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PAD Risk Factors for Women and African Americans

Posted on June 29, 2023

Today, we need to talk about PAD risk factors for women. And for African Americans. Because both groups may be more vulnerable. In fact, according to a J&J campaign to raise PAD awareness, millions of Black Americans don't even know they have this disease. (You'll hear more about this campaign in a minute. But first, let's talk PAD.)

Remember, PAD (peripheral arterial disease) is a thickening of the arteries that affects blood flow. It's a form of cardiovascular disease with symptoms such as painful leg cramps. And those cramps mostly show up when walking or exercising, but get better with risk.

Now, we don't know why, but women and African Americans are nearly twice as likely to be affected by PAD. That's the case even for women and Black people without other heart issues. Regardless of age. Now, while this statistic is scary on its own, we also have to share warnings about things that further increase the PAD risk for women and African Americans.

PAD Risk Factors for Women Smoking: one of many PAD risk factors

Not every woman has the same PAD risk factors. Therefore, you have to look at other factors to figure out your own risk for PAD. Women who are over 60, or who have high blood pressure or cholesterol, have higher PAD risk. But, studies show that PAD risks for women without these factors are almost double that for men without heart disease.

And that's not all. In a study in the Journal of the American Heart Association, we learned other concerns about the PAD risk for women. As it turns out, women get diagnosed with PAD later than men. Then, after their PAD diagnosis, women's health deteriorates faster than men's. In particular, women with PAD lose their ability to walk at a faster rate than men do. Which is why women should start early screening for PAD to help prevent these concerns. As should African Americans, who have additional worries when it comes to their PAD risk.

BMI and PAD

Regardless of your race or gender, your body mass index has an impact on your PAD risk. In a recent study, researchers found a u-shaped relationship between BMI and PAD risk. They discovered that people with BMIs below 25.7 saw a 27% decrease in risk for Peripheral Arterial Disease. And, while there wasn't a concrete number, people with a BMI level above 25.7 had a significant disease risk increase. Want to know your BMI and relative PAD risk? Start with this resource from the National Institutes of Health.

Smoking and PAD Risks

According to a different study in the Journal of the American Heart Association, smoking is a known risk factor for PAD. But it increases PAD risk for African Americans more than for other at risk groups. In this study, researchers followed 5300 participants between the ages of 21 and 84. Of those participants, 13% were current smokers and 19% were former smokers.

Researchers found that current smokers were twice as likely as non-smokers to have PAD in their lower extremities. They were also eight times as likely to have calcium buildups in the aorta. And how much you smoked matters too: the more cigarettes a participant had smoked each day, the worse off their arterial health.

In the wake of this study, Mariell Jessup, chief science and medical officer of the American Heart Association, says: "The findings from this study give us strong evidence of the specific debilitating and life-threatening risks African American smokers face, especially the more they smoke. This type of research can be useful in the development of clear messages targeted to our African American population to underscore the real physical costs of tobacco product use."

Additional PAD Risks for Black Patients

Recently, an Annals of Surgery study gave patients of color even more reason to be concerned about PAD. After following 7,000 patients with peripheral arterial disease who'd had a lower leg bypass to boost circulation, a team of researchers at Michigan Medicine concluded that African American and low income indivduals experienced the worst outcomes.

Specifically, these patients had much higher rates of chronic limb-threatening ischemia (CLTI), a severe disease form that often leads to amputations. In fact, one year after surgery, Black study participants were much more likely to have an amputation than other patients. And that was true, regardless of disease severity. As a result, lead study author Dr. Chloe Powell says, "Health care providers need to recognize the vulnerability of certain subgroups to adverse outcomes and be on alert for early signs and symptoms of PAD, to manage patients accordingly."

Now, about that disease management...once again, this is another area where Black Americans don't have equitable options. In fact, a recent study revealed that there are significant disparities between Black and White patients when it comes to diagnosing and treating PAD. (Perhaps not surprisingly, then, there are also significant disparities in PAD outcomes between Black and White patients.) But what's most upsetting, according to study author David Armstrong, "Black patients are nearly 50% less likely to receive vascular interventions to potentially restore the blood flow than white patients, and consequently are at a disproportionately higher risk of a stroke, heart attack or amputation." As such, we must do all we can to prevent these patients from developing PAD in the first place!

Reducing PAD Risk Factors

Even if your PAD risk is high, you can take steps to prevent disease. In a new study in the European Journal of Vascular & Endovascular Surgery, researchers found that making four healthy lifestyle choices helped prevent peripheral arterial disease.

What were these four choices?

  1. Avoiding too much alcohol.
  2. Following a healthy diet.
  3. Staying moderately to highly active.
  4. Never smoking. (But you probably guessed that one already.)

In fact, these measures were so effective that they reduced your risk by 12%, 16%, 26% and 54% respectively. So imagine what an impact they could have if you worked with all four in combination!

Efforts Toward Equity

In further attempts to improve health equity outcomes, Johnson & Johnson has launched a multi-year, $100 million campaign titled “Our Race to Health Equity.” Launched at this year's American College of Cardiology conference, their first initiative is titled, "Save Legs. Change Lives. Spot Peripheral Artery Disease Now.”

As the initiative gets going, J&J will send an "empower PAD" mobile health unit into communities where PAD rates are high. Their goal is to test between 50 and 60 people at each of their 90 screening events. And they will make special efforts to reach Black Americans, since they are more likely to have PAD without displaying any symptoms.

The key in this initiative, and in our Houston and Dallas area offices, is to get an early diagnosis before you develop devastating complications. So, if you're worried about your risk for PAD, we're here to help. If you are in a vulnerable population, or have any type of heart disease, preventative screening is important. Schedule an appointmentSchedule an appointmentSchedule an appointment with our Houston vein specialists right away. We can help determine your PAD risk level, and start you on preventative care or treatments.

Sources: Journal of the American Heart Association

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