What is peripheral vascular disease? 

Peripheral vascular disease (PVD) is a condition that impacts the blood circulation system outside of the heart and brain. It involves the narrowing, blockage, or spasms in the blood vessels, which can significantly hinder a person’s mobility and physical health. Understanding this condition is important because early recognition of symptoms can lead to more effective management and help prevent serious complications. In this guide, you will learn about the common symptoms, underlying causes, and the primary differences between various vascular disorders. 

What We’ll Discuss in This Article 

• A clear definition of peripheral vascular disease and its impact 

• Common symptoms such as leg pain, cramping, and skin changes 

• Key statistics on the prevalence of vascular issues in the UK 

• Major risk factors including smoking, diabetes, and high cholesterol 

• A comparison table between arterial and venous conditions 

• Guidance on identifying triggers and when to seek emergency help 

What is peripheral vascular disease? 

Peripheral vascular disease is a blood circulation disorder that causes the blood vessels outside of your heart and brain to narrow, block, or spasm. This condition can affect both your arteries and your veins. It typically leads to pain and fatigue, most commonly in the legs during physical activity. Management focuses on lifestyle adjustments and medical care to improve overall blood flow. 

PVD is a broad clinical term that covers any disease or disorder of the circulatory system occurring outside the brain and heart. While it most frequently affects the lower limbs, it can also impact the arms, stomach, and kidneys. When blood vessels are narrowed or blocked, the body’s tissues do not receive the oxygen and nutrients required to function properly. Recent data from the UK Quality and Outcomes Framework (QOF) for 2024/25 indicates that approximately 0.6% of the population in England, representing over 353,880 individuals, are recorded as having peripheral arterial conditions. Globally, more than 230 million people are estimated to be living with these vascular issues. 

What are the symptoms of PVD? 

Symptoms of peripheral vascular disease often include painful cramping in the hips, thighs, or calves after physical exertion, a symptom known as claudication. Other signs include leg numbness, a cold feeling in the lower leg or foot, and sores on the toes that heal slowly. Some individuals may not experience any symptoms in the early stages of the condition. 

The symptoms of PVD tend to develop gradually over time. Initially, the pain may only appear during exercise and vanish with rest. As the condition advances, pain may occur even when sitting or lying down. You might also observe physical changes in the limbs, such as a shiny appearance of the skin, hair loss on the legs, or slower growth of toenails. If one foot feels noticeably colder than the other or if the pulses in your legs are difficult to feel, these are clinical indicators that blood flow is restricted and requires assessment. 

What are the risk factors for PVD? 

The primary risk factors for peripheral vascular disease include smoking, high blood pressure, and high cholesterol. People with diabetes are at a significantly higher risk, with some studies suggesting that 80% of individuals with severe vascular issues either smoke or have diabetes. Age is also a major factor, as the condition is much more common in those aged over 50. 

Medical data suggests that the risk of PVD approximately doubles with each decade of life after the age of 40. Chronic conditions like high blood pressure can damage the vessel walls, making it easier for plaque to build up. Furthermore, a sedentary lifestyle and a high-fat diet contribute to the progression of atherosclerosis, the hardening of the arteries. Managing these risk factors through clinical support and lifestyle changes is essential for maintaining vascular health. 

Causes of Peripheral Vascular Disease 

The most frequent cause of peripheral vascular disease is atherosclerosis, which is the buildup of fatty deposits or plaque on the inner walls of the arteries. Other potential causes include injury to the limbs, unusual anatomy of muscles or ligaments, and certain infections. These factors restrict the flow of oxygenated blood to the extremities, which can lead to tissue damage if the circulation is not improved. 

Atherosclerosis is a progressive process where cholesterol and other substances accumulate, narrowing the vessels and reducing their flexibility. In some cases, PVD is caused by vasculitis, which is inflammation of the blood vessels. Blood clots can also form, causing sudden and dangerous blockages. Understanding the specific cause is necessary for healthcare professionals to determine whether the approach should involve medication, such as antiplatelets or statins, or surgical interventions. 

Triggers of Worsening Symptoms 

Triggers that can make peripheral vascular disease symptoms worse include physical overexertion, exposure to cold temperatures, and emotional stress. Smoking remains the most critical trigger, as it causes immediate constriction of the blood vessels and accelerates plaque buildup. Diets high in saturated fats can also trigger the faster progression of the condition by increasing cholesterol levels. 

When you walk uphill or carry heavy items, your muscles require more oxygen. If your vessels are narrowed, they cannot meet this demand, triggering pain. Cold weather is another external factor that causes vessels to tighten, further reducing blood flow. It is also important to avoid certain over-the-counter medications that contain stimulants, as these can trigger vessel narrowing in some patients. 

Differentiation: PVD vs PAD 

Peripheral vascular disease (PVD) is the umbrella term for any condition affecting the blood vessels outside the heart, including veins and lymphatic vessels. Peripheral arterial disease (PAD) is a specific type of PVD that only affects the arteries. Understanding this distinction is vital for determining the correct clinical path. 

Characteristic	Peripheral Arterial Disease (PAD)	Peripheral Venous Disease (PVD)
Vessels Affected	Arteries (carrying blood away from heart)	Veins (carrying blood to heart)
Pain Type	Sharp, worsens with exercise (claudication)	Heavy, dull ache, worsens with standing
Skin Changes	Cool, thin, shiny skin, hair loss	Warm, thick, tough skin, brownish colour
Swelling	Minimal or none	Common, especially around the ankles
Pulses	Weak or absent	Present and normal

Conclusion 

Peripheral vascular disease is a circulatory condition that results in restricted blood flow to the limbs, often due to atherosclerosis. Recognising signs like leg pain, coldness, and skin changes is essential for preventing complications like non-healing ulcers. Management focuses on reducing risk factors such as smoking and high blood sugar. If you experience severe, sudden, or worsening symptoms, call 999 immediately. 

Authority Snapshot 

This article was reviewed by Dr. Stefan Petrov, a UK-trained physician with an MBBS and postgraduate certifications in Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS). Dr. Petrov has extensive clinical experience in general medicine and emergency care, having worked in hospital wards and intensive care units. This guide provides an evidence-based overview of peripheral vascular disease, focusing on public safety and clinical accuracy according to UK healthcare standards.