PAD IN THE AFRICAN AMERICAN COMMUNITY; BREAKING BARRIERS TO EARLY DIAGNOSIS AND TREATMENT

Understanding the Unique Risk Factors for PAD in African Americans

Peripheral Arterial Disease (PAD) is a silent but deadly condition that disproportionately affects African Americans. Research shows that Black Americans are up to three times more likely to develop PAD than their white counterparts. This stark disparity arises due to a combination of genetics, higher rates of diabetes and hypertension, and limited access to healthcare. However, beyond the medical risk factors, there are also deep-rooted cultural and societal barriers that make early diagnosis and treatment of PAD particularly challenging for this community.

Dr. Polly Kokinos, a highly respected vascular surgeon with over 30 years of experience, understands these challenges. Having served underserved communities both locally and globally—including her missionary work at Tenwek Hospital in Kenya—she is uniquely positioned to provide compassionate, culturally competent care to African American patients facing PAD.

This article will explore the barriers preventing early PAD diagnosis in the African American community and how Dr. Kokinos and her team at South Bay Vascular are working to break down these obstacles.


Cultural Barriers to Seeking Early PAD Diagnosis

For many African Americans, historical distrust of the medical system remains a significant barrier to seeking medical attention for conditions like PAD. Generations of systemic healthcare disparities and unethical medical experiments—such as the Tuskegee Syphilis Study—have left lasting skepticism in many Black communities. This hesitancy often leads to delayed diagnosis and treatment, allowing PAD to progress to Critical Limb Ischemia (CLI), a severe form of PAD that increases the risk of limb amputation.

Additionally, the concept of self-reliance and resilience within Black culture often discourages individuals from seeking help for health issues until they become severe. Many African Americans feel a sense of duty to “tough it out,” prioritizing work and family obligations over personal health concerns. This reluctance can be particularly dangerous for PAD, a disease that advances silently, often without pain in its early stages.


The Role of Extended Families and Community Support

Unlike in some other cultural groups where medical decisions are highly individualized, many African American families rely on extended family networks and community institutions, such as churches, for guidance. When a loved one is diagnosed with a serious illness like PAD, the decision-making process often involves multiple family members. This means that healthcare providers must do more than just educate the patient—they must engage the entire family unit.

Dr. Kokinos recognizes this dynamic and works closely with families to ensure they understand the severity of PAD and the need for early intervention. Her patient-centered approach is based on relational medicine, rather than the transactional care often seen in large hospital systems. She takes the time to build trust, answer questions, and provide families with the resources they need to make informed decisions.


Financial Concerns and Healthcare Access

Another major barrier to PAD treatment in the Black community is the issue of affordability and access to healthcare. Many African Americans face challenges with health insurance coverage, making it difficult to seek preventative care. Even when insured, high co-pays, deductibles, and medication costs can discourage individuals from following through with necessary treatments.

Unlike many physicians who are constrained by large healthcare systems and administrative bureaucracy, Dr. Kokinos operates as an independent vascular surgeon, meaning she has the flexibility to offer tailored treatment plans that fit each patient’s financial situation. Her team at South Bay Vascular assists patients in navigating their insurance plans and finding cost-effective solutions for care.


The Stigma Surrounding PAD and Amputation

Many African Americans associate vascular disease with amputation, often believing that a PAD diagnosis is a precursor to limb loss. While it is true that untreated PAD can lead to amputation, early intervention can prevent severe complications. However, because of the deep-seated fear of limb loss, many Black patients avoid seeking medical attention until the disease has progressed to a critical stage.

Dr. Kokinos and her team emphasize the importance of early screening and non-invasive treatments that can save limbs and lives. She ensures that her patients understand that PAD is manageable when caught early, and that proactive care is the best way to avoid amputation.


Why African American Patients Trust Dr. Kokinos

Dr. Polly Kokinos is not just another vascular surgeon—she is a physician who has dedicated her life to serving communities in need. Her work at Tenwek Mission Hospital in Kenya has given her firsthand experience treating patients in underserved areas, reinforcing her commitment to providing equitable care. In Santa Clara County, she applies these same principles to help African American patients overcome healthcare barriers.

Unlike other vascular surgeons in the area who may rely on their hospital affiliations for credibility, Dr. Kokinos has built her reputation through skill, experience, and patient trust. She holds hospital admitting privileges, ensuring that her patients receive continuity of care, but she is not bound by the financial interests of a hospital system. This independence allows her to always prioritize what is best for her patients.


Conclusion: Taking the First Step

PAD is a life-threatening condition that disproportionately impacts the African American community. However, the barriers to care—ranging from cultural hesitancy to financial limitations—make early diagnosis and treatment difficult. The key to preventing amputations and saving lives lies in trust, education, and proactive healthcare decisions.

Dr. Polly Kokinos and her team at South Bay Vascular are committed to breaking down these barriers by providing compassionate, relationship-based care that empowers African American patients to take control of their health. If you or a loved one are experiencing symptoms of PAD—such as leg pain, numbness, or wounds that won’t heal—it is critical to seek medical attention before it’s too late.

If you or a loved one may be struggling to find answers to difficult medical questions and or a lack of compassionate care, please call our office to schedule an appointment with Dr Kokinos @ 408-858-3586. 

We offer hope when others say there is none. 


PERIPHERAL ARTERIAL DISEASE AND THE AFRICAN AMERICAN COMMUNITY: A SILENT THREAT YOU CAN NOT IGNORE

Introduction

Peripheral Arterial Disease (PAD) is a serious and often overlooked condition that disproportionately affects African Americans. Characterized by narrowed arteries and reduced blood flow to the legs, PAD is a major cause of disability, limb loss, and even death if left untreated. The risk of PAD in the African American community is significantly higher than in other racial or ethnic groups, making awareness, early detection, and expert care critical.

This blog will explore why PAD is more prevalent in African Americans, the specific risk factors that increase its impact, and how families can take action to prevent and treat this disease before it leads to devastating consequences.


Why PAD is More Prevalent in the African American Community

Studies show that African Americans are two to four times more likely to develop PAD than non-Hispanic white individuals. This disparity is due to a combination of genetic, socioeconomic, and lifestyle factors that increase the likelihood of vascular disease.

Key Risk Factors That Affect African Americans

 

  1. Higher Rates of Hypertension (High Blood Pressure)
    • African Americans develop high blood pressure earlier in life and with greater severity than other groups, leading to accelerated artery damage.
  2. Increased Prevalence of Diabetes
    • Diabetes is a major risk factor for PAD. African Americans are 60% more likely to be diagnosed with diabetes than non-Hispanic whites, and poorly controlled diabetes can lead to severe PAD and amputations.
  3. Higher Incidence of Chronic Kidney Disease (CKD)
    • African Americans are nearly four times more likely to develop kidney failure, which is closely linked to PAD. Poor kidney function leads to worsened arterial health and an increased risk of limb loss.
  4. Smoking and Environmental Factors
    • Smoking drastically increases the risk of PAD, and African Americans who smoke are at an even higher risk for severe, treatment-resistant PAD.
  5. Limited Access to Specialized Vascular Care
    • Many African Americans live in communities where access to vascular specialists is limited, leading to delays in diagnosis and treatment. Lack of awareness and preventive care further increases the likelihood of PAD progressing to critical limb ischemia (CLI) and amputation.

Recognizing the Signs of PAD: Don’t Ignore These Symptoms

The earlier PAD is detected, the better the chances of preventing life-altering complications. Unfortunately, many people mistake PAD symptoms for signs of aging or ignore them altogether. Here’s what to look for:

  • Leg pain, cramping, or fatigue when walking
  • Numbness, tingling, or coldness in the feet
  • Darkened or discolored skin on the legs or toes
  • Sores or wounds on the feet that won’t heal
  • Throbbing leg pain at night, a warning sign of critical limb ischemia (CLI)

If you or a loved one experiences these symptoms, don’t wait—seek medical attention immediately.


Why African American Families Must Take Action

PAD doesn’t just affect individuals—it impacts entire families. The burden of limb loss, disability, and heart disease due to PAD can have devastating emotional, financial, and social consequences.

How Families Can Help

  • Encourage Loved Ones to Get Screened – Early diagnosis is key.
  • Adopt a Heart-Healthy Diet – Traditional diets high in fried foods and processed sugars increase PAD risk.
  • Stay Physically Active – Walking can improve circulation and delay PAD progression.
  • Manage Diabetes and Blood Pressure – Keeping these conditions under control reduces PAD risk.
  • Seek Care from a Trusted Vascular Specialist – Not all doctors have the expertise needed to prevent amputations.

Why Choosing the Right Vascular Surgeon Matters

There is a huge disparity in the quality of vascular care provided to African Americans. Many patients are referred too late or receive subpar treatment at hospitals where financial motives override patient care.

Dr. Polly Kokinos and South Bay Vascular are committed to preventing unnecessary amputations by offering: ✔ Advanced, minimally invasive treatments ✔ Limb-salvage expertise ✔ Comprehensive, relationship-based patient care ✔ Immediate access to cutting-edge vascular technology


Conclusion: The Time to Act is Now

PAD is a serious yet preventable disease. African Americans are at higher risk and must be proactive about screening, lifestyle changes, and expert medical care. If you or a loved one has symptoms of PAD, don’t wait until it’s too late—schedule a consultation with Dr. Polly Kokinos today.

Your health and your future matter. Let’s work together to stop PAD in its tracks. Call our office today to schedule an appointment at 408-376-3626 if you suffer or are diagnosed with any of the conditions outlined in this office. Ask your primary care physician for a direct referral to Dr Kokinos or visit our website at www.southbayvascular.com to learn more about how we can help. 

 

“We Offer Hope When Others Say There Is None”

DOES FOOT PAIN WAKE YOU UP AT NIGHT

Many patients as they get older, get up at night to go to the bathroom or because of difficulty sleeping. One serious problem that can wake people up at night is pain in their foot or toes.

This most often occurs in patients over the age of 65 who have a history of smoking, diabetes, high blood pressure, and/or high cholesterol. Some believe this is arthritis or gout, but it is often related to having poor circulation in the foot. The name for this in medical terms is “rest pain”. This is not “pain at rest” but rather pain that happens because the circulation cannot support the tissues even when they are at rest.

This is a sign of critical limb ischemia—another word for lack of blood flow. The arteries are so blocked that they cannot even deliver the minimal amount of oxygen the tissues in the foot and toes require to be happy. Patients often self-adapt to this problem, as it does usually develop slowly over time. They sometimes will tell you their foot doesn’t bother them at night, but on further questioning, you learn they sleep in a recliner or they sleep with their leg hanging over the side of the bed.

The trick here is that when the leg is hanging down, gravity helps pull down a little more blood to the foot so that it doesn’t hurt. Interestingly, the foot often also gets swollen, so the patient is often MIS-DIAGNOSED with a vein problem, not an arterial problem. …that’s why it is the “Right” experience that matters in diagnosing these kinds of vascular problems and why more local independent physicians refer their vein and vascular patients to Dr Kokinos than to any other vascular surgeon in the Silicon Valley Region.  https://www.southbayvascular.com/blog/the-right-experience-counts-when-it-comes-to-your-health/ The patient often thinks that they get up at night to go to the bathroom, but the truth is the foot pain wakes them up, they get out of bed because that makes it feel better (again due to gravity), they go to the bathroom because they think they have to (or maybe really do), and then they can go back to sleep pain -free for a couple of hours. Usually , the pain does wake them up multiple times a night, and that ‘s why they often end up sleeping in a chair.

If this sounds like something you or someone you love is experiencing, it is important to tell your primary care doctor or to schedule an appointment DIRECTLY with a vascular surgeon. These symptoms are a sign that your body is giving you that you need immediate help. This truly is a sign that your foot is starving for oxygen and blood and that if left untreated, might lead to an unnecessary amputation. Help is possible, however and if treated early enough, those suffering from these symptoms can be helped significantly.

If you suffer from painful feet in the middle of the night, contact us today  at 408-376-3626 to learn more about PAD and how Dr. Kokinos can help, click here.

South Bay Vascular Center and Vein Institute: We Offer Hope When Others Say There Is None.

MILLIONS WITH LEG PAIN HAVE PERIPHERAL ARTERIAL DISEASE

A NY Times Health Care blog published in April of 2016 screamed out with the title “Millions With Leg Pain Have Peripheral Arterial Disease”.”More than eight million older Americans have a condition that can cause leg pain when they walk even short distances. Yet half of those who have the condition don’t know it and consequently don’t get treated for it, putting themselves at risk for a heart attack, stroke or worse.The condition, called peripheral artery disease, or P.A.D., is marked by diseased or blocked arteries in the legs. More than half of those with such circulatory problems in the extremities also have coronary or cerebral artery disease, noted Dr. Iftikhar J. Kullo, a cardiovascular specialist at the Mayo Clinic, in The New England Journal of Medicine in March. Failure to diagnose and treat blocked arteries elsewhere in the body can result in more serious, or even fatal, problems if they affect the heart or brain.It may seem odd that people who have serious difficulty walking normal distances would not know something is wrong and get checked out. Yet, as Dr. Kullo noted, P.A.D. is both underdiagnosed and undertreated. And the number of cases of P.A.D. is only likely to rise as the population ages, he said.”The article in its entirety can be read by clicking on the link below

https://well.blogs.nytimes.com/2016/04/11/millions-with-leg-pain-have-peripheral-artery-disease/

San Jose’s South Bay Vascular Center surgeons specialize in the care and treatment of patients suffering from PAD. Recognized as one of California’s leading Vascular Surgeons, Dr Kokinos has a special interest in peripheral re-vascularization procedures. Essential to her success in treating PAD is her ability to perform these re-vascularization procedures in her nationally accredited, custom built, state of the art peripheral arterial disease (PAD) treatment center. This facility, located in Campbell, CA., was specifically designed as a PAD treatment facility and is where South Bay Vascular Center physicians leverage advanced imaging systems (Ziehm C-Arms with Flat Panel Detectors and Phillips Intra Vascular Ultrasound imaging systems) to provide the most advanced surgical techniques available in this area. This advanced technology, together with a vast inventory of specialized medical devices not found in traditional operating rooms allows our surgeons to perform advanced, minimally invasive surgical procedures in their efforts to provide the best possible outcomes in the most difficult circumstances.Diagnosis
Many types of health care providers can diagnose and treat PAD. Family physicians, internists, physician assistants, nurse practitioners and vascular specialists can all diagnose PAD by examining a patient’s medical and family history, performing a physical exam, and conducting diagnostic tests. PAD can be diagnosed through a variety of diagnostic procedures including:

  • Ankle-brachial index (ABI):A common test used to measures the difference between blood pressure at the arm and at the ankle. A difference in the two areas indicates restricted blood flow.
  • Ultrasound
  • CT and MR angiograms
  • Angiography
  • Blood tests

Treatment
Over the past 15 years the interventional treatment of peripheral arterial disease (PAD) has changed significantly. Endovascular techniques have replaced many traditional open surgically invasive procedures as the dominant intervention. More recently, pedal access techniques, accessing the blocked area from the toe versus a traditional access point in the patients groin, has shown, in certain instances, to be significantly more successful that earlier methods of revascularizing the impacted area. Dr. Kokinos has performed more pedal access approach procedures that anyone in Northern California and because of this she able to provide patients with more options for treating their disease than many other surgeons.There are multiple options for treatment of PAD, ranging from medical interventions, surgical revascularization, and endovascular therapy. Vascular Surgeons are uniquely qualified and trained to treat patients diagnosed with PAD. Approaches to treatment include:

  • Minimally invasive endovascular procedures
  • Medical management
  • Exercise and lifestyle modifications
  • Surgical bypass Amputation

Early detection and treatment are important to control the disease and to allow patients a full selection of treatment options. If you suffer from non-healing leg wounds and or have difficulty walking short distances, ask your physician if you can have a vascular ultrasound study to evaluate your risk of PAD.

South Bay Vascular Center and Vein Institute is the recognized as the regional treatment center for the treatment and care of patients suffering from Peripheral Arterial Disease. Dr.’s Kokinos’ specialized training and state of the art interventional facility offers patients a unique alternative to a hospital setting and provides the highest level of care for the treatment of PAD as an alternative to limb amputation.

If you or a loved ones suffers from PAD, call our office today at 408-376-3626 to schedule a visit.

We offer hope when others say there is none.

www.southbayvascular.com