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Peripheral Artery Disease Singapore

Peripheral artery disease (PAD) occurs when the arteries that carry blood to your arms and legs become narrowed or blocked by fatty deposits called plaque. This narrowing reduces blood flow to your limbs, particularly your legs, which means your muscles and tissues receive less oxygen and nutrients than they need. The condition develops gradually over time and can significantly impact your ability to walk comfortably and perform daily activities.

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Dr Adrian Mondry
Physician (FRG) | MD (HHU Düsseldorf) | MRCP (London) | IM Specialist (ÄKNo) | Hypertensiologist (DHL)
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Symptoms Causes Types Methods Treatment Prevention FAQ
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Symptoms
Causes
Types
Methods
Treatment
Prevention
FAQ

Symptoms of Peripheral Artery Disease

The symptoms of peripheral artery disease typically develop gradually as blood flow to your limbs becomes more restricted.

  • Leg pain when walking

    You may experience cramping, aching, or fatigue in your leg muscles during walking or exercise that goes away when you rest. This pain most commonly occurs in your calves but can also affect your thighs or buttocks.

  • Coldness in your lower leg or foot

    One leg or foot may feel noticeably colder than the other, especially when you compare them side by side.

  • Leg numbness or weakness

    You might notice a feeling of heaviness, weakness, or numbness in your legs, particularly after walking or during physical activity.

  • Slow-healing sores on feet or legs

    Cuts, wounds, or sores on your toes, feet, or legs may heal very slowly or not heal properly at all.

  • Changes in leg colour

    Your legs or feet may appear pale, bluish, or darker than usual, and the skin may look shiny.

  • Pain when lying down

    You might experience pain in your toes or feet when lying in bed, which may improve when you hang your legs over the side of the bed or get up and walk.

Causes and Risk Factors

  • Smoking

    Tobacco use is one of the strongest risk factors for PAD, as it damages the lining of your blood vessels and accelerates the buildup of plaque. Even light smoking or exposure to secondhand smoke increases your risk.

  • Diabetes

    High blood sugar levels can damage your blood vessels over time, making them more prone to narrowing and blockage. People with diabetes have a higher risk of developing PAD in their legs and feet.

  • High blood pressure

    Consistently elevated blood pressure puts extra strain on your artery walls, making them more susceptible to damage and plaque formation.

  • High cholesterol

    Elevated levels of cholesterol and other fats in your blood contribute directly to the formation of plaque deposits that narrow your arteries.

  • Age

    Your risk increases as you get older, with most cases occurring in people over 50. The arteries naturally become less flexible with age, and plaque has more time to accumulate.

  • Family history

    Having close relatives with PAD, heart disease, or stroke increases your likelihood of developing the condition due to inherited genetic factors.

  • Obesity

    Carrying excess weight puts additional strain on your circulatory system and is often associated with other risk factors like diabetes and high blood pressure.

  • Physical inactivity

    A sedentary lifestyle contributes to poor circulation and increases your risk of developing conditions that lead to PAD.

Types of Peripheral Artery Disease

Peripheral artery disease is typically classified based on the location and severity of the narrowed arteries.

Lower extremity PAD

This is the most common form, affecting the arteries in your legs and feet. It usually causes symptoms like leg pain when walking and can progress to more serious complications if left untreated.

Upper extremity PAD

This less common type affects the arteries in your arms and hands. You may experience arm pain during activities, weakness, or coldness in your hands and fingers.

Critical limb ischaemia

This represents the most severe stage of PAD, where blood flow is severely reduced. You may experience constant pain even at rest, slow-healing wounds, or changes in skin colour that require urgent medical attention.

Do you have risk factors like diabetes, smoking, or high cholesterol?

Consult our accredited specialist for early detection and management of peripheral artery disease.

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Testing Methods

Your doctor will use several approaches to determine if you have peripheral artery disease and assess the severity of the condition.

  • Physical examination

    Your doctor will check the pulses in your arms and legs, listen for unusual sounds in your arteries with a stethoscope, and examine your skin colour and temperature. They will also look for signs of poor healing or hair loss on your limbs.

  • Ankle-brachial index (ABI)

    This simple, painless test compares the blood pressure in your ankle with the blood pressure in your arm using a blood pressure cuff and ultrasound device. A lower reading in your ankle suggests narrowed arteries in your leg.

  • Blood tests

    Laboratory tests can check your cholesterol levels, blood sugar, and other factors that contribute to artery disease. These results help your doctor understand your overall cardiovascular risk and plan appropriate treatment.

  • Medical history review

    Your doctor will discuss your symptoms, family history, smoking habits, and other health conditions like diabetes or high blood pressure. This information helps identify risk factors and determine the likelihood of PAD.

Treatment Options

Managing peripheral artery disease often begins with medical treatments and lifestyle modifications that can improve blood flow and reduce symptoms.

Blood pressure management

Controlling high blood pressure through medication and monitoring helps protect your arteries from further damage. Regular blood pressure checks and treatment adjustments help maintain optimal levels for your cardiovascular health.

Diabetes management

Keeping blood sugar levels well-controlled through medication, monitoring, and dietary guidance helps prevent further artery damage. Proper diabetes care reduces the risk of complications in people with PAD.

Cholesterol-lowering medications

Statins and other cholesterol medications help reduce the buildup of new plaque in your arteries and may help stabilise existing deposits. These medications work alongside dietary changes to improve your overall cardiovascular health.

Blood-thinning medications

Antiplatelet drugs like aspirin help prevent blood clots from forming in your narrowed arteries. These medications reduce the risk of complete blockage that could lead to more serious complications.

Smoking cessation support

Medical guidance and support programmes help you quit smoking, which is one of the most beneficial steps in slowing PAD progression. Stopping smoking can significantly improve your symptoms and prevent further artery damage.

Prevention and Management

Preventing peripheral artery disease and managing existing symptoms focuses on controlling the underlying risk factors that contribute to artery narrowing. The most beneficial steps include stopping smoking completely, maintaining healthy blood pressure and cholesterol levels, and managing diabetes if present. Regular physical activity, particularly walking programmes that gradually increase your tolerance, can help improve circulation and reduce leg pain over time. Following prescribed medications consistently and attending regular check-ups allows for early detection of changes and adjustment of treatment as needed.

Frequently Asked Questions (FAQ)

How often should I see my doctor for PAD monitoring?

Most people with PAD need check-ups every 3-6 months initially, though this may vary based on your symptoms and how well your condition is controlled. Your doctor will recommend the appropriate follow-up schedule for your situation.

Can cold weather make my PAD symptoms worse?

Cold temperatures can worsen symptoms for some people with PAD, as cold causes blood vessels to narrow further. Keeping your legs warm and avoiding prolonged exposure to cold may help reduce discomfort.

Is it normal for PAD symptoms to vary from day to day?

Yes, it’s common for PAD symptoms to fluctuate, with some days feeling better than others. Factors like activity level, temperature, stress, and how well you’re managing other health conditions can all influence your symptoms.

Should I be concerned if my leg pain happens at night?

Pain that occurs when you’re resting, especially at night, can indicate more severe PAD and should be evaluated promptly by your doctor. This type of pain may signal that your blood flow is significantly reduced.

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Dr Adrian Mondry

Physician (FRG)|MD (HHU Düsseldorf)|Specialist for Internal Medicine (ÄKNo)|Hypertensiologist (DHL)|MRCP (London)

Dr. Mondry has over 30 years of experience as an internal medicine & hypertension specialist.

  • Previously a Senior Consultant in the Department of Medicine at the National University Hospital and Ng Teng Fong General Hospital, where he is currently a visiting consultant.

  • Hypertension Specialist accredited by the German Hypertension League (DHL)

  • Contributed to the latest Singapore ACE Clinical Guidance on “Hypertension – Tailoring the Management Plan to Optimise Blood Pressure Control” as a committee member.

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