You can get PAD with or without the risks below. The more you have, the greater your chances of getting PAD. If you have many, ask your doctor what you can do to lower them.

Things You Can Change


Smoking makes blood vessels narrow. It also builds up plaque in the arteries and raises your pulse and blood pressure. The risk of PAD is four times higher in smokers and former smokers. It can also happen up to 10 years earlier in smokers.


Not being active lowers the health of your vessels and heart. It also raises the chance of other PAD risks.

Talk to your doctor before you start any workout program. Grow the intensity slowly over time.

Long Term Health Problems

High Cholesterol

Cholesterol is a waxy matter used by the body. The body makes it and some also comes from the foods you eat. High levels of certain cholesterol in your blood can lead to atherosclerosis. This is the main cause of PAD.

High Blood Pressure

Blood pressure is the force of blood on the walls of your arteries. It can cause too much stress and force on blood vessel walls when it is too high. Over time, this causes damage. It also raises the risk of PAD. If you have high blood pressure, talk with your doctor about how to control it.

Glucose Intolerance

Glucose intolerance and diabetes happen when the body does not make insulin or does not use it well. Insulin is a hormone that helps pull sugar out of the blood and into cells for use. High levels of it can lead to atherosclerosis and blood vessel damage. Controlling your blood sugar can help lower the risk of diseases like PAD.

Obesity and Overweight

Being obese or overweight raises your risk of PAD even if you do not have other factors. Talk to your doctor about your ideal weight range. Make a plan to help you reach your goal weight.

Metabolic Syndrome

Metabolic syndrome is high blood pressure, cholesterol, blood sugar, and body weight, mainly around the midsection. People with this health problem have an greater risk of PAD because of too much stress on their heart.

HIV Infection

People with long term HIV infection may have a greater risk of PAD. The reason why is not clear.

Factors That You Can't Change


PAD and atherosclerosis get worse over time. This means the older you are, the greater the buildup may be. The heart and blood vessels also have normal changes that can affect function, such as an increase in heart size, slower heart rate, and stiffer blood vessels and valves. This decrease is often not enough to cause problems. But problems can happen when they combine with current vascular diseases, like PAD.


Men have a higher risk of heart disease, but the risk in women raises sharply after menopause. Estrogen is thought to protect blood vessels before that time. The natural drop in estrogen after menopause can lower this protection. This brings risk levels that are like those in men. As a result, men tend to get PAD earlier than women.

PAD is more likely to happen in men over the age of 40, and in women over the age of 50.


Your genes can also play a role in your risk of PAD with or without other risks listed here. Your risk of getting PAD is higher if you have a family history of PAD, high blood pressure, or high cholesterol.


Hills AJ, Shalhoub J, et al. Peripheral arterial disease. Br J Hosp Med (Lond). 2009;70(10):560-565.

Peripheral arterial disease (PAD) of lower extremities. EBSCO DynaMed Plus website. Available at: Updated August 23, 2018. Accessed August 29, 2018.

Understanding your risk for PAD. American Heart Association website. Available at: Updated October 31, 2016. Accessed August 30, 2018.

6/29/2018 DynaMed Plus Systematic Literature Surveillance Beckman JA, Duncan MS, Alcorn CW, et al. Association of HIV infection and risk of peripheral artery disease. Circulation. 2018 Mar 13 [Epub ahead of print].

Last reviewed May 2018 by EBSCO Medical Review Board Daniel A. Ostrovsky, MD  Last Updated: 8/29/2018