Although the symptoms of PAOD can vary from mild to severe, symptom severity isn't a reliable gauge of the degree of stenosis. For example, if Mr. Torres has been accumulating plaque for years, his body has probably developed compensatory collateral pathways. Another patient with a sudden obstruction, such as an acute embolus, could have the same amount of blockage but more severe symptoms because his body hasn't had time to develop alternative routes. Someone else with that degree of stenosis may not have signs and symptoms simply because he's inactive. Several factors increase the risk of developing PAOD, and the risks are compounded when more than one is present.
Hyperlipidemia plays a major role in atherogenesis.
Elevated lipid levels also increase blood viscosity, which increases the risk of occlusion. Cigarette smoking profoundly accelerates atherosclerosis. Smoking restricts blood flow by causing vasoconstriction and promoting coagulation. Quitting or reducing cigarette use to fewer than five per day dramatically lowers the risk. Not only does diabetes accelerate atherogenesis, but the disease progression may be atypical, with the distal arteries being the first to manifest symptoms.