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Lookup NU author(s): Professor Gerard Stansby
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Background: Peripheral arterial disease (PAD) is often associated with risk factors including cigarette smoking, hypertension and hypercholesterolaemia, and patients have a high risk of future vascular events. Good medical management results in improved outcomes and quality of life, but previous studies have documented sub-optimal treatment of risk factors. We assessed the management of cardiovascular risk factors in patients with PAD referred to specialist vascular clinics. Methods: This was a prospective, protocol driven registry carried out in UK vascular clinics. Patients who were first-time referrals for evaluation of PAD were eligible if they had claudication plus ankle-brachial pressure index (ABPI) ≤0.9. Statistical associations between key demographic and treatment variables were explored using a chi-squared test. Results: We enrolled 473 patients from 23 sites. Mean age was 68 years (SD 10) and 66% were male. Mean estimated claudication distance was 100 m, and ABPI was 0.74. Mean systolic blood pressure (SBP) was 155 mmHg, and 42% had a SBP >160 mmHg. Forty percent were current smokers and half had tried to give up in the prior 6 months, but there was no evidence of a systematic method of smoking cessation. Mean total cholesterol was 5.4 (SD1.2) mmol/l and 30% had levels >6 mmol/l. Antiplatelet therapy had been given to 70% and statins to 44%. Prior CHD was present in 29% and these patients had significantly higher use of antiplatelet therapy, statins and ACE-inhibitors. Conclusions: In spite of attempts to raise awareness about PAD as an important marker of cardiovascular risk, patients are still poorly treated prior to referral to a vascular clinic. In particular, the use of evidence-based treatments is sub-optimal, while hypertension and cigarette smoking are poorly managed. More work needs to be done to educate health professionals about the detection and optimal medical management of PAD. © 2006 Elsevier Ltd. All rights reserved.
Author(s): Khan S, Flather M, Mister R, Delahunty N, Fowkes G, Bradbury A, Stansby G
Publication type: Article
Publication status: Published
Journal: European Journal of Vascular and Endovascular Surgery
Year: 2007
Volume: 33
Issue: 4
Pages: 442-450
Print publication date: 01/04/2007
ISSN (print): 1078-5884
ISSN (electronic): 1532-2165
Publisher: Elsevier Inc.
URL: http://dx.doi.org/10.1016/j.ejvs.2006.11.010
DOI: 10.1016/j.ejvs.2006.11.010
PubMed id: 17196851
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