Millions go undiagnosed and undertreated for artery disease
PARTNERS project points to need for increased awareness and treatment recommendations to prevent heart attacks and stroke
MINNEAPOLIS / ST. PAUL (September 18, 2001)--The largest study ever done on peripheral artery disease (PAD) shows significant numbers of people are undiagnosed, underdiagnosed or undertreated. In the study, which is published in the September 19, 2001 issue of the Journal of the American Medical Association (JAMA), almost 30 percent of the 6,417 participants were diagnosed with PAD, more than half for the first time.
People with PAD are six times more likely to die from cardiovascular disease within 10 years than those who do not have PAD. It is believed that PAD affects between 8 and 12 million people in the United States and an equal number in Western Europe.
PAD is easily detected using a noninvasive technique measuring the systolic blood pressure in the legs and arms to calculate the ankle-brachial index (ABI), according to Alan T. Hirsch, M.D., cardiologist and associate professor, University of Minnesota Medical School. "Those diagnosed with PAD can reduce their risk for complications by normalizing all risk factors, such as high blood sugar or cholesterol levels, treating high blood pressure, stopping smoking, exercising regularly, especially for those with leg symptoms, and using an antiplatelet, or clot-preventing, medication under a doctor's supervision," he said.
PAD is a condition in which the arteries become narrowed due to the formation of plaque inside the artery walls. Symptoms may include pain, cramps or a tired feeling in the calf or thigh muscles that occurs during walking and is relieved by rest. However, symptoms alone are not reliable indicators of the presence or progression of PAD because more than three-fourths of those with PAD do not have classic symptoms.
Left untreated, the plaque can rupture, leading to platelet-induced thrombosis, or blood clot formation, a process known as atherothrombosis. Atherothrombosis can lead to serious health consequences, including heart attack and stroke.
PARTNERS (PAD Awareness Risk and Treatment: New Resources for Survival) is a national program to assess awareness of PAD among patients and healthcare professionals across the United States. The project was modeled after a pilot study done at the University of Minnesota, which revealed similar results. Nearly 7,000 at-risk patients from 27 regional centers and 320 primary care practices were evaluated. "At risk" patients were defined as people 70 years of age or older or those between 50 and 69 years of age with a history of smoking and/or diabetes.
The PARTNERS study also suggests that more can be done to raise awareness in both physicians and patients so that an early diagnosis and treatment recommendations can be outlined in the primary care setting. "There is almost no other disease that affects so many people, that creates so much suffering, yet that is so easy to diagnose and so easily treated," said Hirsch.
Alan Hirsch, M.D., associate professor, Medical School
Diane Treat-Jacobson, coordinator, Vascular Medicine Research Program
Sarah Youngerman, Academic Health Center, 612-624-4604
Tonya Femal, Academic Health Center, 612-625-2640
Deane Morrison, University News Service, 612-624-2346