Peripheral artery disease or PAD is probably the most common and dangerous medical condition you've never heard of. Although it affects as many as 8 million Americans and increases the risk of deadly—and better-known—diseases like heart attack and stroke, most of us have no idea what it is. But knowing the signs and symptoms of the disease—and the regions of the country where it most often strikes—could save your life.
That's the message that Phylicia Rashad is working to get out. The Cosby Show mom and 2008 Emmy Award nominee for ABC's A Raisin in the Sun, recently kicked off a national campaign to spread the word about PAD, which hits Rashad close to home: Eight of her family members, including her father and grandparents, died of a heart attack or stroke. She now realizes that each of them lived with some of the common risk factors for PAD, such as diabetes, high blood pressure, high cholesterol, smoking and a family history of heart attack and stroke.
"At the time of my relatives' deaths, PAD wasn't a recognized condition," says Rashad, 60, who lives outside of New York City. "But now that I know about it, I see a very strong possibility that my father had it at the time of his death in 1983. It makes me look back and wonder, what if? Might knowing about PAD have made a difference? I don't know, but I know this campaign can make a difference for people now."
PAD is a confusing, sometimes silent disease. About one in three patients with PAD actually feels pain or heaviness in the feet, calves, buttocks or legs that goes away with rest, symptoms that generally occur when the disease has progressed. By that time, their arteries may be so clogged or hardened that they are not getting enough oxygen to supply their leg muscles. Many ignore the pain, thinking it's a natural part of aging. Still, others don't feel anything at all.
"I remember my father would have cramps in his legs at night," says Rashad, who was raised in Houston. "He was a dentist, so we chalked it up to fatigue from standing. I wish we had known that it was a sign of something much more serious."
Clogged arteries can eventually lead to the formation of a clot. If this happens in an artery that supplies blood to the heart, the result can be a heart attack or heart-related chest pain. If it happens in an artery supplying blood to the brain, a stroke can occur.
A number of factors raise the risk of contracting PAD. Talk to your doctor about getting tested for PAD if: You're over 50 and have high blood pressure, high cholesterol, diabetes, smoke or used to smoke, a family history of heart attack or stroke. Or if you're over 70 and have pain in your legs while walking that eases after rest.
The test is simple and painless. "The most accurate way to test for it is with an ankle-brachial index, which compares the blood pressure in the ankle with the arm," says Dr. says Peter Sheehan, senior faculty at Mount Sinai School of Medicine in New York City. "If blood pressure in the ankle is less than in the arm, that indicates it's probably PAD."
Though some patients require medication to promote blood flow to the legs, and severe cases call for surgery, others can manage symptoms and prevent more serious problems by taking better care of themselves. That means, quitting smoking, exercising several times a week—and at best, every day—and maintaining a diet low in fat, salt and sugar. These self-help measures are also the best way to prevent contracting PAD in the first place.
Given her family history, Rashad takes this advice seriously. "My father and his people were from Louisiana, my mother from South Carolina, and you know what that means in terms of food," says Rashad. "I love Southern cooking, but in general, I eat differently. I learned a lot working with dancers, like my sister, Debbie. I observed how they ate and how they took care of their bodies and tried to copy them. I eat a lot of clean, simple food mainly protein and vegetables, and I try and prepare my food myself.
She also exercises regularly, though she's been slowed in recent months by a knee injury. Rashad is careful about her health because it's the right thing to do, she says, not because she's scared of her family history. "I don't go around with fear and worry. That does not promote good health," she says. "I don't have diabetes, I don't have cardiovascular problems and I don't live in the negative. It's not about being afraid; it's about being aware."
In the coming weeks, Rashad will travel to cities where PAD is most common. According to research conducted by the National Minority Quality Forum (NMQF), these "hot spots," in order of ranking, include Detroit, Washington, D.C., Baltimore, Philadelphia, Cleveland, St. Louis, Memphis, Buffalo, Pittsburgh, Atlanta, Fort Lauderdale, Chicago, Milwaukee, Cincinnati, Indianapolis and Miami.
"I'm visiting PAD hot spots to tell people about my family's health struggles and educate them about the risks and what symptoms to look out for," says Rashad. "I hope my efforts help people begin to think of peripheral artery disease as a cardiovascular event that needs immediate and ongoing treatment."
Linda Villarosa is a regular contributor to The Root.