Peripheral vascular disease | Rerenga toto manauhea

Also known as peripheral artery disease or PVD

Key points about peripheral vascular disease

  • Peripheral vascular disease (rerenga toto manauhea) is caused by narrowing of your arteries restricting blood flow around your body, especially to your legs.
  • It's usually caused by 'plaque' – a build-up of cholesterol, calcium and fat within your arteries causing them to narrow and harden (atherosclerosis).
  • Many people don't have symptoms, but the most common symptom is painful, aching or tired legs when walking or exercising, which improves with rest.
  • Risk factors include smoking, diabetes, being overweight, high cholesterol, high blood pressure, aging and a family history of atherosclerosis.
  • Lifestyle changes (eg, quitting smoking, exercise, healthy eating and maintaining a healthy weight) can help prevent and manage it.
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Peripheral vascular disease is when arteries (blood vessels carrying blood and oxygen from your heart to the rest of your body) are narrowed, usually due to a build up of fatty deposits (atherosclerosis). This leads to poor blood circulation in your legs, or sometimes your arms. You may not be aware you have it, but if it gets worse you may develop symptoms.

Image showing normal and blocked artery, atherosclerosis

Image credit: Blausen Medical Gallery 2014 via Wikimedia Commons(external link)

For many people, peripheral vascular disease causes no symptoms, or they may develop slowly over time. For others, the most common symptom is painful, aching or tired legs with walking or exercise. This is called intermittent claudication and is due to the lack of blood flow. It always occurs with activity and gets better with rest. If untreated, PAD can get worse and can lead to sores that don't heal or even gangrene (the death of muscle and/or skin).

Other symptoms include:

Legs and feet

  • Hair loss.
  • Changes in skin colour, eg, turning pale or blue.
  • Cramps.
  • Chronic ulcers.
  • Changes in temperature – one leg may feeler colder than the other.
  • Slow growing toenails.

Rest of your body

Peripheral vascular disease is caused by changes within your blood vessels. It’s usually due to atherosclerosis, which restricts blood flow to your organs, arms and legs.

You’re more at risk of developing peripheral vascular disease if you:

Your risk also increases with age and if you have a family history of atherosclerosis.

Your healthcare provider will usually diagnose peripheral vascular disease based on your symptoms and a physical examination. They will check your pulse in different places around your body and look for any signs of reduced blood flow, eg, hair loss or changes in skin colour or temperature to your legs.

They may perform a test called an ankle brachial pressure index, which compares the blood pressure of both arms to the blood pressure of both legs. If you have peripheral vascular disease the blood pressure in your legs will be much lower than in your arms.

Depending on the severity of your peripheral vascular disease, your healthcare provider may begin treatment or refer you for further tests (eg, an MRI or ultrasound), or to a vascular surgeon for further management.

Being diagnosed with peripheral vascular disease is a sign your blood vessels are unhealthy. It’s a type of cardiovascular disease and can lead to more serious problems, eg, coronary artery disease, heart disease and stroke.

There’s no cure for peripheral vascular disease so treatment is aimed at stopping it from getting worse, managing your symptoms and reducing your risk of developing further complications.

Changes to your diet and improved lifestyle choices play a significant role in managing peripheral vascular disease. These include:

Your healthcare provider may recommend medicines to help reduce your cholesterol and blood pressure and manage your atherosclerosis.

What you eat and how much physical activity you do throughout our life makes a big difference to your risk of developing peripheral vascular disease. Prevention is better than cure, so to minimise your risk:

  • don’t smoke
  • keep physically active
  • eat a healthy diet
  • have regular check-ups with your GP or nurse to monitor your blood pressure, cholesterol and diabetes risk.

Intermittent claudication and peripheral vascular disease(external link) Vascular Society of Aotearoa New Zealand


  1. Peripheral arterial disease (PAD)(external link) Centers for Disease Control CDC, US, 2024
  2. Peripheral arterial disease(external link) Auckland Vascular Centre, NZ
  3. Peripheral arterial disease(external link) NHS Choices, UK, 2016
  4. Intermittent claudication and peripheral vascular disease(external link) Vascular Society of Aotearoa New Zealand

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Credits: Healthify editorial team. Healthify is brought to you by Health Navigator Charitable Trust.

Reviewed by: Dr Art Nahill, Consultant General Physician and Clinical Educator

Last reviewed: