Millions in U.S. Do Not Receive PAD Prevention Therapies

Treatment of peripheral artery disease with multiple agents tied to reduced all-cause mortality

TUESDAY, June 21 (HealthDay News) -- Millions of U.S. adults with peripheral artery disease (PAD) may not be receiving secondary prevention therapies, despite the fact that treatment with multiple agents is significantly correlated with lower all-cause mortality, according to a study published online June 20 in Circulation.

Reena L. Pande, M.D., from Brigham and Women's Hospital in Boston, and colleagues estimated the number of U.S. adults (40 years or older) with PAD not receiving preventive therapies, and investigated the association between preventive therapies and all-cause mortality in adults with PAD, but no known cardiovascular disease. Data were collected from 7,458 eligible participants in the National Health and Nutrition Examination Survey from 1999 to 2004, with follow-up through 2006. PAD was defined as an ankle-brachial index (ABI) of 0.90 or less.

The investigators identified 647 participants with PAD, with a weighted average prevalence of 5.9 percent, corresponding to approximately 7.1 million U.S. adults with PAD. An average of 30.5 percent of participants reported statin use (corresponding to 5.0 million untreated adults with PAD), 24.9 percent reported angiotensin-converting enzyme inhibitor/angiotensin receptor blocker use (corresponding to 5.4 million untreated adults with PAD), and 35.8 percent reported aspirin use (corresponding to 4.5 million untreated). PAD was significantly associated with all-cause mortality after multivariable adjustments (hazard ratio [HR], 2.4). After excluding participants with known cardiovascular disease, participants with PAD had significantly higher mortality rates than those without PAD or cardiovascular disease (adjusted HR, 1.9). Use of multiple preventive therapies was associated with significantly lower all-cause mortality in patients with PAD without cardiovascular disease (HR, 0.35).

"Millions of U.S. adults with PAD are not receiving secondary prevention therapies," the authors write.

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