Savvy Senior: How leg pains could be an early sign of heart attack or stroke

Dear Savvy Senior,

I started a walking program a few months ago to help me lose weight, but I've been having problems with my legs and hips hurting during my walk, although they feel better once I stop. I thought it was just because I’m getting old, but my neighbor was telling me about a leg vein disease she has called PAD and thinks I may have something similar. What can you tell me about this?

— Limping Linda

Dear Linda,

The health condition your neighbor is telling you about is known as “peripheral arterial disease” (or PAD), which is an under-the-radar disease that affects approximately 8 to 12 million Americans.

It happens when the arteries that carry blood to the legs and feet become narrowed or clogged over the years with fatty deposits or plaque, causing poor circulation.

But you also need to be aware that because PAD is a systemic disease, people that have it are also much more likely to have clogged arteries in other areas of the body like the heart, neck and brain, which greatly increase the risks of heart attack or stroke. 

Few symptoms

Unfortunately, PAD goes undiagnosed and untreated way too often because most people that have it experience few, if any symptoms. The most common symptom, however, is similar to what you’re experiencing: pain and cramping in the hip, thigh or calf muscles, especially when walking or exercising but usually disappears after resting for a few minutes.

Another reason PAD is under-diagnosed is because many people assume that aches and pains go along with aging and simply live with it instead of reporting it to their doctor.

Other possible symptoms to be aware of include leg numbness or weakness, coldness or skin color changes in the lower legs and feet, or ulcers or sores on the legs or feet that don’t heal.

Are you at risk?

Like most other health conditions, the risk of developing PAD increases with age. Those most vulnerable are people over the age of 50 who smoke or used to smoke, have elevated cholesterol, high blood pressure, diabetes, are overweight or have a family history of PAD, heart attack or stroke. African Americans are also twice as likely to have PAD as Caucasians.

If you’re experiencing any symptoms or if you’re at increased risk of PAD, you need to be tested by your doctor or a vascular specialist. He or she will probably perform a quick and painless ankle-brachial index test, which is done by measuring your blood pressure in your ankle as well as your arm and compare the two numbers. Your doctor may also do imaging tests such as ultrasound, magnetic resonance angiography (MRA), and computed tomographic (CT) angiography.

With early detection, many cases of PAD can be treated with lifestyle modifications including an improved diet, increased physical activity and smoking cessation.

If lifestyle changes aren’t enough, your doctor may also prescribe medicine to prevent blood clots, lower blood pressure and cholesterol, and control pain and other symptoms. And for severe PAD, the treatment options are angioplasty (inflating a tiny balloon in the artery to restore blood flow then removed), the insertion or a stent to reopen the artery, or a graft bypass to reroute blood around the blockage.

To learn more about PAD, visit the National Heart, Lung and Blood Institute at NHLBI.NIH.gov/health-topics/peripheral-artery-disease.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.