Lifestyle Medicine and Peripheral Artery Disease in Viet Nam: Structured Exercise, Cardiovascular Risk, and Limb Safety

Lifestyle Medicine and Peripheral Artery Disease in Viet Nam: Structured Exercise, Cardiovascular Risk, and Limb Safety

Last reviewed: October 30, 2026

A person with peripheral artery disease may develop calf pain after walking a short distance. The discomfort improves with rest, but over time, walking becomes more difficult. A trip to the market takes longer, climbing stairs becomes uncomfortable, and activities that once seemed ordinary gradually become harder to manage.

Another person may have significant disease in the arteries supplying the legs without experiencing typical pain. This can occur in people with diabetes-related neuropathy, whose reduced sensation may make symptoms less noticeable. Others gradually reduce their physical activity without recognizing how much their walking ability has changed.

Although these patients may have the same underlying vascular condition, their clinical needs can be quite different.

Peripheral artery disease is often discussed in relation to walking exercise and smoking cessation. Both are important, but effective management involves more than improving mobility. The condition is associated with increased risks of myocardial infarction, stroke, serious limb complications and premature death. Treatment must therefore address cardiovascular protection and limb safety alongside physical function.

Evidence-based Lifestyle Medicine can contribute through structured exercise, smoking cessation, appropriate nutrition and support for sustainable health behaviors. However, these interventions need to be guided by clinical assessment and integrated with established medical care.

For healthcare professionals in Viet Nam, the challenge is to identify who can benefit from exercise, who needs urgent vascular evaluation and how to support meaningful improvements without delaying necessary treatment.

Peripheral Artery Disease Is More Than a Walking Problem

Peripheral artery disease involves impaired arterial circulation, most commonly because of atherosclerosis. Although arterial disease can affect different parts of the body, this article focuses on atherosclerotic disease of the lower extremities.

The 2024 American College of Cardiology and American Heart Association guideline identifies four clinical presentations: asymptomatic peripheral artery disease, chronic symptomatic disease, chronic limb-threatening ischemia and acute limb ischemia.

These categories matter because they represent different clinical circumstances and treatment priorities.

Patients with chronic symptomatic disease may experience intermittent claudication, typically described as discomfort in the calf, thigh or buttock during walking that improves after stopping activity. Others experience less characteristic symptoms, including fatigue, weakness or reduced walking endurance.

Not everyone with peripheral artery disease reports pain. Some people gradually limit their physical activity to avoid discomfort without consciously recognizing the reason. Others have sensory impairment, musculoskeletal conditions or additional medical problems that make symptoms difficult to interpret.

At the more severe end of the spectrum, chronic limb-threatening ischemia may involve ischemic pain at rest, nonhealing wounds or gangrene. Acute limb ischemia, caused by a sudden reduction in arterial blood flow, represents a vascular emergency.

The distinction between these presentations is essential. A person with stable intermittent claudication may benefit from structured walking rehabilitation, while someone with a nonhealing ischemic wound or sudden deterioration in limb circulation may need urgent specialist assessment.

Peripheral artery disease also reflects a broader vascular problem. Atherosclerosis affecting the arteries of the legs may coexist with coronary artery disease, cerebrovascular disease or atherosclerosis in other arterial territories.

Consequently, improving walking ability is only one part of effective management. Patients also need appropriate assessment and treatment of cardiovascular risk.

Recognizing Peripheral Artery Disease Before Serious Complications Develop

Clinical evaluation begins with the patient's history, cardiovascular risk factors, symptoms and examination of the lower extremities.

Smoking, diabetes, hypertension, dyslipidemia, chronic kidney disease, older age and established atherosclerotic cardiovascular disease are among the factors associated with increased peripheral artery disease risk.

Healthcare professionals should ask about exertional leg discomfort, changes in walking distance, pain at rest, previous wounds and any history of vascular treatment. Examination may include assessment of peripheral pulses, skin temperature, color changes, foot integrity and signs of tissue damage.

However, symptoms and physical examination findings alone cannot reliably confirm or exclude the condition in every patient.

The resting ankle-brachial index is a widely recommended initial physiological test. It compares systolic blood pressure measured at the ankle with systolic blood pressure measured in the arm.

According to the 2024 American guideline, an ankle-brachial index of 0.90 or lower is considered abnormal and supports a diagnosis of peripheral artery disease. Values between 0.91 and 0.99 are classified as borderline, while values from 1.00 to 1.40 are generally considered normal.

A value above 1.40 suggests noncompressible arteries, which can make the measurement unreliable.

Interpretation becomes particularly important in patients with diabetes or chronic kidney disease. Arterial calcification can make vessels difficult to compress and produce falsely elevated ankle pressure measurements.

In these circumstances, additional physiological investigations, such as toe pressure measurements or the toe-brachial index with appropriate waveform assessment, may be necessary.

Patients with exertional leg symptoms but normal or borderline resting ankle-brachial index measurements may also require exercise ankle-brachial index testing when clinically indicated.

For patients with suspected chronic limb-threatening ischemia, additional measures of tissue perfusion may help assess disease severity and the likelihood of wound healing.

Vascular ultrasound and other anatomical imaging techniques can help define arterial disease when the information is needed for further assessment or treatment planning. However, not everyone with suspected peripheral artery disease requires computed tomography angiography or invasive angiography.

Diagnostic testing should be selected according to the clinical question and whether the findings are likely to influence management.

Risk-based assessment is also different from indiscriminate screening. The 2024 American guideline considers resting ankle-brachial index screening reasonable in people at increased risk of peripheral artery disease. Routine screening is not recommended for individuals without suggestive symptoms, examination findings or increased risk.

For healthcare services, this approach helps avoid both missed diagnoses and unnecessary investigations.

What Recent Evidence From Viet Nam Tells Us

A study published in the Vietnam Journal of Community Medicine on June 25, 2026, examined clinical and paraclinical characteristics of lower-extremity arterial disease among patients with type 2 diabetes at Viet Tiep Friendship Hospital in Hai Phong.

The investigators conducted a cross-sectional study involving 42 patients with diabetes and peripheral artery disease and 46 patients with diabetes but without peripheral artery disease. Participants received care at the hospital's cardiology and nephrology–endocrinology departments between January 2023 and June 2024.

Among the 42 patients with peripheral artery disease, 57.2% were classified as asymptomatic, while 28.6% experienced typical intermittent claudication. The investigators also reported associations with factors including older age, hypertension, smoking, poorer glycemic control, chronic kidney disease and established atherosclerotic cardiovascular disease.

These findings illustrate how peripheral artery disease may be present without the classic symptoms that patients or healthcare professionals expect.

A person with diabetes may already have neuropathy, musculoskeletal limitations or reduced physical activity, making it difficult to recognize vascular symptoms from history alone.

However, the study's limitations must be considered.

The sample was relatively small and consisted of selected hospital patients. It was not designed to estimate peripheral artery disease prevalence in the Vietnamese population or among all people living with diabetes.

The associations identified in a cross-sectional study also cannot establish that individual risk factors caused the disease. The reported proportion of asymptomatic patients should therefore not be interpreted as a national estimate.

Nevertheless, the research provides locally relevant evidence supporting careful vascular assessment in patients with diabetes and other risk factors.

For healthcare professionals in Viet Nam, the practical implication is to consider peripheral artery disease when clinical risk, functional changes or examination findings raise concern, rather than relying exclusively on typical calf pain.

Structured Exercise Is More Than Advising Someone to Walk More

Exercise therapy is one of the most strongly supported interventions for improving walking performance in appropriately selected patients with chronic symptomatic peripheral artery disease.

The 2024 American College of Cardiology and American Heart Association guideline recommends supervised exercise therapy and structured community-based exercise programs incorporating behavior-change techniques. Both approaches have demonstrated benefits for walking performance, functional status and health-related quality of life.

The 2024 European Society of Cardiology guideline also recommends supervised exercise training for symptomatic lower-extremity arterial disease. Structured home-based exercise may provide an alternative when supervised programs are unavailable or impractical.

More recently, the American College of Cardiology published its scientific statement, Exercise Prescriptions for Cardiovascular Health in Adults, on October 15, 2026. The statement reinforces structured exercise as a first-line treatment for appropriately selected patients with intermittent claudication and emphasizes individualized exercise prescription across cardiovascular conditions.

The important distinction is that structured exercise follows a plan developed according to the patient's clinical condition.

It involves appropriate initial assessment, selection of the exercise modality, instructions on intensity and progression, monitoring of symptoms and reassessment of functional outcomes. Simply telling someone to walk more does not provide the same level of support.

Supervised walking programs commonly involve repeated periods of walking followed by rest when claudication discomfort develops. Walking intensity and progression are adjusted according to clinical assessment, symptoms, functional capacity and treatment tolerance.

The European guideline describes programs commonly performed at least three times per week, with sessions lasting approximately 30–60 minutes over at least 12 weeks.

The American guidance similarly describes supervised programs involving approximately 30–45 minutes of active training within a longer session, generally performed at least three times weekly over a minimum of 12 weeks.

These parameters characterize evidence-based rehabilitation programs. They should not be interpreted as an exercise prescription that every patient can follow independently.

An important consideration is how claudication discomfort is managed during training.

The October 2026 American College of Cardiology scientific statement supports repeated walking intervals to moderate or near-maximal claudication discomfort, followed by rest and gradual progression as tolerated.

However, this recommendation applies within an appropriately selected and structured exercise program. It does not mean that patients should independently continue walking through severe or unfamiliar pain.

The European guidance recognizes that walking performance can improve at different levels of claudication discomfort, including lower levels of pain. It also notes that prescribing high-pain exercise may reduce participation and long-term adherence.

A flexible approach that considers patient preferences, clinical circumstances and treatment tolerance is therefore appropriate.

Patients should understand the difference between discomfort anticipated within their agreed exercise plan and new or concerning symptoms that require reassessment.

New severe pain, pain at rest, sudden coldness of the limb, sensory changes, weakness or other signs of possible acute ischemia should never be managed by simply continuing to walk.

Although walking is the most extensively studied form of exercise, it is not the only option.

Stationary cycling, recumbent stepping, arm ergometry and selected strengthening exercises may provide benefits for patients who cannot tolerate conventional walking programs.

The most appropriate approach depends on vascular status, cardiovascular stability, mobility, balance, foot condition, coexisting medical problems and personal goals.

The updated 2026 scientific statement also highlights the importance of considering frequency, intensity, duration, exercise type and progression when developing individualized programs.

These principles reinforce the role of exercise as a clinically planned intervention rather than general advice to increase activity without assessment or follow-up.

Better Walking Capacity Does Not Necessarily Mean an Artery Has Reopened

One important distinction in exercise rehabilitation is the difference between improving physical performance and reversing arterial obstruction.

A patient may become able to walk farther, tolerate activity for longer and experience fewer functional limitations even when their resting ankle-brachial index remains unchanged.

These improvements may reflect adaptations in skeletal muscle function, energy metabolism, physical conditioning and the ability to perform repeated activity.

They do not necessarily mean that a narrowed artery has reopened or that atherosclerotic disease has disappeared.

The 2024 European Society of Cardiology guideline notes that exercise training can improve walking performance without consistently increasing the ankle-brachial index.

This distinction matters when communicating treatment outcomes.

A rehabilitation program should not be described as restoring arterial circulation solely because the patient can walk farther. Conversely, an unchanged ankle-brachial index does not automatically mean that exercise therapy has failed.

The interpretation depends on the outcome the intervention was designed to improve.

For someone whose main problem is intermittent claudication, meaningful outcomes may include increased walking distance, fewer limitations in daily activities and improved quality of life.

Vascular status and cardiovascular risk still require appropriate assessment and management.

Healthcare professionals should avoid suggesting that lifestyle interventions can reliably remove established arterial plaques or replace procedures when restoring blood flow is medically necessary.

Accurate communication helps patients understand both the value and the limits of exercise rehabilitation.

Exercise Safety and the Importance of Protecting the Limb

The strongest evidence for structured walking rehabilitation applies to appropriately selected patients with chronic symptomatic peripheral artery disease, particularly those with stable intermittent claudication.

It should not be applied indiscriminately to people with advanced ischemia.

Chronic limb-threatening ischemia may involve ischemic pain at rest, nonhealing wounds or gangrene in the presence of significant arterial disease.

These findings require prompt vascular assessment because tissue viability may already be compromised.

In people with diabetes, neuropathy can reduce pain perception. A patient may develop a serious foot wound without experiencing the degree of pain that would normally be expected.

The absence of severe pain therefore does not establish that the limb is safe.

Nonhealing foot ulcers, new tissue damage, gangrene or worsening ischemic symptoms should prompt appropriate specialist evaluation rather than routine advice to increase walking.

Acute limb ischemia requires even greater urgency.

Sudden severe limb pain, pallor, coldness, reduced pulses, new numbness or weakness may indicate an abrupt reduction in arterial blood flow.

Not every patient develops all these features, and emergency assessment should not be delayed while waiting for a complete set of symptoms.

The 2024 American and European guidelines emphasize urgent treatment of acute limb ischemia and timely consideration of revascularization in appropriate patients with chronic limb-threatening ischemia.

Exercise therapy cannot substitute for these interventions.

Preventive foot care also deserves attention throughout the course of peripheral artery disease.

Regular foot inspection, appropriate footwear, skin protection and early assessment of wounds or infection can help identify problems before they become severe.

These measures are particularly important for patients with diabetes, peripheral neuropathy, previous ulcers, foot deformities or impaired mobility.

The American guideline recommends regular clinical foot inspection and comprehensive preventive foot evaluation, with additional protective measures for patients at increased risk of ulceration or amputation.

Exercise programs should take foot integrity into account.

A patient with an active wound, significant neuropathy or impaired protective sensation may require a different rehabilitation approach from someone with stable claudication and intact skin.

For some patients, modified or non-weight-bearing activities may be considered, depending on wound characteristics, perfusion status and specialist assessment.

The goal is to support physical function without exposing an already vulnerable limb to avoidable harm.

Cardiovascular Risk Reduction Must Continue Alongside Exercise

Peripheral artery disease is a manifestation of systemic atherosclerotic disease.

Improving walking performance is valuable, but it does not remove the patient's underlying risk of myocardial infarction, stroke or other cardiovascular events.

The 2024 American guideline recommends comprehensive medical management, including appropriate lipid-lowering therapy, antithrombotic treatment, blood pressure management, diabetes care and smoking cessation.

High-intensity statin therapy is a central component of cardiovascular risk reduction for patients with peripheral artery disease when appropriate and tolerated. Additional lipid-lowering treatment may be indicated according to clinical risk, treatment response and relevant professional recommendations.

Antiplatelet therapy is recommended for appropriate patients with symptomatic peripheral artery disease.

In selected patients who are not at increased bleeding risk, low-dose rivaroxaban combined with low-dose aspirin can reduce major cardiovascular and limb events.

However, this combination is not suitable for everyone.

Treatment decisions require consideration of bleeding risk, contraindications, concurrent medications, kidney function and the patient's overall clinical condition.

The indication may also differ between asymptomatic disease, chronic symptomatic disease and the period following lower-extremity revascularization.

Importantly, full-intensity anticoagulation should not be prescribed solely to reduce cardiovascular or limb events in patients with peripheral artery disease who have no other established indication for anticoagulation.

The 2024 American guideline specifically identifies this practice as potentially harmful. The distinction between low-dose rivaroxaban used with aspirin for selected patients and full-intensity anticoagulation is therefore clinically important.

These medicines should never be started, stopped or adjusted solely on the basis of general Lifestyle Medicine advice.

Diabetes management is particularly important because the combination of diabetes and peripheral artery disease is associated with elevated cardiovascular and limb risks.

The American College of Cardiology published a scientific statement on managing peripheral artery disease in adults with diabetes in December 2025, with final journal publication in 2026.

The statement emphasizes integrated care that addresses cardiovascular, kidney, metabolic and limb protection rather than treating individual risk factors separately.

Smoking cessation is another major priority.

Continued tobacco exposure contributes to cardiovascular and limb risk. Effective cessation support may involve structured behavioral interventions, follow-up and appropriate pharmacological treatment.

Simply advising patients to stop smoking is less useful than helping them access an evidence-based cessation pathway.

Healthy dietary patterns, appropriate weight management, physical activity, restorative sleep and attention to psychological well-being can support broader cardiovascular health.

However, evidence that a dietary pattern improves cardiovascular risk factors should not be interpreted as proof that it can reverse established lower-extremity arterial obstruction.

The contribution of Lifestyle Medicine is to strengthen comprehensive cardiovascular care and support sustained participation in recommended treatment, not to replace therapies with demonstrated cardiovascular or limb benefits.

When Revascularization Becomes Part of the Treatment Plan

Not every patient with peripheral artery disease requires an endovascular or surgical intervention.

For people with stable but functionally limiting intermittent claudication, guideline-directed medical therapy and structured exercise are important initial treatment options.

Revascularization may be considered when symptoms continue to substantially interfere with daily activities despite appropriate treatment and when the anticipated functional benefit justifies procedural risks.

Decisions should consider arterial anatomy, symptom severity, other medical conditions, patient preferences and the likelihood of meaningful improvement.

The situation is different in chronic limb-threatening ischemia.

When inadequate arterial blood flow contributes to ischemic rest pain, nonhealing wounds or gangrene, revascularization may be essential for wound healing and limb preservation.

Endovascular, surgical or hybrid approaches may be appropriate depending on the patient's vascular anatomy, clinical condition and treatment goals.

Wound care, infection management, diabetes treatment, nutrition and rehabilitation remain important components of care, but they cannot replace restoration of blood flow when limb viability is threatened.

Acute limb ischemia requires emergency evaluation and prompt treatment according to the urgency and severity of the presentation.

Exercise may also remain relevant after successful revascularization.

The 2024 American guideline recommends supervised exercise therapy following revascularization for chronic symptomatic peripheral artery disease when appropriate, because it can further improve walking performance, functional status and quality of life.

The October 2026 American College of Cardiology scientific statement likewise recognizes structured exercise as an important component of treatment before and after selected vascular interventions.

Patients also require continued vascular follow-up after an intervention.

A successful procedure does not eliminate the need for cardiovascular risk management, medication review, foot care or ongoing assessment of symptoms.

Medical treatment, vascular procedures and Lifestyle Medicine are complementary components of care whose relative roles may change throughout the course of the disease.

Measuring Improvement Beyond Walking Distance

Healthcare organizations may record how many patients received exercise advice, attended rehabilitation sessions or underwent vascular procedures.

These measures describe activities, but they do not necessarily establish that care has improved.

For someone whose main limitation is intermittent claudication, treatment success may mean being able to walk to a nearby market, return to work or participate in family activities without frequent rest.

Walking performance can be assessed using standardized treadmill testing, the six-minute walk test or other validated functional measures appropriate to the clinical setting.

Patient-reported measures can provide additional information about mobility, symptom burden, daily functioning and health-related quality of life.

These outcomes matter because improvements in physical functioning can be meaningful even when arterial measurements change little.

However, functional outcomes do not replace the need to evaluate cardiovascular protection and limb safety.

Clinical follow-up should consider smoking status, blood pressure, lipid management, diabetes control, medication use, foot condition, new symptoms and the need for further vascular assessment.

The importance of measuring appropriate care is reflected in the 2026 American College of Cardiology and American Heart Association clinical performance and quality measures for peripheral artery disease.

Published online on January 8, 2026, the document translates selected recommendations from the 2024 clinical guideline into measures that can support healthcare quality assessment.

The performance measures address areas such as blood pressure management, lipid-lowering treatment, antithrombotic therapy, diabetes management, smoking cessation and structured exercise.

Additional quality measures address preventive foot care, vascular assessment, healthcare disparities and other aspects of comprehensive management.

An important distinction is that not every measure has the same status.

Performance measures are designed for more formal accountability applications, while additional quality measures can support improvement and further evaluation.

These American professional measures should not be treated as mandatory Vietnamese healthcare standards.

Nevertheless, they provide useful examples of how evidence-based recommendations can be translated into measurable care processes.

For example, the American framework includes a performance measure assessing whether adults with chronic symptomatic peripheral artery disease are offered supervised exercise therapy or an appropriate structured community-based alternative within 12 months of diagnosis.

The relevance of this measure for Viet Nam is not that all healthcare organizations must adopt the same reporting requirement. It is that evidence-based exercise should be considered an organized clinical intervention, with attention to patient eligibility, referral and access.

Healthcare organizations may also assess whether patients receive appropriate physiological testing, cardiovascular treatment review and timely specialist assessment when concerning limb findings are identified.

Outcome evaluation should determine whether these processes contribute to better functional capacity, cardiovascular risk management, limb protection and quality of life.

Measurement is most useful when the information leads to better care rather than simply increasing documentation.

Making Structured Exercise Practical in Viet Nam

International guidelines provide a strong clinical foundation, but implementation needs to reflect local healthcare capacity and the circumstances of patients.

Structured exercise programs require appropriately trained professionals, suitable patient selection, safe facilities or community-based alternatives, and reliable follow-up.

Not every healthcare organization in Viet Nam has a dedicated supervised exercise therapy service for peripheral artery disease.

Patients may also experience barriers related to travel, cost, work schedules, mobility limitations or access to rehabilitation professionals.

These challenges should not lead to abandoning evidence-based exercise therapy.

They reinforce the importance of distinguishing structured home-based rehabilitation from unsupervised advice.

A professionally guided home-based program may be suitable for selected patients with stable symptomatic disease who cannot access supervised rehabilitation.

Such a program should include an appropriate initial clinical assessment, individualized exercise instructions, realistic goals, education about concerning symptoms and planned review of progress.

Behavior-change techniques, activity records, structured follow-up calls or suitable digital tools may help some patients maintain participation.

The 2026 American College of Cardiology scientific statement recognizes that home-based, hybrid and virtual rehabilitation models may help expand access to exercise interventions. It also emphasizes that exercise prescriptions should reflect clinical status, functional capacity and the patient's ability to participate safely.

Digital tools and wearable devices may support activity tracking and communication, but they should not be assumed to provide clinical assessment or identify all vascular complications.

Home-based rehabilitation is not simply an instruction to walk until pain becomes unbearable.

It also should not imply that people with advanced ischemia, active tissue-threatening wounds or significant medical instability can manage their condition independently.

The 2026 American performance measures recognize that access to supervised exercise may be limited by geography, affordability or other practical circumstances.

A structured community-based program, prescribed and guided by qualified healthcare professionals and incorporating behavior-change support, can be an acceptable alternative in appropriate circumstances.

For Viet Nam, this distinction is relevant because healthcare services vary in equipment, specialist staffing and access to formal rehabilitation.

A program delivered through an outpatient service, a rehabilitation department or an appropriate community-based setting may differ in organization, but the underlying clinical principles should remain consistent.

Patient selection, professional oversight, safety monitoring and outcome evaluation remain essential.

Collaboration among primary care physicians, cardiovascular specialists, vascular surgeons, nurses, physiotherapists and other appropriately qualified rehabilitation professionals can help coordinate care.

This is particularly important for patients with several conditions affecting mobility and treatment, including diabetes, chronic kidney disease, heart failure, peripheral neuropathy or musculoskeletal limitations.

The practical environment also matters. Heat, air pollution, limited safe walking spaces and uneven pavements may affect the feasibility of outdoor exercise in some Vietnamese settings.

Healthcare professionals should consider these barriers when selecting exercise locations and developing realistic plans.

Health equity deserves attention as well. Someone who lives near a specialist center may have access to services that are unavailable to a person living in a rural area or unable to attend repeated hospital appointments.

The objective is not to reproduce an international service model without adaptation. It is to preserve the clinical principles that make treatment safe and effective while developing approaches suited to Vietnamese healthcare settings.

Professional Responsibilities and Legal Boundaries in Viet Nam

Lifestyle Medicine can contribute to peripheral artery disease care through evidence-based professional education, smoking cessation support, appropriate nutrition, physical activity and assistance with maintaining healthier behaviors.

However, diagnosing peripheral artery disease, interpreting vascular investigations, determining clinical stability, prescribing treatment, evaluating limb-threatening ischemia and making decisions about revascularization are regulated clinical activities.

In Viet Nam, the Law on Medical Examination and Treatment No. 15/2023/QH15, together with its applicable amendments and implementing regulations, provides the relevant legal framework.

Consolidated Document No. 26/VBHN-VPQH, issued by the Office of the National Assembly on February 26, 2026, reflects the consolidated provisions of the Law.

Healthcare professionals must act within their qualifications, competence, legally authorized professional scope and applicable institutional responsibilities.

Education or certification in Lifestyle Medicine does not independently authorize someone to diagnose peripheral artery disease, prescribe cardiovascular medication, perform specialized clinical assessments or provide individualized clinical rehabilitation beyond their permitted professional responsibilities.

Exercise training delivered as part of medical treatment must involve appropriate clinical assessment, professional oversight and compliance with applicable requirements.

The Law on Disease Prevention No. 114/2025/QH15, effective July 1, 2026, also provides a broader legal framework for preventing and managing noncommunicable diseases and related risk factors.

This framework is relevant to health education, risk-factor management and lifestyle-related prevention activities. However, it does not independently establish Lifestyle Medicine as a new licensed clinical profession or authorize unlicensed medical practice.

International recommendations from the American College of Cardiology, American Heart Association and European Society of Cardiology can inform professional education, evidence appraisal and clinical quality improvement.

However, they do not automatically become Vietnamese regulatory requirements or establish the approval, availability, reimbursement or suitability of specific medicines, vascular procedures or rehabilitation services.

Data protection is also important when healthcare organizations use digital monitoring, exercise records, patient-reported outcomes or follow-up systems.

Identifiable vascular diagnoses, medication information, functional assessments, wound photographs and other personal health information must be handled according to applicable confidentiality and personal data protection requirements.

Viet Nam's Law on Personal Data Protection No. 91/2025/QH15 and Decree No. 356/2025/NĐ-CP, both effective January 1, 2026, are relevant to organizations processing identifiable personal health information.

Organizations should establish appropriate lawful processing arrangements, security safeguards, access controls and clearly defined responsibilities when collecting, storing or sharing such information.

For the Vietnam Lifestyle Medicine Alliance, the appropriate role is professional education, scientific knowledge sharing, critical appraisal of evidence and responsible communication about applying research in healthcare.

Educational materials should not be presented as official Vietnamese clinical practice guidelines, individualized medical advice or authorization to provide regulated medical treatment.

Better Mobility Must Be Connected to Cardiovascular and Limb Protection

Peripheral artery disease demonstrates why Lifestyle Medicine needs to remain closely integrated with established medical care.

Structured exercise can improve walking performance, daily functioning and quality of life in appropriately selected patients. Smoking cessation, healthier dietary patterns and sustained participation in treatment can also contribute to cardiovascular risk management.

However, these benefits depend on accurate diagnosis, appropriate clinical assessment and timely recognition of patients who need more urgent care.

A patient with stable intermittent claudication may benefit from an individualized walking rehabilitation program. Another with a nonhealing ischemic wound or pain at rest may require prompt vascular assessment. Someone with sudden deterioration in limb circulation may need emergency treatment.

These clinical situations cannot be managed through the same lifestyle recommendations.

The international evidence available in 2026 reinforces the importance of evaluating outcomes that matter to patients.

Better walking distance, improved daily functioning and greater independence are meaningful goals. So are the prevention of cardiovascular events, protection from limb complications and continuity of appropriate medical treatment.

For Viet Nam, the opportunity is to strengthen the connection between vascular assessment, exercise-based rehabilitation, cardiovascular prevention, foot protection and coordinated follow-up.

The contribution of Lifestyle Medicine is not simply to encourage patients to become more active. It is to support safe, sustainable improvements that reflect their medical condition and daily circumstances.

The goal is not only to help people walk farther, but to help them remain active while protecting cardiovascular health, limb function and quality of life.

Selected References

1. Gornik HL, Aronow HD, Goodney PP, et al. 2024 ACC/AHA/AACVPR/APMA/ABC/SCAI/SVM/SVN/SVS/SIR/VESS Guideline for the Management of Lower Extremity Peripheral Artery Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Journal of the American College of Cardiology. 2024;83(24):2497–2604. doi:10.1016/j.jacc.2024.02.013.

2. Mazzolai L, Teixido-Tura G, Lanzi S, et al. 2024 ESC Guidelines for the Management of Peripheral Arterial and Aortic Diseases. European Heart Journal. 2024;45(36):3538–3700. doi:10.1093/eurheartj/ehae179.

3. Myers J, Beckie TM, Chastin S, et al. Exercise Prescriptions for Cardiovascular Health in Adults: 2026 ACC Scientific Statement: A Report of the American College of Cardiology. Journal of the American College of Cardiology. Published online October 15, 2026. doi:10.1016/j.jacc.2026.09.008.

4. Das SR, Bonaca MP, Creager MA, et al. Management of Peripheral Artery Disease in Adults With Diabetes: 2025 ACC Scientific Statement: A Report of the American College of Cardiology. Journal of the American College of Cardiology. 2026;88(8):891–906. First published online December 17, 2025. doi:10.1016/j.jacc.2025.11.027.

5. Goodney PP, Ross EG, Bruckel JT, et al. 2026 ACC/AHA Clinical Performance and Quality Measures for Patients With Peripheral Artery Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Performance Measures. Journal of the American College of Cardiology. 2026;88(8):856–890. First published online January 8, 2026. doi:10.1016/j.jacc.2025.09.003.

6. Nguyễn Thị Nhung, Kê Thị Lan Anh, Nguyễn Ngọc Ánh. Đặc điểm lâm sàng, cận lâm sàng, một số yếu tố liên quan bệnh động mạch chi dưới ở bệnh nhân đái tháo đường típ 2 tại Bệnh viện Hữu nghị Việt Tiệp. Tạp chí Y học Cộng đồng. 2026;67(6). Published June 25, 2026. doi:10.52163/yhc.v67i6.5484.

7. Rea BL, Cheema S, Lanza S, et al. Lifestyle Medicine Core Competencies: 2025 Update. American Journal of Lifestyle Medicine. 2026;20(3):443–451. First published online October 28, 2025. doi:10.1177/15598276251379821.

8. National Assembly of Viet Nam. Law No. 15/2023/QH15, dated January 9, 2023. Law on Medical Examination and Treatment.

9. Office of the National Assembly of Viet Nam. Consolidated Document No. 26/VBHN-VPQH, dated February 26, 2026. Law on Medical Examination and Treatment.

10. National Assembly of Viet Nam. Law No. 114/2025/QH15, dated December 10, 2025. Law on Disease Prevention. Effective July 1, 2026.

11. National Assembly of Viet Nam. Law No. 91/2025/QH15, dated June 26, 2025. Law on Personal Data Protection. Effective January 1, 2026.

12. Government of Viet Nam. Decree No. 356/2025/NĐ-CP, dated December 31, 2025. Detailing Certain Articles and Measures for the Implementation of the Law on Personal Data Protection. Effective January 1, 2026.

Editorial, Clinical and Legal Disclaimer

This article is published by Vietnam Lifestyle Medicine Alliance (VLMA) for general information and professional education. VLMA is a physician-led professional education and knowledge-sharing initiative operated by Vietnam Lifestyle Medicine Alliance Company Limited. The article presents an evidence-informed discussion of Lifestyle Medicine in peripheral artery disease care and does not constitute an official clinical practice guideline, individualized medical advice, a diagnosis, an exercise prescription, a medication recommendation, a vascular treatment protocol or a rehabilitation plan.

The information must not be used to independently diagnose peripheral artery disease, interpret vascular investigations, determine clinical stability, initiate or discontinue cardiovascular medication, prescribe structured exercise for an individual patient or make decisions about vascular procedures without appropriate professional assessment.

Exercise therapy and other lifestyle interventions may support peripheral artery disease management but must not replace clinically indicated medication, vascular assessment, wound care, revascularization or other necessary medical and surgical treatment.

People experiencing sudden severe limb pain, new limb coldness or pallor, sensory loss, weakness or other signs of acute limb ischemia require immediate emergency medical evaluation. Patients with suspected chronic limb-threatening ischemia, including ischemic rest pain, nonhealing wounds or gangrene, require prompt specialist assessment.

The exercise recommendations discussed in this article primarily apply to appropriately selected patients with stable chronic symptomatic peripheral artery disease. They should not be generalized to people with advanced limb ischemia, unstable cardiovascular conditions or other contraindications without individualized clinical evaluation.

International recommendations, including the 2024 American and European clinical guidelines, the October 2026 American scientific statement on exercise prescription and the 2026 American performance and quality measures, do not automatically constitute Vietnamese clinical standards or establish the regulatory approval, availability, reimbursement or suitability of particular medicines, procedures or rehabilitation services in Viet Nam.

All regulated clinical activities must be undertaken by appropriately qualified healthcare professionals acting within their legally authorized scope of practice and applicable requirements governing healthcare facilities in Viet Nam.

This article does not endorse any commercial exercise program, dietary product, supplement, medication brand, vascular device, rehabilitation provider or healthcare organization. Identifiable personal health information must be managed in accordance with applicable confidentiality and personal data protection requirements.

The content reflects the scientific evidence, professional recommendations and legal sources reviewed as of October 30, 2026, and may require updating as further research, clinical guidance and Vietnamese regulatory requirements evolve.