Peripheral Artery Disease

PAD (Peripheral Artery Disease) Awareness Month: The "Silent Amputator" Millions of Americans Don't Know They Have

September is Peripheral Artery Disease (PAD) Awareness Month, and the numbers behind it help explain why medical societies keep pushing to make this condition better known. PAD affects somewhere between 10 and 12 million Americans — some estimates put the U.S. figure as high as 20 million — and it's described by cardiologists as the largest cause of nontraumatic amputations in the country, contributing to an estimated 400 amputations every single day.

What PAD Actually Is

PAD develops when plaque builds up in the arteries that carry blood to the limbs — most commonly the legs, though it can also affect arteries supplying the arms, stomach, and head. As the Society for Cardiovascular Angiography and Interventions explains, this restricted blood fl ow can cause leg pain, cramping, or fatigue when walking or climbing stairs — a symptom called intermittent claudication — that often eases with rest. Left untreated, PAD can progress to wounds or ulcers that won't heal, changes in skin color or temperature, and in severe cases, gangrene, amputation, or death.

Why It's Called "Silent"

The reason PAD gets nicknamed the "silent amputator" is that its early symptoms are easy to dismiss. Leg fatigue or cramping on stairs is often chalked up to normal aging or being out of shape rather than a vascular warning sign. That delay has real consequences: cardiologists estimate that roughly 60% of amputation procedures performed in the U.S. could have been prevented with earlier diagnosis and treatment.

PAD is also a marker for broader cardiovascular risk — the same plaque process narrowing leg arteries is often happening elsewhere, which is why PAD significantly raises the risk of heart attack and stroke, not just limb complications.

A Disparity Problem

One of the sharpest statistics driving this year's awareness campaigns is about who's being left out of the conversation entirely. Among Black and Hispanic adults, nearly 80% report that a doctor or healthcare provider has never discussed PAD with them — despite these communities facing disproportionately higher PAD risk and worse outcomes. The PAD Pulse Alliance, a coalition of vascular medical societies, is using this September to specifically push clinicians to "kick off the conversation" with at-risk patients rather than waiting for symptoms to become severe.

Globally, the scale is even larger. PAD is estimated to affect around 230 million people worldwide, and researchers estimate at least 15% of the global population over age 50 has undiagnosed PAD.

Who's at Higher Risk

Common risk factors overlap heavily with those for other cardiovascular disease: smoking, diabetes, high blood pressure, high cholesterol, older age, and a family history of vascular disease. Because symptoms are often mild or mistaken for something else, people with these risk factors are encouraged to ask their doctor about PAD screening specifically, rather than waiting for pain to prompt the conversation.

What Screening Looks Like

The good news is that PAD screening is simple and non-invasive in most cases — commonly an ankle-brachial index test, which compares blood pressure readings at the ankle and arm. Many hospitals and vascular centers offer free or low-cost PAD screenings during September specifically because of the awareness push.

The Takeaway

PAD is common, underdiagnosed, and often treatable if caught early — which is exactly why the "silent amputator" framing exists. If you or someone you know has leg pain when walking that eases with rest, a wound on the foot or leg that won't heal, or several of the risk factors above, it's worth raising PAD by name at your next doctor's visit.

*This article is for general information and isn't a substitute for medical advice. If you're experiencing symptoms of PAD, talk to a healthcare provider about screening options.