title: Evaluation of medical treatment for peripheral arterial disease in Chinese high-risk patients.
abstract: BACKGROUND
  Peripheral arterial disease (PAD) is an important manifestation of systemic atherosclerosis and is associated with elevated cardiovascular morbidity and mortality. The aim of the present study was to evaluate the use of antiplatelet agents, statins and angiotensin-converting enzyme inhibitors (ACEI) in Chinese high-risk cardiovascular (CV) patients with PAD, with an emphasis on the need for aggressive medical management of all atherosclerotic manifestations.
  
  
  RESULTS
  Medical records from 5,263 Chinese patients at high risk of CV were evaluated for the use of antiplatelet agents, statins and ACEI in patients with and without PAD. PAD was defined as an ankle-brachial index (ABI)<0.9 in either leg. Multivariable logistic regression analyses were performed to compare medication use in the 2 groups. A total of 5,254 patients were analyzed (52.9% male, mean age 67.3 years). The prevalence of PAD in the total patient group was 25.4%; 22.5% of them had PAD only. Overall, 5.7% had PAD only, 19.6% had PAD and coronary heart disease (CHD) or stroke or diabetes, 7.7% had CHD only, 12.6% had stroke only, and 13.6% had diabetes only. The 28.9% subjects having none of PAD, CHD, stroke or diabetes were used as the reference group. Only 65%, 37% and 47% of all patients received antiplatelet agents, statins and ACEI, respectively. Antiplatelets, statins, ACEI and all 3 medications were used less frequently in PAD only patients (58.1%, 35.9, 53.5% and 21.6%) vs CHD only (90.9%, 74.5%, 70.6% and 55.9%, p<0.001). All 3 proven efficacious therapies were prescribed for only 56% of patients with CHD only, 8% with stroke only, 13% with diabetes only and 21% with PAD only.
  
  
  CONCLUSIONS
  PAD is prevalent in Chinese high-risk CV patients, equivalent to CHD, but these patients receive less intensive treatment than those with CHD. Programs to improve CV risk reduction in these high-risk patients are needed.
authors.affiliation: Heart, Lung and Blood Vessel Center, Tongji University, Shanghai, and Heart Center, Beijing Tongren Hospital, China.
authors.forename: Buaijiaer
authors.initials: B
authors.lastname: Hasimu
authors.forename: Jue
authors.initials: J
authors.lastname: Li
authors.forename: Jinming
authors.initials: J
authors.lastname: Yu
authors.forename: Yitong
authors.initials: Y
authors.lastname: Ma
authors.forename: Mingzhong
authors.initials: M
authors.lastname: Zhao
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Nakayama
authors.forename: Wenlin
authors.initials: W
authors.lastname: Ma
authors.forename: Jingang
authors.initials: J
authors.lastname: Yang
authors.forename: Liqiang
authors.initials: L
authors.lastname: Zheng
authors.forename: Xiankai
authors.initials: X
authors.lastname: Li
authors.forename: Yingyi
authors.initials: Y
authors.lastname: Luo
authors.forename: Yuanxi
authors.initials: Y
authors.lastname: Xu
authors.forename: Lihua
authors.initials: L
authors.lastname: Zhang
authors.forename: Lilin
authors.initials: L
authors.lastname: Zou
authors.forename: Weilin
authors.initials: W
authors.lastname: Xiao
authors.forename: Yalei
authors.initials: Y
authors.lastname: Han
authors.forename: Dayi
authors.initials: D
authors.lastname: Hu
mesh_terms: D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D002681:China / Q000453:epidemiology; D003327:Coronary Disease / Q000628:therapy; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000628:therapy; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D015995:Prevalence; D012044:Regression Analysis; D012307:Risk Factors; D020521:Stroke / Q000628:therapy
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010975:Platelet Aggregation Inhibitors