By AMERICAN HEART ASSOCIATION NEWS
Aruna Pradhan, M.D., grew up in the 1970s in Selma, Alabama, when the small Southern city was tending to wounds from its years of racial unrest.
She was bothered by things she saw and even experienced as a teenager, but she was not sure just what she might be able to do about them.
Pradhan’s experiences later developed into a desire to help heal those with a long-ignored vascular disease called peripheral artery disease, which more often afflicts African-Americans than whites.
“It’s a pretty devastating disease, and one of the most disfiguring cardiovascular disorders,” said Pradhan, recently named chair of the Peripheral Vascular Disease Council of the American Heart Association.
She comes by an interest in medicine naturally.
Pradhan’s parents were both doctors, and she loved hearing their talk of medicine. Their high standards translated into high grades for their daughters, but Pradhan and her two sisters were not allowed into the private, academically demanding school in Selma her parents wanted to enroll the girls in.
“My mother said they told her that our grades would not transfer, which was puzzling because we were all in gifted programs” Pradhan remembered one day recently.
It also could have been because her mother chose to wear a sari rather than Western clothing, she said.
Pradhan graduated from the Selma public school system when she was 16 and then headed to Georgetown University.
But the things she saw in Selma stayed with her. Why was the health of African-Americans so much worse than that of whites? Was it risk factors or neglect? What could be done about it? What could she do about it?
The natural path for her was medicine.
And yet, “I wanted to do something more. I felt like I was on this path, but it’s not really singing to me,” Pradhan said.
Soon, she was at Harvard, studying cardiology. Next came a master of public health degree in epidemiology. That’s when she began to find the work that would soon be serenading her.
“I had a really great mentor, Dr. Mark Creager (past president of the AHA and vascular medicine specialist), and I just saw the types of patients who were most affected by it,” Pradhan said. “I saw the effects that it had on our patients. It was hard not to see. You can’t turn your back on these people.”
Peripheral artery disease is a narrowing of arteries in parts of the body away from the heart, such as arms, hands, feet and legs. The narrowing interferes with blood flow to these essential body parts. It can be very painful and result not only in loss of mobility but also loss of limbs. It also is a strong risk factor for stroke.
While blockage of the arteries and vessels near the heart has been well-studied and understood for some time, there has been less focus on PAD, Pradhan explained.
And yet, while she and Creager were seeing PAD patients in the clinic, they weren’t seeing as many research findings to guide their clinical decisions. There hadn’t been many clinical trials focusing specifically on PAD, or even studies that included PAD as a condition to investigate.
“I realized we didn’t have enough out there,” Pradhan said.
She heard her song.
Since that time, PAD has been a major research focus at Brigham and Women’s Hospital in Boston. She has conducted more than a dozen clinical studies to determine the various factors that contribute to and complicate PAD.
She has investigated the relationship between inflammation and PAD, and studied the condition’s role in metabolic syndrome.
Most recently, she has been an investigator for a multi-center trial that examined whether lowering triglycerides—not just bad LDL cholesterol—can lower the risk of cardiovascular disease, including PAD.
Pradhan enjoys poring over numbers, looking for possible relationships between factors that lead to disease. She also looks for visual ways to express the numbers and explain the relationships she sees in them.
“It’s that nerdy part of me,” she said with a laugh but also a note of pride. “I’ll see this signal but think hmm, that doesn’t make sense.”
So she goes looking for answers among other data sets—or designs a new study.
“She brings her knowledge of population health to the bedside,” said Creager, director of Heart and Cardiovascular Health at Dartmouth-Hitchcock Medical Center in Lebanon, N.H. He also credited Pradhan’s “probing scientific mind” in designing studies and exploring risk factors for PAD.
Now, Pradhan is a mentor to others. One of those she mentors, Aaron Aday, M.D., said that Pradhan’s persistence and strict adherence to study design most stands out in his mind.
“There are no shortcuts, no sloppy research, no easy way out,” Aday said. “She asks questions, she probes. Any time I’m discussing a study, she’ll ask, ‘But why does this matter? What will it mean?’ She brings an extremely rigorous epidemiological background to this work.”
For Pradhan, the best part of her work with the AHA council has been the opportunity to learn more about PAD so that she can help more people.
“It’s put me in a position to do all those things I dreamed about in Alabama,” she said.