2. Peripheral Artery Disease (AHA)

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.

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