Peripheral vascular disease | Rerenga toto manauhea

Also known as peripheral artery disease

Peripheral vascular disease (rerenga toto manauhea) is caused by a narrowing of your arteries causing restricted blood flow around your body, especially to your legs.

On this page, you can find the following information:

Key points

  1. Peripheral vascular disease is usually caused by a build-up of cholesterol, calcium and fat within your arteries. This build-up is commonly referred to as "plaque".
  2. Plaque causes your arteries to narrow and harden, which is known as atherosclerosis.
  3. Many people do not have any symptoms, but the most common symptom is painful, aching or tired legs when walking or exercising, which improve with rest.
  4. Risk factors include smoking, diabetes, being overweight, high cholesterol, high blood pressure, aging and a family history of atherosclerosis.
  5. Lifestyle changes, such as quitting smoking, regular exercise, healthy eating and maintaining a healthy weight, can help prevent and manage peripheral vascular disease.

Image credit: 123rf 

What are the symptoms of peripheral vascular disease?

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. 

Other symptoms include:

Legs and feet

  • hair loss
  • changes in skin colour, such as 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

What are the causes of peripheral vascular disease?

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:

  • smoke
  • have diabetes
  • are overweight
  • have heart disease
  • have high cholesterol
  • have high blood pressure.

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

How is peripheral vascular disease diagnosed?

Your GP will usually diagnosis 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, such as 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 your arms.

Depending on the severity of your peripheral vascular disease, your GP may begin treatment or refer you for further tests, such as an MRI or ultrasound, or to a vascular surgeon for further management.

How is peripheral vascular disease treated?

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, such as 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 GP may recommend medications to help reduce your cholesterol and blood pressure and manage your atherosclerosis.

What self-care can I do with peripheral vascular disease?

What we eat and how much physical activity we do throughout our life makes a big difference to our 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.

Learn more

Assessment of vascular disease Australian and New Zealand Society for Vascular Surgery, 2018


  1. Atherosclerosis Health Navigator, NZ, 2016
  2. Peripheral arterial disease Auckland Vascular Centre, NZ
  3. Peripheral arterial disease NHS Choices, UK, 2016

Information for healthcare providers

Peripheral arterial disease Patient Info Professional, UK, 2015
Peripheral arterial disease NICE Quality Standard, UK, 2014
2017 ESC guidelines on the diagnosis and treatment of peripheral arterial diseases European Society for Vascular Surgery, 2017
The ankle-brachial pressure index – an under-used tool in primary care? BPAC, NZ, 2014

Reviewed by

Dr Lupe Taumoepeau is a vascular and transplant surgeon at Wellington Hospital. While she is involved in all forms of open and endovascular surgery, her interests include management of diabetic foot disease, complex endovascular aortic surgery and renal transplant. She is also actively involved in prevocational medical education and mentoring of women wanting to pursue a career in surgery.
Credits: Health Navigator Editorial Team. Reviewed By: Dr Lupe Taumoepeau, vascular and endovascular surgeon Last reviewed: 03 May 2019