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Few Americans aware of dangerous peripheral arterial disease
DALLAS, Sept. 18 – Three out of four people aren’t aware of peripheral arterial disease (PAD), a common and dangerous vascular disease that affects approximately 8 million Americans, according to a new study published in Circulation: Journal of the American Heart Association.
The disease occurs when arteries in the legs become narrowed or clogged with fatty deposits, reducing blood flow to the legs. This can result in leg muscle pain when walking and disability, amputation and a poor quality of life. Blocked arteries found in people with PAD can be a warning sign that other arteries, including those in the heart and brain, may also be blocked – increasing the risk of a heart attack or stroke.
In a cross-sectional, population-based telephone survey of 2,501 adults over age 50, researchers found that public awareness of PAD (25 percent) is markedly lower than for other cardiovascular diseases such as stroke (74 percent), coronary artery disease (67 percent) and heart failure (67 percent). Yet, the risk for PAD is equal to or greater than the risk for these conditions.
Survey respondents were much more aware of relatively rare diseases that affect far fewer people, including Lou Gehrig’s Disease (36 percent), multiple sclerosis (42 percent) and cystic fibrosis (29 percent).
Few Americans know that having PAD significantly increases the risk for heart attack, stroke, amputation and death, the survey showed. Only one in four adults who were familiar with PAD associate the disease with an increased risk of heart attack; only 28 percent associate PAD with an increased risk of stroke; and only 14 percent link PAD with either amputation or death.
“Every day that PAD is undetected and untreated, we permit preventable heart attacks, strokes and death to occur,” said Alan T. Hirsch, M.D., chair of the national Peripheral Arterial Disease Coalition, professor of epidemiology and community health at the University of Minnesota School of Public Health, and director of the vascular medicine program at the Minneapolis Heart Institute. “PAD can either represent a tragedy waiting to happen or the single best opportunity for this nation to take preventative steps to save limbs and lives.”
PAD affects both women and men and can strike adults of any age. The risk of PAD is increased in people over age 50, particularly in smokers and former smokers, and in people with diabetes, high blood pressure, abnormal cholesterol, a personal history of heart disease or stroke, and in African Americans.
Awareness of PAD was low in all sub-groups studied, including African Americans. “The risk of PAD in African Americans is twice what it is in other ethnic groups, and like other high-risk groups, African Americans should be a major focus of educational efforts about PAD,” said Michael H. Criqui, M.D., M.P.H., co-author and professor of family and preventive medicine at the University of California-San Diego.
The study also found that most Americans do not know the causes or risk factors of PAD. Cigarette smoking and diabetes contribute to the development and progression of PAD, a fact unknown even by many survey respondents who reported familiarity with the disease. Further, more than half of those familiar with PAD do not know that high blood pressure and high blood cholesterol are also risk factors.
“These findings show that awareness of a disease does not necessarily translate to knowledge. If the public is uninformed about the devastating consequences and causes of PAD, they will be less likely to take steps to avoid it,” said co-author Timothy Murphy, M.D., professor of diagnostic imaging at Brown University in Providence, RI.
The survey also found that almost half of adults familiar with PAD first became aware of the disease through the media – broadcast or cable television (26 percent), a magazine (15 percent), newspaper (5 percent), the Internet (3 percent) or radio (0.7 percent). Only 19 percent of adults reported first hearing about PAD from a healthcare provider, and about 17 percent first heard about PAD from a family member or friend.
“If we are now – perhaps many decades late – entering a time when we use our scientific knowledge to inform Americans about PAD, then we can share a future in which PAD can be appropriately diagnosed, and individuals and health professionals can work together to promptly initiate evidence-based therapies proven to save lives,” Hirsch said.
Other authors are Marge B. Lovell, R.N.; Gwen Twillman; Diane Treat-Jacobson, Ph.D., R.N.; Eileen M. Harwood, Ph.D.; Emile R. Mohler, III, M.D.; Mark A Creager, M.D.; Robert W. Hobson, II, M.D.; Rose Marie Robertson, M.D.; William James Howard, M.D.; Paul Schroeder, M.A.
The Peripheral Arterial Disease Coalition funded the study through grants from the Bristol-Myers Squibb/Sanofi Aventis Partnership and Cordis Endovascular, a division of Cordis Corporation.
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