February is American Heart Month, when we raise awareness about heart disease and how to prevent it. Heart disease is one of the leading causes of death in adults living in New York City, and it is important to know if you are at risk for heart disease. New York City Department of Health and Mental Hygiene has tools and resources to help you identify and manage your risk for heart disease. You can access these resources and use their Heart Age Calculator tool by going to https://www1.nyc.gov/site/doh/health/health-topics/heart-age-calculator.page.

One condition related to heart disease is peripheral artery disease (PAD). This is caused by a build-up of fat in the arteries outside the heart, which blocks the flow of oxygen and blood to the arms, legs, and feet. If you have pain or cramping in your calves, it might be PAD. It’s not uncommon. According to the Centers for Disease Control and Prevention (CDC), almost 6.5 million people aged 40 and above in the U.S. have signs or symptoms of this condition. Both men and women are affected by PAD, and African Americans are at an increased risk.

The earliest and most frequent symptom in patients with PAD is pain in the calf or thigh muscles when walking. This pain is called intermittent claudication (IC) and it happens when a person is active and stops when the person is at rest. This pain is a sign that not enough blood is flowing to that part of the body. As the disease progresses, patients may experience pain in the feet even when resting, especially when the legs are elevated, such as in bed. This pain can be relieved by hanging the legs over the side of the bed, standing, or sitting in a chair.

The signs of PAD can be mistaken for other conditions and can sometimes go undiagnosed. PAD can be dangerous and even life-threatening. People with PAD are at a higher risk for developing coronary artery disease, and this can lead to a heart attack or stroke. If left untreated, PAD can progress, causing ulcers (painful sores on the skin) and gangrene (death of the tissues). In about a third of these patients, PAD can lead to surgical removal of the leg or foot.

The CDC reports that the following factors can increase our risk for PAD, especially as we age:

• smoking
• high blood pressure
• atherosclerosis
• diabetes
• high cholesterol
• being 60 years or more.

The good news is that peripheral artery disease can be prevented or managed by following a heart healthy lifestyle. You can help prevent PAD by quitting smoking and exercising to help manage blood pressure and diabetes. Eating a heart healthy diet with vegetables, fruits, whole grains, and healthy fats can help keep cholesterol under control. Speak with your doctor or a nutritionist about ways to incorporate healthy food and exercise into your life.

If you or a family member is diagnosed with PAD, the first treatment is gentle, supervised exercise and medical management. Historically, surgery has been the primary treatment for patients with very advanced PAD. However, minimally invasive medical techniques have rapidly evolved over the past decade, and can be helpful for people whose symptoms don’t resolve with exercise and/or medical management.

PAD can be diagnosed using a painless, simple process. If you or a family member notice ongoing pain and swelling in your calves and legs, see your doctor to rule out PAD, and keep up the healthy habits for Heart Month.

José M. Wiley MD, MPH, is director of the cardiac catheterization laboratory and director of endovascular interventions at Montefiore Health System, and professor of medicine at Albert Einstein College of Medicine.