title: Perceptions of Canadian vascular surgeons toward pharmacological risk reduction in patients with peripheral arterial disease.
abstract: Patients with peripheral arterial disease (PAD) are at a markedly higher risk of cardiovascular morbidity and mortality, with evidence indicating that risk-reduction pharmacotherapy can serve to attenuate cardiovascular events in these patients. Given the central role of vascular surgeons in the treatment of patients with PAD, we sought to determine their perceptions and knowledge of risk-reduction pharmacotherapy in patients with PAD. We conducted a cross-sectional survey of 79 Canadian vascular surgeons who attended the 2004 annual meeting of the Canadian Society for Vascular Surgery, the largest and most representative meeting of its kind in Canada. The recommended targets of low-density lipoprotein cholesterol, blood glucose, and blood pressure were known to 53.8%, 40.4%, and 57.7% of vascular surgeons, respectively. The majority of vascular surgeons (65.4%) reported screening for risk factors in <50% of cases. Although 90.4% of vascular surgeons would recommend antiplatelet therapy for PAD, only 5.8% would recommend angiotensin converting enzyme (ACE) inhibitors and 19.2% would recommend lipid-lowering therapy with statins. Eighty-four percent of Canadian vascular surgeons indicated that their self-assessment of risk reduction in PAD was average to below average, yet 90.4% of them believed that risk-reduction therapy should be recommended or initiated by vascular surgeons. Canadian vascular surgeons' perceptions toward risk reduction in PAD identify knowledge and action gaps, despite the recognition that recommending and instituting therapy is important to patient care. Given the heightened risk of cardiovascular disease in patients with PAD, these data have important implications.
authors.affiliation: Division of Vascular Surgery, Toronto General Hospital, Toronto, Ontario, Canada.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Al-Omran
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Lindsay
authors.forename: Jennifer
authors.initials: J
authors.lastname: Major
authors.forename: Ali
authors.initials: A
authors.lastname: Jawas
authors.forename: Larry A
authors.initials: LA
authors.lastname: Leiter
authors.forename: Subodh
authors.initials: S
authors.lastname: Verma
mesh_terms: D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D002170:Canada; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control*; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D019983:Guideline Adherence; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D016491:Peripheral Vascular Diseases / Q000150:complications / Q000188:drug therapy* / Q000601:surgery; D010819:Physician's Role; D010820:Physicians / Q000706:statistics & numerical data*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014656:Vascular Surgical Procedures
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010975:Platelet Aggregation Inhibitors