Up Assessment

Peripheral Arterial Disease (PAD) of the legs

Atherosclerosis (or hardening of the arteries) of the legs affects up to one in five of the UK population aged over 60 years.

There are four main causes:

  • Smoking - this damages the "non-stick" lining of the arteries, also makes the blood extra "sticky", and prevents the blood it from carrying its full complement of oxygen

  • High blood pressure (hypertension) - this also damages the lining of the arteries

  • High blood cholesterol levels - this leads to fat furring up and eventually blocking the arteries

  • Diabetes - this condition can cause damage to arteries of all sizes

Many patients with early lower limb atherosclerosis have no symptoms.  However, as the disease progresses, many will develop intermittent claudication, which is a cramping type pain in the leg muscles when walking

Please refer to the Edinburgh Claudication Questionnaire to see if you have intermittent claudication

If intermittent claudication is not recognised, diagnosed and treated then patients can go on to develop what is termed critical or severe limb ischaemia, which manifests as pain at rest, usually in the feet and often at night. Untreated this can lead to ulceration and gangrene.

Atherosclerosis also affects the arteries of the

  • Heart  - leading to angina and heart attacks

  • Brain - leading to stroke and blindness (see page on in the carotid arteries)

  • Kidneys - leading to high blood pressure and kidney failure

  • Bowels - leading to pain in eating and weight loss

In the first instance all patients with atherosclerosis should be treated with so-called Best Medical Therapy.

Some patients with lower limb arterial disease will require further assessment and may benefit from drug therapy, exercise therapy, angioplasty or bypass surgery.


To download our information sheet on peripheral arterial disease please click here

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