Feel as if you can't stroll as far—or as easily—as you once used to? Or maybe you get cramping in your calves when taking a walk, but it subsides when you stop. Before dismissing it as just another consequence of aging, consider: These subtle hints could be one of the best opportunities you'll get to prevent two of the top killers in the United States—heart and cerebrovascular disease.
The cause of the slowdown in your step could be peripheral artery disease, the accumulation of plaque in the arteries of the extremities, typically the legs, which may affect some 10 million Americans. If you've got PAD, the likelihood of having plaque buildup, or atherosclerosis, elsewhere—say, in arteries to your heart or head—is virtually 100 percent, says Christopher White, chairman of cardiology at Ochsner Medical Center in New Orleans.
The thing is, not everybody with PAD has symptoms. The American Heart Association estimates that only 10 percent have the classic cramping leg pain with exertion; another 50 percent have a range of other leg or foot symptoms, like poor toenail growth. Men and women are equally prone to PAD, though onset in women is later than in men—typically after menopause—and blacks have a higher incidence than whites.
Doctors can diagnosis PAD relatively easily by testing a patient's ankle-brachial index, a ratio of blood pressure in the arm to that in the ankle. But patients may have to start the conversation about PAD because doctors often don't. Many primary-care physicians lack the Doppler device most often used to do the test. Luckily, the automated, oscillometric blood pressure cuff, which is more common in clinics, is also a reliable tool for diagnosing PAD, a 2006 study suggested.
Citing recent guidelines, Mark Creager, Vascular Center director at Brigham and Women's Hospital in Boston, says ABI should be assessed if you experience leg symptoms, are 70 or older, are between age 50 and 69 and have ever smoked cigarettes or have diabetes, or are younger than 50 but have diabetes and another cardiovascular risk factor, say, high blood pressure. Last year, research suggested that insulin resistance, a precursor to diabetes, is associated with risk of PAD.
PAD can't be undone, but it doesn't have to get worse—and its deadliest complications are preventable. A more healthful diet can improve blood pressure and insulin levels. So can exercise, which has been linked to lowered rates of cardiovascular death in PAD patients. And cholesterol-fighting statins can block the buildup of arterial plaque. Just don't take the disease lightly, says White. He treats new PAD patients "like they just had a heart attack two weeks ago."