Atherosclerotic risk factors are less intensively treated in patients with peripheral arterial disease than in patients with coronary artery disease.
OBJECTIVE
To compare rates of therapy for atherosclerotic risk factors between patients with lower extremity peripheral arterial disease (PAD) and patients with coronary artery disease (CAD).


METHODS
Cross-sectional.


METHODS
Academic medical center.


METHODS
Three hundred forty-nine consecutive patients diagnosed with PAD or CAD identified from the blood flow and cardiac catheterization laboratories, respectively.


RESULTS
Participants were interviewed by telephone for medical history as well as therapies prescribed and recommended by their physicians. Among patients with hypercholesterolemia, more CAD patients were taking cholesterol-lowering drugs (58% vs 46%, p = .08) and more CAD patients recalled a physician's instruction to follow a low-fat, low-cholesterol diet (94% vs 83%, p = .01). CAD patients were more likely to exercise regularly (71% vs 50%, p < .01). Among patients not exercising, more CAD patients recalled a physician's advice to exercise (74% vs 47%, p < .01). In logistic regression analysis, hypercholesterolemic patients with exclusive CAD were more likely to be treated with drug therapy (odds ratio [OR] 2.3, p = .05). CAD patients were more likely to recall advice to exercise (OR 4.0, p < .001), and more likely to be taking aspirin or warfarin (OR 4.8, p = .01).


CONCLUSIONS
Atherosclerotic risk factors are less intensively treated among PAD patients than CAD patients. A number of possible explanations could account for these disparities in therapeutic intensity.
McDermott
M M
MM
Department of Medicine, Northwestern University Medical School Chicago, IL 60611, USA.
Mehta
S
S
Ahn
H
H
Greenland
P
P
D000368:Aged; D001161:Arteriosclerosis / Q000150:complications* / Q000453:epidemiology / Q000628:therapy*; D006328:Cardiac Catheterization; D003327:Coronary Disease / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007087:Illinois / Q000453:epidemiology; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D011379:Prognosis; D012307:Risk Factors; D011795:Surveys and Questionnaires; D015996:Survival Rate