The AHA identifies peripheral artery disease (PAD) as a manifestation of systemic atherosclerosis. PAD reduces blood flow to the legs and feet due to narrowed arteries.
Reduced blood flow leads to:
Delayed wound Healing
Increased infection risk
Higher likelihood of ulcers
In severe cases, tissue death (gangrene)
When neuropathy and PAD occur together — a common scenario in people with diabetes — the risk of serious foot complications increases dramatically.
Warning Signs in the Feet That May Reflect Cardiovascular Risk
Both the ADA and AHA emphasize that early recognition of vascular and neurological symptoms is essential.
Watch for:
• Cold feet or decreased temperature
May indicate reduced arterial blood flow.
• Swelling in ankles or feet
According to the AHA, persistent swelling (edema) can be a sign of heart failure.
• Leg pain during walking (claudication)
A classic PAD symptom described in AHA guidelines — pain that improves with rest.
• Slow-healing wounds
The ADA recommends immediate evaluation of any foot ulcer that does not improve within two weeks.
• Skin discoloration (pale, bluish, or reddish tone)
May signal compromised circulation.
The Compounded Risk
The ADA reports that people with diabetes are at significantly increased risk for lower-extremity amputation, particularly when peripheral neuropathy and PAD coexist.
The AHA further states that PAD is not just a leg problem — it is a marker of widespread atherosclerosis and increases the risk of heart attack and stroke.
This means that foot symptoms may indicate broader cardiovascular disease.
Guideline-Based Prevention Strategies
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