Background: There has been increasing recognition of the detrimental effect of peripheral arterial disease (PAD) on the health of Americans, and yet there is no common national program of public PAD education designed to diminish this effect.
Format: To heighten awareness of this problem, a 2-day PAD Public Education Strategy Meeting was recently attended by representatives of 17 professional societies and public health associations whose missions support the prevention, diagnosis, treatment, and rehabilitation of vascular diseases. This Public Education Strategy Meeting was intended to provide the rationale and structure to create a national PAD public awareness campaign to diminish the health effect of PAD and to improve cardiovascular outcomes in the United States. This document (1) provides the rationale for creation of a national PAD public education program; (2) reviews the development and success of national hypertension, hypercholesterolemia, and Women’s Heart Health public education programs as models of educational efficacy; (3) elucidates how the work of many vascular professionals has led to a national consensus for creation of a national PAD public educational program; (4) provides an overview of the National Heart, Lung, and Blood Institute PAD education meeting; and (5) outlines the “next steps” required to accomplish these goals.
Outcome: This meeting achieved consensus that we share responsibility for developing accurate, unified messages to promote PAD awareness and improved care. Participants agreed
Get full access to this article
View all access options for this article.
References
1.
Criqui MH, Fronek A, Barrett-Connor E, et al: The prevalence of peripheral arterial disease in a defined population. Circulation71:510-515, 1985.
2.
Meijer WT, Hoes AW, Rutgers D, et al: Peripheral arterial disease in the elderly. The Rotterdam Study. Arterioscler Thromb Vasc Biol18:185-192, 1998.
3.
Fowkes FG, Housley E, Cawood EH, et al, Edinburgh Artery Study: prevalence of asymptomatic and symptomatic peripheral arterial disease in the general population. Int J Epidemiol20:384-392, 1991.
4.
Leng GC, Lee AJ, Fowkes FG, et al: Incidence, natural history and cardiovascular events in symptomatic and asymptomatic peripheral arterial disease in the general population. Int J Epidemiol25:1172-1181, 1996.
5.
Kornitzer M, Dramaix M, Sobolski J, et al: Ankle/arm pressure index in asymptomatic middle-aged males: An independent predictor of ten-year coronary heart disease mortality. Angiology46:211-219, 1995.
6.
Zheng ZJ, Sharrett AR, Chambless LE, et al: Associations of ankle-brachial index with clinical coronary heart disease, stroke and preclinical carotid and popliteal atherosclerosis: The Atherosclerosis Risk in Communities (ARIC) Study. Atherosclerosis131:115-125, 1997.
7.
Newman AB, Sutton-Tyrrell K, Vogt MT, et al: Morbidity and mortality in hypertensive adults with a low ankle/arm blood pressure index. JAMA270:487-489, 1993.
8.
Criqui MH, Langer RD, Fronek A, et al: Mortality over a period of 10 years in patients with peripheral arterial disease. N Engl J Med326:381-386, 1992.
9.
Smith GD, Shipley MJ, Rose G: Intermittent claudication, heart disease risk factors, and mortality. The Whitehall Study. Circulation82:1925-1931, 1990.
10.
Vogt MT, Cauley JA, Newman AB: Decreased ankle/arm blood pressure index and mortality in elderly women. JAMA270:465-469, 1993.
11.
Breek JC, Hamming JF, De Vries J, et al: The impact of walking impairment, cardiovascular risk factors, and comorbidity on quality of life in patients with intermittent, claudication. J Vasc Surg36:94-99, 2002.
12.
Treat-Jacobson DT, Halverson SL, Ratchford A, et al: A patient-derived perspective of health-related quality-of-life in peripheral arterial disease. J Nurs Scholarsh34:55-60, 2002.
13.
Khaira HS, Hanger R, Shearman CP: Quality of life in patients with intermittent claudication. Eur J Vasc Endovasc Surg11:65-69, 1996.
14.
Vogt MT, Cauley JA, Kuller LH, et al: Functional status and mobility among elderly women with lower extremity arterial disease: The Study of Osteoporotic Fractures. J Am Geriatr Soc42:923-929, 1994.
15.
Barletta G, Perna S, Sabba C, et al: Quality of life in patients with intermittent claudication: Relationship with laboratory exercise performance. Vasc Med1:3-7, 1996.
16.
Pell JP, for the Scottish Vascular Audit Group: Impact of intermittent claudication on quality of life. Eur J Vasc Endovasc Surg9:469-472, 1995.
17.
Ponte E, Cattinelli S: Quality of life in a group of patients with intermittent claudication. Angiology47:247-251, 1996.
18.
McDermott MM, Mehta S, Greenland P: Exertional leg symptoms other than intermittent claudication are common in peripheral arterial disease. Arch Intern Med159:387-392, 1999.
19.
McDermott MM, Mehta S, Liu K, et al: Leg symptoms, the ankle-brachial index, and walking ability in patients with peripheral arterial disease. J Gen Intern Med14:173-181, 1999.
20.
McDermott MM, Fried L, Simonsick E, et al: Asymptomatic peripheral arterial disease is independently associated with impaired lower extremity functioning: The Women's Health and Aging Study. Circulation101:1007-1012, 2000.
21.
McDermott MM, Greenland P, Liu K, et al: Leg symptoms in peripheral arterial disease: Associated clinical characteristics and functional impairment. JAMA286:1599-1606, 2001.
Belch JJF, Topol EJ, Agnelli G, et al: Critical issues in peripheral arterial disease detection and management: A call to action. Arch Int Med163:884-892, 2003.
24.
Hirsch AT, Halverson SL, Treat-Jacobson D, et al: The Minnesota Regional Peripheral Arterial Disease Screening Program: Toward a definition of community standards of care. Vasc Med6:87-96, 2001.
25.
Hirsch AT, Criqui MH, Treat-Jacobson D, et al: Peripheral arterial disease detection, awareness, and treatment in primary care. JAMA286:1317-1324, 2001.
26.
Hiatt WR: Medical treatment of peripheral arterial disease and claudication. N Engl J Med344:1608-1621, 2001.
27.
CAPRIE Steering Committee: A randomised, blinded, trial of clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE). Lancet348:1329-1339, 1996.
28.
N Engl J Med342:145-153, 2000.
29.
MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin in 20,536 high-risk individuals: A randomised placebo-controlled trial. Lancet360:7-22, 2002.
30.
Burt VL, Cutler JA, Higgins M, et al: Trends in the prevalence, awareness, treatment, and control of hypertension in the adult US population: Data from the health examination surveys, 1960 to 1991. Hypertension26:60-69, 1995.
31.
Chobanian AV, Bakris GL, Black HR, et al, and the National High Blood Pressure Education Program Coordinating Committee: The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. The JNC 7 Report. JAMA289:2560-2571, 2003.
32.
Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA285:2486-2497, 2001.
33.
Pieper RM, Arnett DK, McGovern PG, et al: Trends in cholesterol knowledge and screening and hypertension awareness and treatment, 1980-1992. The Minnesota Heart Survey. Ach Intern Med157:2326-2332, 1997.
34.
Farquhar JW, Fortmann SP, Flora JA, et al: Effects of communitywide education on cardiovascular disease risk factors. The Stanford Five-City Project. JAMA264:359-365, 1990.
35.
Frank E, Winkleby MA, Fortmann SP, et al: Improved cholesterol-related knowledge and behavior and plasma cholesterol levels in adults during the 1980s. JAMA268:1566-1572, 1992.
36.
Fortmann SP, Flora JA, Winkleby MA, et al: Community intervention trials: Reflections on the Stanford Five City Project experience. Am J Epidemiol142:576-586, 1995.
37.
NHLBI Workshop on peripheral arterial disease (PAD): Developing A Public Awareness Campaign Meeting Summary. U.S. Department of Health and Human Services, National Institutes of Health, National Heart, Lung, and Blood Institute. Bethesda, MD, 2003.
