title: Risk modification in patients with peripheral arterial disease: a retrospective survey.
abstract: Peripheral arterial disease (PAD) is underdiagnosed and undertreated. This is despite the high vascular morbidity and mortality rates associated with PAD. There is also evidence that quitting smoking, improving the lipid profile, lowering the blood pressure, and administering antiplatelet drugs reduce the risk of vascular events in these patients. Secondary prevention for patients with PAD is yet to meet the standard of care for those with ischemic heart disease. The authors surveyed 200 claudicants attending a vascular clinic with additional follow-up in a risk modification clinic. After a median follow-up of 28 months (range: 6-65) there was a significant (p = 0.001) improvement in walking distance; 34 patients (17%) had a vascular ischemic event. Of those, 11 patients (5.5%) had worsening intermittent claudication and 9 had a stroke/transient ischemic attack; 9 events (4.5%) were fatal. The lipid targets were met in 76% the patients. Half the smokers quit smoking and 94% of the patients were taking antiplatelet drugs or anticoagulants. Blood pressure reached the accepted target in 87% of the patients. Secondary prevention in patients with PAD may reduce the risk of vascular events. Aggressive risk modification is therefore recommended.
authors.affiliation: University Department of Surgery, Royal Free and University College Medical School, University College London, UK.
authors.forename: Fahed
authors.initials: F
authors.lastname: Youssef
authors.forename: Prakash
authors.initials: P
authors.lastname: Gupta
authors.forename: Dimitri P
authors.initials: DP
authors.lastname: Mikhailidis
authors.forename: George
authors.initials: G
authors.lastname: Hamilton
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use; D003404:Creatinine; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D007383:Intermittent Claudication / Q000150:complications / Q000503:physiopathology / Q000517:prevention & control*; D008019:Life Style; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D012189:Retrospective Studies; D012307:Risk Factors; D016540:Smoking Cessation; D014527:Uric Acid / Q000097:blood; D016138:Walking
chemical_list: D000925:Anticoagulants; D008055:Lipids; D010975:Platelet Aggregation Inhibitors; D014527:Uric Acid; D003404:Creatinine