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. For example, although superficial femoral artery occlusion is common in PAOD, management becomes more difficult if the patient also has blockages in the small tibial arteries. Because his distal vessels are affected, he may not be a suitable candidate for surgical correction and his risk of amputation increases. It causes the artery walls to lose elasticity and increases plaque formation.