans fat help lower your cholesterol. Focus on meals that highlight vegetables, fruits, and whole grains. Include low-fat dairy products, fish, poultry, legumes, nuts, seeds, and non-tropical vegetable oils like olive oil. Reduce salt, added sugars, and red meat.

Stay away from certain medications. Over-the-counter cold medications that contain pseudoephedrine constrict your blood vessels and could make PAD symptoms worse.

Maintain a healthy weight. This lowers your risk of developing another form of CVD. Talk to your doctor about what a healthy weight looks like for you and the best ways to lose weight if you need to.

Cut down on alcohol. Long-term, heavy drinking can cause your heart to become enlarged, a serious condition that's not reversible. But if you stop drinking, you can keep it from getting worse.

Take care of your feet. People with PAD may have trouble with injuries on their feet and lower legs, especially if they have diabetes. Sores there may not heal properly due to poor blood flow. This puts you at a higher risk for infection. To care for your feet:

  • Wash your feet every day and dry them completely.
  • Moisturize often to avoid cracks that may lead to infection. But don't put lotion between your toes. This can promote the growth of fungus.
  • Make sure your shoes fit properly. Wear thick, dry socks.
  • Treat any fungal infections (like athlete's foot) right away.
  • Be careful not to nick yourself when you cut your nails.
  • Look over your feet every day to see if you have any injuries.
  • Have a foot doctor treat bunions, corns, or calluses.
  • If you have a foot injury, see your doctor right away.

What Medical Treatments Can Help PAD?

When you have PAD, your doctor will want to control your symptoms and stop further buildup of plaque in your arteries. Sometimes, lifestyle changes are enough to meet these goals. If not, your doctor might suggest medication or surgery.

They might prescribe drugs to prevent the blood clots that PAD can cause, lower your blood pressure and cholesterol, and control your pain and other symptoms. These could include:

Cholesterol-lowering medications. Your doctor may prescribe drugs called statins to reduce your risk of heart attack and stroke.

High blood pressure medications. Controlling your blood pressure helps protect you from heart disease and strokes.

Medication to prevent blood clots. Medications such as clopidogrel (Plavix) or aspirin work against clots by improving the blood flow to your limbs. You can also take a blood thinner called rivaroxaban (Xarelto) along with low-dose aspirin to stop clots from forming.

Medication to control blood sugar. Diabetes can make PAD worse. So it's especially important to control your blood sugar levels when you have both conditions.

Symptom-relief medications. Your doctor might prescribe drugs like cilostazol (Pletal) or pentoxifylline (Pentoxil) to treat leg pain by improving the blood flow in your legs.

Surgery. If your PAD causes pain in your legs when you walk, called claudication, you might need surgery. You could have an angioplasty, in which your doctor inserts a thin tube called a catheter into your artery through a blood vessel. They inflate a small balloon on the tip of the catheter to open the artery and flatten the plaque deposit inside. This improves blood flow. Your doctor might also insert a mesh tube, called a stent, into your artery to keep it open.

You could also have bypass surgery. In this operation, your doctor uses a blood vessel from elsewhere in your body to create a path around a blocked artery. They could also use a synthetic blood vessel for the bypass.

Thrombolic therapy. You get this procedure when you have a blood clot in your artery. Your doctor uses a catheter to inject a clot-dissolving drug directly into the vein. They use imaging techniques to guide the catheter to the right place.

Show Sources

SOURCES:

Cleveland Clinic: “Peripheral Artery Disease (PAD).”

American Heart Association: “Prevention and Treatment of PAD.”

National Health Service, UK: “Treatment: Peripheral arterial disease (PAD),” “Tips on cutting down.”

Mayo Clinic: “Peripheral artery disease (PAD).”

Vascular Medicine: "Vascular Disease Patient Information Page: Exercise for peripheral artery disease."

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