Peripheral arterial disease (PAD) is atherosclerosis of blood vessels in the legs. Atherosclerosis causes narrowing or blockage of the vessels, resulting in impaired blood flow. Risk factors for PAD include smoking, high blood pressure, high cholesterol level, and diabetes. Peripheral arterial disease causes leg pain or heaviness that develops with walking and is relieved by rest. The pain often limits the distance that people can walk. Peripheral arterial disease is diagnosed by showing that blood pressure in the lower leg is lower than blood pressure in the arm. Ramipril is a drug that lowers blood pressure and decreases the frequency of death in people with atherosclerosis even when they do not have high blood pressure. The effect of ramipril on walking ability in patients with PAD has never been studied.