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January 16, 2002

Diagnosis and Treatment of Peripheral Arterial Disease

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthor

JAMA. 2002;287(3):313-316. doi:10.1001/jama.287.3.313

To the Editor: Dr Hirsch and colleagues1 highlight the high prevalence of PAD and the great extent to which PAD is asymptomatic, undiagnosed, and untreated. Although Hirsch et al state that the epidemiology of PAD is well understood, it is in fact poorly characterized in the United States. Most epidemiologic knowledge of PAD has been derived from a few population-based studies, primarily in European populations.2,3 Furthermore, although Hirsch et al report that 8 to 12 million Americans have PAD, these statistics are not based on national survey data. The current state of understanding of lower-extremity disease (including PAD and peripheral neuropathy) in the United States is similar to that of hypertension a few decades ago. Even though scientifically validated measures are available to measure lower-extremity disease, few population-based studies have been conducted, and there are no nationally representative data on lower-extremity disease and its risk factors.