Vascular disease is a critical health issue affecting millions of Americans, but it disproportionately impacts Black communities due to a combination of genetic, environmental, and systemic factors.
BlackDoctor.org spoke with Dr. Chelsea Dorsey, a vascular surgeon at The University of Chicago Medicine to discuss what vascular disease is, its symptoms and the steps you can take to protect your health.
What Is Vascular Disease?
Vascular disease refers to conditions that affect your blood vessels. One of the most common types is peripheral arterial disease (PAD), where blockages in the arteries reduce blood flow, usually to the legs.
Dr. Dorsey explains that PAD is similar to a heart attack, but instead of the heart, the blockages occur in the legs.
“When people say they have a circulation issue, often, it’s this issue that’s happening in the legs. People can have pain related to this,” Dr. Dorsey says. Symptoms can include:
- Leg pain or cramping while walking, relieved by rest (called claudication).
- Pain at rest in the toes or feet, especially when lying down.
- Slow-healing wounds on the legs or feet.
Why Are Black Americans More Affected?
Black Americans are disproportionately impacted by PAD and other vascular conditions due to higher rates of risk factors such as:
- Diabetes: Linked to diet, lifestyle, and genetic factors.
- High blood pressure: Common in Black communities, partly due to genetic predispositions and stress.
- Smoking: A major risk factor, with over 40 percent of Black Americans being current or former smokers.
Another factor is delayed diagnosis.
“I think one thing that we often don’t talk about a lot is that individuals from the Black community often come late to get diagnosed or to come to a doctor and talk about some of the problems that they’re having,” Dr. Dorsey notes. “There are probably multiple reasons for that, possibly mistrust in the medical community. But many of us, unfortunately, don’t prioritize our health. Taking care of our family is often higher on the to-do list, and oftentimes, it can take weeks before someone will come to a doctor and say that something’s wrong.”
Symptoms to Watch For
While PAD can sometimes be silent, there are warning signs:
- Leg cramps or pain while walking that improve with rest. “Usually, they’ll describe it like this: ‘I can walk a certain distance, but then I’ll start to get this sharp cramping pain in my leg, and I have to stop,’” Dr. Dorsey shares.
- Pain in the feet or toes when lying down, relieved by dangling your legs. “This pain is really consistent; it’s not just a pain in the toe once a month. It happens every time they put their leg up,” Dr. Dorsey adds.
- Wounds that heal slowly or not at all. “If they hit their toe or leg and it takes several weeks or more for that wound to heal, that could also be a sign,” Dr. Dorsey notes.
If you notice these symptoms, it’s essential to seek medical attention promptly.
Prevention and Lifestyle Changes
Preventing PAD and other vascular diseases involves addressing risk factors:
- Quit Smoking: Smoking is the number one preventable cause of PAD. Talk to your doctor for support to quit.
- Stay Active: Regular walking improves circulation and helps prevent blockages.
- Monitor Your Health: Control diabetes, blood pressure, and cholesterol levels.
- Healthy Diet: Focus on foods low in salt, sugar, and unhealthy fats.
“What’s nice about my specialty as a vascular surgeon is that we can treat patients who have this issue at all levels. For individuals with mild peripheral arterial disease, we focus more on conservative measures and lifestyle changes,” Dr. Dorsey says.
Treatment Options
If diagnosed early, PAD can often be managed with lifestyle changes and medication. For more advanced cases:
- Minimally invasive procedures: Techniques like stents or balloons can open blocked arteries.
- Surgical options: Severe cases may require bypass surgery to restore blood flow.
“There are also medications that can help people in this situation. For people who have more significant blockages, we sometimes recommend procedures. We usually start with more minimally invasive techniques, like stents or balloons, to temporarily open up the blood vessels and improve circulation,” Dr. Dorsey shares.
“In more severe cases, we can do larger procedures or surgery to improve blood flow, similar to when someone has a heart attack and needs a bypass. We can also do a bypass in the leg, essentially bypassing the blockage to improve blood flow down to the foot. We try to leave amputations as a last resort,” Dr. Dorsey adds.
The Importance of Early Detection
Screenings are vital for preventing complications like amputations. These tests are simple and non-invasive, often using ultrasound to check blood flow. If you have risk factors like diabetes, high blood pressure, or a history of smoking, talk to your doctor about regular screenings.
“If you’re having any of the symptoms I described—like cramping pain, pain in the toes, or slow-to-heal wounds—those are reasons to go to your doctor. You can usually start with your regular doctor, or your primary care doctor, to discuss your symptoms. You can also start with a specialist, like a vascular surgeon,” Dr. Dorsey notes.
How to Advocate for Your Health
Advocating for yourself is also a key component of your journey. Dr. Dorsey advises being proactive during medical visits by doing the following:
- Write down your symptoms and concerns beforehand. “I encourage folks to feel empowered when sitting in front of their doctor. It’s important to share what symptoms they’re experiencing, like the pain they’re having,” Dr. Dorsey says.
- Seek a doctor you trust. “There needs to be a trusting relationship. You should feel heard. If you’re not, I would say, move on to someone else,” Dr. Dorsey adds.
Raising Awareness in Our Community
Spreading awareness about PAD is critical. Organizations like the Society for Vascular Surgery are working on campaigns to educate and empower communities such as that being done with the Highway to Health campaign. Sharing information with family and friends can also help prevent severe outcomes.
“We need to be talking about peripheral arterial disease and its symptoms. A big part of it is that people don’t understand how severe it can be, and when left untreated, it leads to devastating complications, like amputation. We need to take this conversation seriously and help patients better understand the steps they can take to prevent or manage the disease early on,” Dr. Dorsey concludes. “It’s important that everyone, from the doctor to the patients themselves, prioritize these concerns. More importantly, physicians need to ask questions and listen closely when patients are describing their symptoms.”
Final Takeaway
Vascular disease is preventable and treatable when caught early. By addressing risk factors, recognizing symptoms, and seeking timely care, we can protect our health and the health of our communities. Remember, your health is a priority—don’t delay in seeking care.
