'Cosby' Star Tackles a Silent Heart Threat
WEDNESDAY, Sept. 19 -- Actress Phylicia Rashad has spent decades tickling America's funny bone and tugging at its heart.
But it's Americans' heart health she's working for now, crisscrossing the country to raise awareness of a common but underappreciated and underdiagnosed cardiovascular threat called peripheral artery disease (PAD).
Rashad -- famous for her Emmy-nominated turn as Claire Huxtable during the 1980's TV hit The Cosby Show -- has lost too many family members to heart disease to ignore the problem, she said.
"PAD isn't new, but the diagnosis is recent," said Rashad. "People just used to refer to it as poor circulation, not understanding that PAD is a serious cardiovascular disease, and an indicator that a person is at two times the risk for a heart attack or stroke, and four times as likely to die of a heart attack or stroke."
PAD sets in when plaque formation -- or atherosclerosis -- clogs the arteries and impedes the flow of blood to the legs. Such plaque build-up raises the risk for clot formation and additional arterial blockage, potentially affecting blood flow to the heart or brain.
Part of a larger year-long public health effort entitled P.A.D.: Make the Connection, the campaign is being launched in conjunction with the first National PAD Awareness Month. It is co-sponsored by the nonprofit Peripheral Artery Disease Coalition (PAD Coalition).
A signal of more serious heart disease down the road, PAD often strikes without recognizable symptoms, and experts estimate that 8 million Americans who have the chronic condition remain undiagnosed and untreated.
"It's a condition that physicians don't test for regularly," noted Rashad. "Most people don't even really know about it."
To counter that lack of awareness, Rashad will address press and patients nationwide in face-to-face discussions on screening and treatment options.
Much of her outreach on behalf of PAD awareness is being coordinated by two of the world's largest drug companies, Bristol-Myers Squibb and Sanofi Aventis. The two pharmaceutical giants co-manufacture the anti-platelet PAD medication clopidogrel (Plavix) and together have launched a Web site called www.PADFACTS.org.
This is Rashad's second time out stumping on behalf of a health concern. In 2002, she helped launch a diabetes awareness campaign, sponsored by drug maker GlaxoSmithKline.
This time 'round, Rashad offered up recollections of her own family's experience battling cardiovascular disease.
"My father, who had diabetes, died of a heart attack," she recalls. "And his father, who had diabetes, died of a heart attack. My father's brother, who had diabetes, and one of his sisters died of heart attacks. Two of his sisters died of a stroke."
Of eight family members who had diabetes and went on to die of heart disease, none was ever tested for PAD, Rashad said.
"And had there been awareness, and had this test been performed, and if they had this condition -- which is likely -- then there was maybe something that could have happened to avert those circumstances," she said.
According to the American Heart Association (AHA), risk for this specific form of peripheral vascular disease rises with age, with somewhere between 12 percent and 20 percent of men and women developing the condition by the age of 65.
People who smoke, diabetics, those with high blood pressure and/or high cholesterol, and those with a family history of cardiovascular disease are at an increased risk for developing PAD.
Patients who do experience symptoms often complain of cramping, pain, and fatigue in the leg or hip muscles when walking or climbing. Such symptoms often temporarily dissipate with rest.
The AHA points out that if left untreated the condition can sometimes lead to gangrene and even amputation.
However, patients can be effectively screened for PAD by having their "ankle-brachial index" calculated by their doctor. The reading is based on blood pressure results taken from the ankles and arms.
"It isn't painful, it isn't costly, and it's simple," Rashad said. She said people at risk for PAD should be tested at least once yearly, a routine she herself follows.
"I don't have PAD," she said. "I have not had to deal with it personally -- I mean other than the consequences of my family members' deaths."
People who do receive a PAD diagnosis should know that good treatment options are available, however.
Routine exercise, including walking and treadmill exercise, is the most effective treatment for PAD, according to the AHA. Kicking the smoking habit and maintaining a diet low in cholesterol, saturated fats, and trans-fat is another weapon against PAD, and cholesterol-lowering drugs are sometimes recommended, the association says.
In some serious cases, patients may have to undergo clot and/or clog removal or even by-pass surgery to reroute blood around a blocked leg artery. Most are able to avoid such invasive procedures by taking anticlotting medications such as aspirin or Plavix, which prevent blood platelets from sticking together to form clots.
Dr. Peter Sheehan, a senior faculty member of the Mount Sinai School of Medicine in New York City, strongly backed the awareness effort.
"People have to understand that this is a major cardiovascular disease," he said. "When you have it, it's the tip of the iceberg, because it's systemic. It's not just something with the legs giving problems walking. You have it everywhere."
"So PAD is a good warning sign," he added. "It provides an alert to the person and their doctor to go ahead and try to lower the risk for heart attack or stroke."
As the campaign gets under way, Rashad's first major stop will be in Washington D.C., where, on Sept. 18, she and a PAD Coalition team will advocate for increased PAD screening at a special Congressional briefing.
Meanwhile, her career continues apace. She's already the first black actress on Broadway to win a Tony Award as lead actress in a play, for 2004's A Raisin in the Sun, and she just completed work on bringing that play to TV, in an adaptation scheduled to air on ABC next February.
This fall, Rashad will return to Broadway as a wicked queen in the Lincoln Center's production of Shakespeare's Cymbeline.
For more on PAD, visit the American Heart Association.
Posted: September 2007
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