Final answer:
Smoking cigarettes is the strongest factor in the development of atherosclerotic lesions for a patient with peripheral arterial disease, smoking being the main risk factor for PAD and causing atherosclerosis.
Step-by-step explanation:
The strongest factor in the development of atherosclerotic lesions in a patient diagnosed with peripheral arterial disease (PAD), who is overweight, has been smoking cigarettes, and leads a sedentary lifestyle, is smoking cigarettes. Smoking is the main risk factor for PAD and a cause of atherosclerosis, which involves the buildup of plaques in the walls of the arteries.
Other risk factors include a high-fat, high-cholesterol diet, obesity, and a sedentary lifestyle, but among these, smoking has been identified to have the most significant impact on the development of cardiovascular diseases, including the progression of atherosclerosis. As a primary preventive measure, quitting smoking would be the most effective approach to reduce the risk of further atherosclerotic development.