A new national survey reveals a startling reality: most Americans—especially Black and Hispanic adults—have never heard of peripheral artery disease (PAD), one of the leading causes of limb amputation and a major warning sign of cardiovascular risk.
Despite affecting over 12 million Americans, PAD remains largely underdiagnosed and underdiscussed, particularly in communities at highest risk. Experts say this lack of awareness has serious consequences for early detection, treatment, and long-term survival.
What Is Peripheral Artery Disease (PAD)?
Peripheral artery disease is a cardiovascular condition caused by plaque buildup—made of cholesterol, fat, and other substances—inside the arteries that carry blood from the heart to the legs and feet. This buildup, called atherosclerosis, reduces blood flow to the limbs, making it harder for muscles and tissues to receive enough oxygen.
Without treatment, PAD can lead to chronic pain, mobility issues, ulcers, tissue death (gangrene), and even amputation. It also significantly raises the risk of heart attack and stroke.
PAD Awareness Is Alarmingly Low
The PAD Pulse Consumer Survey, which polled 2,000 Americans, found that nearly 70% of respondents had never heard of PAD or couldn’t identify its symptoms.
Dr. Kumar Madassery, director of the Peripheral Vascular Intervention & CLI Program at Rush University Medical Center, said:
“While I expected awareness to be low, I did not anticipate it would be this poor. This survey highlights an urgent need to better educate the public for the sake of our patients and the healthcare system.”
PAD’s lack of visibility contrasts sharply with its widespread impact. It affects more Americans than many better-known conditions such as multiple sclerosis or leukemia, yet remains largely unrecognized by both patients and healthcare professionals.
What Causes PAD?
The primary cause of PAD is atherosclerosis—the same process that leads to coronary artery disease. When fatty deposits accumulate in arterial walls, they narrow the passageway, restricting blood flow to the lower extremities.
This lack of circulation causes muscle pain or cramps, especially during walking or exercise, and can lead to more severe symptoms over time.
Major Risk Factors for PAD
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Smoking or tobacco use
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High blood pressure (hypertension)
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Diabetes
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High cholesterol
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Obesity
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Family history of vascular disease
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Age over 50
Smoking and diabetes together create an especially dangerous combination, dramatically accelerating PAD progression and increasing amputation risk.
A Disproportionate Impact on Black and Hispanic Americans
The new survey included 500 Black and 500 Hispanic participants—two populations shown by decades of research to face higher risks and worse outcomes from PAD.
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Black Americans are twice as likely to develop PAD as White Americans.
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About 30% of Black men and 27% of Black women will experience PAD during their lifetimes.
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Among Hispanic Americans, PAD tends to be more aggressive. Within one year of diagnosis, the risk of major amputation or death can reach 17%.
Despite these alarming figures, over 70% of Black and Hispanic respondents said they had never been told about PAD by a healthcare provider, even though most had at least one risk factor such as diabetes or high blood pressure.
Dr. Foluso Fakorede, an interventional cardiologist in Mississippi, noted:
“Nearly 80% of Black and Hispanic adults have never had a doctor talk to them about PAD. That’s a massive gap in communication and awareness.”
Dr. Anahita Dua, a vascular surgeon and co-director of the PAD and Limb Preservation Program at Massachusetts General Hospital, added:
“It’s shocking that so few people know about PAD, especially when it’s one of the most severe complications of diabetes. Minority patients face higher rates of PAD and amputation—we need to get the message out.”
This lack of awareness among at-risk populations underscores a broader issue: systemic disparities in healthcare education and preventive outreach.
Other Populations at Risk
While PAD rates are highest among Black and Hispanic adults, other groups are also vulnerable:
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Native Americans and South Asians experience disproportionately high PAD and amputation rates.
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Men over 50, especially those with a history of smoking or cardiovascular disease, are at elevated risk.
Dr. Dua emphasized,
“We need consistent outreach to all minority and high-risk groups. Regular screenings can save lives and limbs.”
Early Symptoms of PAD
Recognizing PAD early can make a major difference in outcomes. Unfortunately, symptoms often develop gradually and are mistaken for normal signs of aging.
Common early symptoms include:
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Leg pain, cramping, or fatigue during walking (intermittent claudication)
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Numbness or tingling in the feet
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Coldness in one or both legs
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Slow-healing wounds or sores
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Shiny or discolored skin on the legs
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Weak pulse in the ankles or feet
Many people ignore these signs until the disease becomes advanced. The survey found:
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91% of respondents believed leg pain is a normal part of aging.
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More than half said they would wait over a week of persistent leg pain before seeing a doctor.
This delay can allow PAD to progress silently, leading to severe complications or the need for amputation.
Why Early Diagnosis Is So Important
Because PAD symptoms overlap with normal muscle aches, diagnosis often comes too late. Yet the disease can be detected easily through a simple, non-invasive test known as the Ankle-Brachial Index (ABI).
The ABI test compares blood pressure in your arm and ankle to determine how well blood is flowing to your legs. According to Dr. Madassery:
“It’s quick, low-cost, and can identify PAD before serious damage occurs. Every high-risk patient should get screened.”
Experts recommend PAD screening if you:
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Are over 50 with a history of diabetes, smoking, or hypertension
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Experience unexplained leg pain or numbness
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Have non-healing wounds or discoloration on your legs or feet
Symptoms of Advanced PAD
As PAD progresses, blood flow becomes increasingly restricted, and symptoms worsen. Signs of advanced or critical PAD include:
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Persistent numbness or tingling
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Hair loss on lower legs
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Thickened toenails
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Skin that appears pale, blue, or shiny
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Cold feet or toes
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Sores or ulcers that don’t heal
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Gangrene (dead tissue due to lack of blood flow)
Left untreated, severe PAD can result in amputation—and tragically, half of patients who undergo a PAD-related amputation die within two years.
The Hidden Mental Health Toll
Amputation doesn’t just affect physical health—it also deeply impacts mental and emotional wellbeing.
Studies show that PAD-related amputations are linked to higher rates of depression and anxiety, both for patients and their families.
Dr. Dua explained,
“The physical and mental toll this takes on patients is immense. It’s a life-altering event that affects self-esteem, independence, and quality of life.”
Treatment Options for PAD
PAD treatment focuses on slowing disease progression, restoring blood flow, and managing underlying conditions.
Lifestyle and Medical Interventions
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Quit smoking: Tobacco accelerates arterial damage.
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Control blood pressure and diabetes: Use prescribed medications as directed.
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Adopt a structured exercise plan: Supervised walking programs improve circulation and reduce symptoms.
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Manage cholesterol: Statins or other lipid-lowering drugs can help prevent plaque buildup.
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Avoid injuries: Even minor foot cuts can lead to serious infections when blood flow is poor.
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Take medications: Blood thinners or vasodilators may prevent clots and improve leg perfusion.
Surgical Options
In severe cases, procedures may be necessary to restore blood flow, including:
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Angioplasty or stenting: Opens narrowed arteries.
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Bypass surgery: Reroutes blood around blocked arteries.
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Atherectomy: Removes plaque buildup directly from the artery.
These treatments can significantly improve mobility, reduce pain, and lower the risk of amputation.
The Urgent Need for Awareness
Experts agree: the biggest obstacle to fighting PAD is awareness.
Despite its prevalence, PAD is not commonly discussed in public health messaging or primary care settings. This is particularly true in minority communities, where systemic barriers—such as limited access to specialists, insurance gaps, and mistrust of medical institutions—compound the problem.
Dr. Madassery emphasized,
“We’ve advanced in medicine over the past 50 years, but not in how we engage and educate our patients. Awareness is the first step toward prevention.”
He added,
“If healthcare providers, insurers, and government agencies work together to educate the public, we can dramatically reduce PAD-related amputations and deaths.”
How to Protect Yourself and Loved Ones
If you or someone you know has diabetes, high blood pressure, or a history of smoking—get screened for PAD.
Here’s what you can do today:
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Ask your doctor about a PAD screening test (ABI).
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Manage chronic conditions with medication and regular checkups.
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Stay active—walking is one of the best exercises for improving circulation.
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Eat a heart-healthy diet low in saturated fats and rich in fruits, vegetables, and whole grains.
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Educate your community about PAD risk and symptoms.
Early diagnosis and lifestyle changes can make the difference between recovery and irreversible damage.
A Call to Action
PAD is preventable, detectable, and treatable—but only if people know it exists.
The PAD Pulse Consumer Survey is a wake-up call to prioritize outreach, education, and screening—especially for communities most affected.
As Dr. Dua concluded,
“It’s crucial for patients to be engaged with this information. Awareness empowers them to take charge of their health and live the healthiest lives possible.”
