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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 imply that early screening for PAD will somehow improve the treatment of risk factors for the secondary prevention of cardiovascular disease. Their results do not support this. The risk factors identified—smoking, hypertension, hyperlipidemia, and diabetes—need to be treated whether or not PAD is present. Nothing in their study suggested that identifying PAD will make primary care physicians recognize and treat the risk factors more appropriately than they do now. If an intervention is necessary based on their results, it is to improve primary care physicians' history taking so that they know what their patients know. Hirsch et al found that 83% of patients knew they had PAD, while only 49% of physicians were aware of the diagnosis.