Criqui MH, Matsushita K, Aboyans V, Hess CN, Hicks CW, Kwan TW, McDermott MM, Misra S, Ujueta F, American Heart Association Council on Epidemiology and Prevention; Council on Arteriosclerosis, Thrombosis and Vascular Biology; Council on Cardiovascular Radiology and Intervention; Council on Lifestyle and Cardiometabolic Health; Council on Peripheral Vascular Disease; and Stroke Council, et al.
Circulation. Date of publication 2021 Aug 31;volume 144(9):e171-e191.
1. Circulation. 2021 Aug 31;144(9):e171-e191. doi: 10.1161/CIR.0000000000001005.
Epub 2021 Jul 28.
Lower Extremity Peripheral Artery Disease: Contemporary Epidemiology, Management
Gaps, and Future Directions: A Scientific Statement From the American Heart
Association.
Criqui MH, Matsushita K, Aboyans V, Hess CN, Hicks CW, Kwan TW, McDermott MM,
Misra S, Ujueta F; American Heart Association Council on Epidemiology and
Prevention; Council on Arteriosclerosis, Thrombosis and Vascular Biology;
Council on Cardiovascular Radiology and Intervention; Council on Lifestyle and
Cardiometabolic Health; Council on Peripheral Vascular Disease; and Stroke
Council.
Erratum in
Circulation. 2021 Aug 31;144(9):e193.
Lower extremity peripheral artery disease (PAD) affects >230 million adults
worldwide and is associated with increased risk of various adverse clinical
outcomes (other cardiovascular diseases such as coronary heart disease and
stroke and leg outcomes such as amputation). Despite its prevalence and clinical
importance, PAD has been historically underappreciated by health care
professionals and patients. This underappreciation seems multifactorial (eg,
limited availability of the first-line diagnostic test, the ankle-brachial
index, in clinics; incorrect perceptions that a leg vascular disease is not
fatal and that the diagnosis of PAD would not necessarily change clinical
practice). In the past several years, a body of evidence has indicated that
these perceptions are incorrect. Several studies have consistently demonstrated
that many patients with PAD are not receiving evidence-based therapies. Thus,
this scientific statement provides an update for health care professionals
regarding contemporary epidemiology (eg, prevalence, temporal trends, risk
factors, and complications) of PAD, the present status of diagnosis
(physiological tests and imaging modalities), and the major gaps in the
management of PAD (eg, medications, exercise therapy, and revascularization).
The statement also lists key gaps in research, clinical practice, and
implementation related to PAD. Orchestrated efforts among different parties (eg,
health care providers, researchers, expert organizations, and health care
organizations) will be needed to increase the awareness and understanding of PAD
and improve the diagnostic approaches, management, and prognosis of PAD.
DOI: 10.1161/CIR.0000000000001005
PMCID: PMC9847212
PMID: 34315230 [Indexed for MEDLINE]
Conflict of interest statement: The American Heart Association makes every
effort to avoid any actual or potential conflicts of interest that may arise as
a result of an outside relationship or a personal, professional, or business
interest of a member of the writing panel. Specifically, all members of the
writing group are required to complete and submit a Disclosure Questionnaire
showing all such relationships that might be perceived as real or potential
conflicts of interest.
