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Treatment for peripheral artery disease, or PAD, aims to reduce symptoms and prevent the disease from getting worse. For many people, lifestyle changes, exercise and  medications can help slow PAD and even reverse symptoms.

Quitting tobacco 

Tobacco smoke is a major risk factor for PAD. It increases your risk for heart attack and . If you smoke, take steps to quit. Help is available, including behavior change programs, nicotine replacement products and medications. Quitting can slow PAD and lower your risk of other heart problems. Ask your health care professional about options to help you quit.

Learn how you can kick the habit.

Physical activity

Being physically active can help with PAD symptoms. Your health care professional may recommend supervised exercise therapy (SET). You may have to begin slowly, but walking outdoors or on a treadmill and leg exercises can ease symptoms.

For leg pain caused by PAD, called claudication, exercise usually includes short periods of walking followed by rest. Over time, this helps you walk longer before pain starts. The program works best when done in a monitored rehabilitation center. If that’s not possible, your health care professional may recommend a structured community or home-based program.

Learn more about cardiac rehabilitation.

Eating habits

Many people with PAD have elevated cholesterol levels. A diet low in saturated and trans fat can help lower blood cholesterol levels. Cholesterol-lowering medication may also be needed.

Try for a healthy diet that:

• Emphasizes vegetables, fruits and whole grains
• Includes low-fat dairy products, poultry, fish, legumes, nuts, seeds and non-tropical vegetable oils such as olive oil
• Features foods that are unprocessed or minimally processed
• Limits sodium, added sugars, sugar-sweetened beverages and red and processed meat

Medication

It’s important to take the medication that your health care professional prescribes. Not taking these medications can increase your risk for heart attack, stroke and PAD-related problems. Medications that may be prescribed include:

• Antiplatelet medication, such as aspirin and/or clopidogrel, to prevent blood clots
• Cholesterol-lowering medications, such as statins
• High blood pressure medications (In people with PAD and high blood pressure, angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers are recommended.)
• Oral anti-coagulants, such as rivaroxaban, to decrease blood clots from forming
• Low-dose rivaroxaban combined with aspirin to reduce the risk of major adverse cardiovascular events (including heart attack and stroke) and major adverse limb events (including acute limb ischemia and amputation)

If you have claudication, you may also be prescribed cilostazol to help improve your walking distance and decrease leg symptoms. Cilostazol should not be used in people with heart failure.

Talk to your health care professional about which medications you may need based on your condition and other risk factors.

In addition, people with PAD should get a yearly flu vaccine and the COVID vaccine plus boosters.

Managing diabetes

Diabetes can make PAD worse and raise the risk of serious problems. Keeping blood sugar under control helps people with diabetes and can lower the risk of leg problems in those with PAD.

Work with your health care team to manage diabetes and PAD. Your care plan may include:

• Eating healthy to manage your cholesterol and diabetes
• Reaching and staying at a healthy weight
• Medications for blood sugar control
• Managing other cardiovascular risk factors
• Taking care of your feet and preventing sores

Procedures

For some people with PAD, minimally invasive treatment or surgery may be needed.

•  or  are procedures that use a catheter placed through a tiny cut in a vein to reach a blocked artery. A small balloon is inflated inside the artery to open the clog. A small wire mesh tube, called a stent, may be placed to keep the artery open. In some cases, medication or a special device is used to remove a blood clot that’s blocking the artery. 
• An atherectomy is a minimally invasive procedure to remove plaque from an artery. A catheter is guided to the blockage, and a small cutting tool is used to remove the plaque and improve blood flow.
• Bypass surgery may be needed if a long portion of an artery in your leg is blocked and symptoms are severe. A healthy vein from another part of the body is used to reroute blood around the blockage. 

Talk with your health care professional about treatment options and the best choice for you. Get the most out of your next appointment with the PAD Discussion Guide.