What is PVD?

PVD usually happens when atherosclerosis (a build-up of fatty plaque) narrows the arteries supplying blood to your limbs. This restricts the flow of oxygen-rich blood, most commonly to your legs.

Symptoms of PVD

Symptoms can vary, and many people have none initially. Common signs include:

• Leg Pain with Activity (Intermittent Claudication): Aching, cramping, or tiredness in your leg muscles (often calves, thighs, or buttocks) that starts with walking or exercise and eases with rest.

• Leg Numbness or Weakness: After exercise or occasionally at rest.

• Coldness in one lower leg or foot.

• Slow-healing sores on toes, feet, or legs.

• Changes in skin: Shiny skin, hair loss on legs, or brittle toenails.

• Pain at Rest: In severe cases, pain in the foot or toes even when resting or when the leg is elevated in bed.

If you notice these symptoms, especially leg pain during exercise, it’s important to discuss them with your GP.

Causes and Risk Factors

The main cause is atherosclerosis. Factors that increase your risk include:

• Smoking: Active or a lengthy past history of smoking remains the biggest risk factor.

• Diabetes: Poor blood sugar control damages blood vessels over time.

• High Blood Pressure.

• High Cholesterol.

• Obesity.

• Age (over 50): Natural aging of blood vessels can contribute to atherosclerosis

• Family history of PVD or significant heart disease.

Diagnosis and Treatment

Your doctor will usually start with a Physical exam and an Ankle-Brachial Index (ABI) study, which is a non-invasive test which compares blood pressure in your ankle and arm. An Ultrasound or CT scan may also be used to assess blood flow.

Treatment aims to manage symptoms and prevent complications. This often involves:

Lifestyle Changes

• Quitting smoking (extremely important!).

• Regular exercise, especially walking programs help minimise symptoms.

• Healthy diet and weight management.

• Good management of diabetes, blood pressure, and cholesterol.

Medications

• Antiplatelet drugs (like aspirin) to prevent clots.

• Statins to lower cholesterol and slow blood vessel damage.

• Medications to improve blood flow or manage blood pressure.

Procedures & Surgery

For more severe cases:

• Angioplasty and Stenting: A procedure using keyhole access to allow the use of balloons to open the blocked artery, and a small tube (stent) to keep it open.

• Bypass Surgery: An inpatient hospital procedure under general anaesthetic, using open surgical cuts to create a new path for blood flow around a blocked vessel.

Preventing PVD

Many of the lifestyle changes for treatment also help prevent PVD:

• Don’t smoke tobacco or cannabis or vape nicotine.

• Stay active and maintain a healthy weight.

• Eat well and manage existing health conditions like diabetes, high blood pressure, and high cholesterol.

For personalised advice or concerns about PVD, consult your GP or vascular surgeon.