Stephen J.LurieMD, PhD, Senior EditorIndividualAuthor
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.
Merenstein JH. Diagnosis and Treatment of Peripheral Arterial Disease. JAMA. 2002;287(3):313–316. doi:10.1001/jama.287.3.313
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