Heart Risk Factors and Peripheral Arterial Disease

Men with certain cardiovascular risk factors may be at increased risk of developing peripheral arterial disease (PAD), according to new research from researchers at Beth Israel Deaconess Medical Center and Harvard Medical School. People with diabetes, and particularly those with Type 2 diabetes, are at increased risk of developing PAD, which affects between 8 and 10 million people in the United States.

Peripheral arterial disease is a condition in which arteries leading to the legs and feet (or in some cases, to the arms) become blocked by fatty deposits known as plaque, reducing blood flow to these extremities. Many people with PAD have no symptoms, but when symptoms do appear, they may include cramping, numbness, or weakness in the legs or feet; shiny skin or hair loss; and no pulse or a weak pulse in the legs or feet.


To determine the degree to which four cardiovascular risk factors — smoking, high blood pressure, high cholesterol, and Type 2 diabetes — are associated with the risk of PAD in men, researchers looked at 44,985 men without a history of cardiovascular disease at the beginning of the study in 1986. Participants were followed for 25 years until January 2011; the presence of risk factors was updated every other year.

At a follow-up of 24.2 years, there were 537 cases of PAD. The researchers found that each of the four risk factors was significantly and independently associated with an increased risk of the condition. All men with a risk factor had a higher risk of developing PAD than men without a risk factor, regardless of how long they’d had the risk factor; each additional risk factor roughly doubled the risk for PAD. Men without any of the risk factors had a 77% lower chance of developing PAD than all other men in the group. The longer a man had had Type 2 diabetes or high cholesterol, the higher his risk of developing PAD.

According to the study authors, “in this well-characterized cohort of US men followed up for longer than 2 decades, smoking, hypertension, hypercholesterolemia, and Type 2 diabetes each demonstrated strong, graded, and independent associations with risk of clinically significant PAD.”

To learn more about the research, read the article “Men With Certain Cardiovascular Risk Factors May Be at Increased Risk of Peripheral Artery Disease” or see the study’s abstract in The Journal of the American Medical Association. And for more information about peripheral arterial disease, see the article “When Your Legs Ache: Peripheral Arterial Disease and Diabetes.”

  • Connie Reed

    What about women – cramping of the feet that are on Chlorestrol medication? Can this cramping be reduced if not stopped?

  • Joe Schneider

    My doctor prescribed Losartin for my heart and these symptoms became unbearable until I stopped taking it. The symptoms described here could also be caused by certain medications evidently.

  • Margaret Wheeler

    What I read about diabetes type II and peripheral artery disease mentioned MEN not women. Why not?

    In 2011, I had corroted artery surgery on my left side.
    (forgive my spelling if it’s not correct)

    I asked the surgeon about my right side. He said I would eventually need the same surgery on my right side.

    I was diagnosed diabetic type II when I was about 40 years of age. I follow the rules and I eat healthy, but not large portions. I focus on fiber, protein and variety. I do have a small glass of red wine with my evening meal.

    I’m a veteran of the U.S. Navy and I get my healthcare at the VA. The care is excellent in my opinion.

  • Paula Martin

    And vibration and other work requirements of labor intensive jobs are also a factor.
    Workers in jobs that contribute to PAD should be advised by their doctors what to look out for before the pain becomes permanent.
    Stress is also linked to Diabetes and Heart Problems so that reducing stress is much more important than it is commonly promoted.

  • Diane Fennell

    Hi Ms. Wheeler,

    Thanks for your comments and for sharing your experience. With regard to your question, this particular study only looked at PAD in men, so we cannot currently say whether the same risk factors would apply to women.

    Thank you for your interest in Diabetes Self-Management!

    Diane Fennell
    Web Editor

  • mark miller

    I am a type I diabetic with current neuropathy in my feet. I have dark splotchy discoloration on both legs from my knees down to my feet and including my feet. I’ve been told that it is from my heart problems (plaque build up throughout my circulatory system and a stent in my right coronary artery). I forget the diagnostic term my cardiologist gave me??? Coronary something disease. MY concern is with loss of feeling, cramping, and weakness in both legs, what am I headed for if I don’t change my lifestyle. I smoke! I’ve also had a heart attack and two strokes within the last 3 years. I appreciate any comment you can give me.

    Thank You,

    Mark C. Miller

  • Catherine L

    I am prediabetic (last A1c 5.4) with rather severe peripheral neuropathy in my hands and feet (burning, tingling, hypersensitivity). I take Metformin, gabapentin and atorvastatin daily. For several years I have been plagued by terrible cramps in my feet, lower legs, even my thighs. This usually occurs toward the morning hours. I can hardly move for fear the cramping will start. My sleep is often disrupted because I have to jump out of bed to stretch and stop the cramping. I had a scan in my lower legs for PAD. They found nothing. I drink plenty of water to hydrate before I go to sleep in hopes that will help. I am not overweight. I am thin & and I walk 25 to 30 miles a week. What could be causing these cramps? I am at my wits end!