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April 28, 2003

Meeting the Challenge of Peripheral Arterial Disease

Arch Intern Med. 2003;163(8):877-878. doi:10.1001/archinte.163.8.877

PERIPHERAL arterial disease (PAD) is common and associated with considerable morbidity and mortality. Caused by atherosclerotic occlusion of the leg arteries, PAD is a manifestation of systemic atherosclerosis with a prevalence of approximately 12%, affecting men and women equally.1 Even in the absence of a history of myocardial infarction or stroke, the relative risk of death from cardiovascular causes in patients with PAD is about the same as in patients with coronary or cerebrovascular disease. The risk of death is increased whether or not PAD is symptomatic, and patients with critical leg ischemia (the most severe form of PAD) face an annual mortality of 25%, which is overwhelmingly due to myocardial infarction and ischemic stroke.2 As a marker of systemic atherosclerosis, PAD demands a comprehensive clinical approach that fosters prevention, detection, and timely intervention. In this issue of the ARCHIVES, the Executive Committee of the Prevention of Atherothrombotic Disease Network3 issues a "call to action," citing critical issues in PAD detection and clinical management and recommending 5 measures to address PAD as a significant public health concern. This call resounds with overtones that reverberate across the landscape of American health care.

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