Peripheral Arterial Disease

• Diagnosis, Imaging, Screening
• General Information
• Guidelines
• Internet Sites
• Risk Factors
• Risk Reduction
• Treatment - Daily Report

Treatment is updated daily with the most recent articles listed on top.
To view only the last month's articles for the other sub-topics, go to our Monthly Online Newsletters page

If you have any questions regarding our Search Reports, please contact us at info@infomedsearch.com.

PAD

NIH - Arteriosclerosis of the extremities

"Arteriosclerosis of the extremities is a disease of the blood vessels characterized by narrowing and hardening of the arteries that supply the legs and feet. This causes a decrease in blood flow that can injure nerves and other tissues. Arteriosclerosis, or "hardening of the arteries," commonly shows its effects first in the legs and feet. The narrowing of the arteries may progress to total closure (occlusion) of the vessel. The vessel walls become less elastic and cannot dilate to allow greater blood flow when needed (such as during exercise). Calcium deposits in the walls of the arteries contribute to the narrowing and stiffness. The effects of these deposits may be seen on ordinary X-rays. This is a common disorder, usually affecting men over 50 years old. People are at higher risk if they have a personal or family history of coronary artery disease (heart disease) or cerebrovascular disease (stroke), diabetes, smoking, hypertension (high blood pressure), or kidney disease involving hemodialysis."

Highlighted Article

Medical treatment of peripheral arterial disease.

"CONTEXT: Peripheral arterial disease (PAD) affects approximately 20% of adults older than 55 years and is a powerful predictor of myocardial infarction, stroke, and death due to vascular causes. The goals of treatment are to prevent future major coronary and cerebrovascular events and improve leg symptoms. … CONCLUSION: The substantial and increasing burden of PAD, and its local and systemic complications, can be reduced by lifestyle modification (smoking cessation, exercise) and medical therapies (nicotine replacement therapy, bupropion, antihypertensive drugs, statins, and antiplatelet drugs)."

Visit InfoMedSearch's Home Page for all InfoMedLinks Cardiovascular Topics: Atherosclerosis, Atrial Fibrillation, Coronary Artery Disease, Cholesterol - Lipids, General Cardiovascular, Heart Failure, Hypertension, Myocardial Infarction (Heart Attack), Peripheral Artery Disease, and Stroke.

CONTINUE YOUR INFOMEDSEARCH RESEARCH with our previous InfoMedLinks. Start with InfoMedLinks 2006.

Peripheral Arterial Disease

General Information

NEWS:

Peripheral Artery Disease Up Sharply Among U.S. Women: The condition, which is symptomless, can lead to heart attack and stroke " 'Treatment, especially for asymptomatic patients, is exactly what we would want people to do for coronary disease,' added Erwin, who's also a cardiologist with Scott & White Hospital in Temple, Texas. 'If we take tight control of diabetes, we help them lose weight, quit smoking, get cholesterol levels down. This has been very, very efficacious in preventing further stenosis [narrowing of the blood vessels] and, in some small trials, there's even been a question about regression of the disease.' "

ARTICLES:

Peripheral Artery Disease "PAD is a form of atherosclerosis, the same disease that causes most strokes and nearly all heart attacks. It most commonly affects the legs, but it can affect arteries anywhere in the body, including the heart and brain. That's why people with PAD have an increased risk of heart attack and stroke and are two to four-times more likely to die from cardiovascular disease than people without PAD. … The earliest and most common symptom is called intermittent claudication, which causes cramp-like muscle pain. Claudication occurs when muscles are not getting enough oxygen. The discomfort can occur in the foot, calf, thigh, or buttock, depending on the site of the blockage. Men can also develop erectile dysfunction if PAD strikes in the aorta or iliac arteries because they supply blood to the penis. PAD can also produce numbness, tingling, weakness or fatigue. Because muscles need more oxygen when they're working, claudication begins during exercise and resolves with a few minutes of rest."

Prevalence of and risk factors for peripheral arterial disease in the patients with hypertension among Han Chinese. (J Vasc Surg. 2007)

JOURNAL ARTICLES:

A cross sectional survey of secondary prevention measures in patients with peripheral arterial disease in primary care. (Postgrad Med J. 2007) "CONCLUSION: The cross sectional survey suggested the treatment received by some patients with established PAD is substandard. There is considerable potential to increase secondary prevention of CHD in patients with PAD disease in primary care."

A pilot study showing an association between platelet hyperactivity and the severity of peripheral arterial disease. (Platelets. 2007) "These results indicate that platelet hyperactivity is associated with increasing severity of PAD. Increased platelet aggregation may result in thromboembolic events in the affected limb."

A Prognostic Risk Index for Long-term Mortality in Patients With Peripheral Arterial Disease. (Arch Intern Med. 2007)

Abdominal fat and risk of coronary heart disease in patients with peripheral arterial disease. (Obesity (Silver Spring). 2007) " DISCUSSION: An increased waist circumference, a crude measure of intra-abdominal fat, is associated with an increased risk of concomitant CHD in patients with PAD."

Association between C-reactive protein level and peripheral arterial disease among US adults without cardiovascular disease, diabetes, or hypertension. (Am Heart J. 2007) "CONCLUSIONS: Higher CRP levels are associated with PAD among US adults free of CVD, diabetes, and hypertension. These results suggest that inflammatory mechanisms related to atherosclerosis may be operative even among clinically healthy adults."

Asymptomatic Carotid Artery Stenosis and the Risk of New Vascular Events in Patients With Manifest Arterial Disease (Stroke. 2007) "Background and Purpose— The frequency of asymptomatic carotid artery stenosis (CAS) increases with age from 0.5% in individuals below 50 years of age to 5% to 10% in individuals over 65 years of age in the general population."

Diabetic foot disease in the elderly. (Diabetes Metab. 2007)

Diagnosis and treatment of dyslipidemia are neglected in patients with peripheral artery disease (Scandinavian Cardiovascular Journal 2007) "Conclusions. Dyslipidemia was highly under-diagnosed among PAD patients. Serum lipids were measured only in a minority and among them serum lipid values and the use of hypolipidemic drugs were not optimal according to guidelines."

Direct Association between C-reactive Protein Serum Levels and Endothelial Dysfunction in Patients with Claudication. (Eur J Vasc Endovasc Surg. 2007) “CONCLUSION: Impaired endothelial dysfunction is association with increased plasma concentrations of inflammatory markers, and both may have a role in the aetiopathogenesis of peripheral arterial disease.”

Effect of type 2 diabetes mellitus on exercise intolerance and the physiological responses to exercise in peripheral arterial disease. (Diabetologia. 2007)

Epidemiology, classification, and modifiable risk factors of peripheral arterial disease. (Vasc Health Risk Manag. 2007)

Ethnic-specific prevalence of peripheral arterial disease in the United States. (Am J Prev Med. 2007) " CONCLUSIONS: Roughly one in 16 individuals residing in the United States in 2000 who were aged 40 years and older had PAD. Clinicians are encouraged to screen for the presence of PAD using the ABI."

High prevalence of undiagnosed patients with peripheral arterial disease in patients hospitalised for non-vascular disorders (International Journal of Clinical Practice 2007) "Conclusions: In a tertiary care hospital, the prevalence of unrecognised PAD among patients hospitalised for non-PAD-related causes is high and the preventive CVD therapy rates are low. Hospitalisation is a good opportunity to detect PAD."

Intermittent claudication in the Erfurt Male Cohort (ERFORT) Study: Its determinants and the impact on mortality A population-based prospective cohort study with 30 years of follow-up. (Atherosclerosis. 2007)

Is heart failure more prevalent in patients with peripheral arterial disease? A meta-analysis. (Congest Heart Fail. 2007) "The presence of PAD is associated with a 2-fold increase in the prevalence of HF. The use of PAD as a risk marker for underlying HF may enhance the effectiveness of screening criteria for HF detection."

Left ventricular hypertrophy is present in one-half of newly-diagnosed peripheral arterial disease patients. (J Hypertens. 2007) " CONCLUSION: In conclusion, there is already a high prevalence of LVH in patients at first diagnosis of PAD. LVH is therefore common enough in PAD patients to potentially make a major contribution to cardiac death, which means that future research should now investigate whether screening for and regressing LVH when present would actually reduce cardiac deaths over and above merely achieving target blood pressure."

[Metabolic syndrome and peripheral arterial disease as indicators for increased cardiovascular risk.] (Dtsch Med Wochenschr. 2007) "CONCLUSIONS: Patients with MetS carry a substantially increased risk of premature death, especially cardiovascular death, and therefore require intensive treatment of their risk factors. This holds especially true if concomitant PAD is present."

Myocardial ischaemia in patients with peripheral arterial disease. (Clin Physiol Funct Imaging. 2007)

Peripheral artery disease and hypertension: the relation between ankle–brachial index and mortality "Individuals with peripheral arterial disease (PAD), characterized by atherosclerosis of peripheral arteries, particularly those involving the lower extremities are at an increased risk of adverse cardiovascular events and consequent morbidity and mortality.1 Indeed, the presence of PAD is in itself evidence of widespread atherosclerosis in other vascular territories, with further evidence that it is also a predictor of future cardiovascular outcomes such as stroke, myocardial infarction and death. It would be logical to infer that the risk factors associated with the development of PAD would also have a significant role in the pathogenesis of cardiovascular disease (CVD) and its complications."

Peripheral arterial disease: diagnosis, treatment, and systemic implications. (Clin Dermatol. 2007) "Beneficial therapies include smoking cessation, exercise therapy, cholesterol reduction, antiplatelet therapy, and treatment of hypertension and diabetes. For patients with symptomatic claudication, cilostazol can be considered. Patients with nonhealing ulcers, rest pain, or severe claudication should be referred for interventions."

Peripheral Artery Disease: Pathophysiology, Diagnosis and Treatment. (Rev Esp Cardiol. 2007)

Peripheral arterial disease - high prevalence in rural black South Africans. (S Afr Med J. 2007)

Platelet activation increases with the severity of peripheral arterial disease: Implications for clinical management. (J Vasc Surg. 2007) "CONCLUSION: We have demonstrated for the first time that progression of severity of PAD is not only reflected by symptoms, signs, and ABPI but also by increased platelet activity as assessed by both flow cytometry and aggregation. As patients with more severe PAD have increased cardiovascular mortality, our findings suggest that new strategies for platelet inhibitory therapy are indicated in these patients."

Poor health-related quality of life in patients with peripheral arterial disease: Type D personality and severity of peripheral arterial disease as independent predictors. (J Vasc Surg. 2007)

Prevalence of peripheral arterial disease and prior stroke in octogenarians with symptomatic severe aortic stenosis or severe coronary artery disease: influence in management and outcome. (Int Angiol. 2007) "AIM: Severe aortic stenosis (SAS) and severe coronary artery disease (SCAD) are the most frequent reasons to perform cardiac surgery in octogenarians. Non-coronary vascular disease is frequently present in these patients."

Prevalence of Peripheral Arterial Disease and Risk Factors in Persons Aged 60 and Older: Data from the National Health and Nutrition Examination Survey 1999–2004 (Journal of the American Geriatrics Society 2007) "CONCLUSION: PAD prevalence increases with age and is associated with treatable risk factors for cardiovascular disease."

[Prevalence of peripheral artery disease evaluated by ankle brachial index in patients with metabolic syndrome. MERITO I study.] (Rev Clin Esp. 2007) "CONCLUSION: Prevalence of a low ABI is elevated in subjects with metabolic syndrome without known cardiovascular disease and related with age and active tobacco use."

Prognostic Significance of Declining Ankle-brachial Index Values in Patients with Suspected or Known Peripheral Arterial Disease. (Eur J Vasc Endovasc Surg. 2007) "CONCLUSIONS: This study shows that major 1-year declines in resting and post-exercise ABI are associated with all-cause mortality, cardiac events, stroke and kidney failure in patients with PAD."

Risk factors of peripheral arterial disease and relationship between low ankle brachial index and mortality from all-cause and cardiovascular disease in Chinese patients with hypertension. (J Hum Hypertens. 2007)

Risk factors of peripheral arterial disease and relationship between low ankle - brachial index and mortality from all-cause and cardiovascular disease in Chinese patients with type 2 diabetes. (Circ J. 2007)

The long-term experience of living with peripheral arterial disease and the recovery following revascularisation: A qualitative study. (Int J Nurs Stud. 2007) "CONCLUSIONS: Becoming aware of having a chronic disease results in a need to adapt to and accept permanent restrictions in daily life. The findings showed that revascularisations offer several benefits. However, when PAD symptoms were relieved, other ailments became discernable, which reflects the complex course of PAD and atherosclerotic disease. Moreover, several critical points and events such as other concurrent diseases, unrealistic hopes for recovery, and the complex course of PAD and atherosclerotic disease complicated the transition process towards health and well-being."

The prevalence of peripheral arterial disease in high risk subjects and coronary or cerebrovascular patients. (Angiology. 2007) "In conclusion, our findings confirm a high prevalence of both symptomatic and asymptomatic PAD in patients at high cardiovascular risk and its association with both CAD and CVD."

Go to the top