Peripheral arterial disease (PAD) presents a major health problem in the UK and is often over looked because many patients are asymptomatic. The prevalence rises markedly in diabetes. Primary care has an important role in the identification and management of vascular disease and the prevention of secondary events. New guidelines underline the importance of antiplatelet agents.
Krentz AJ, Mani R., Shearman CPPeripheral arterial disease in diabetes: time for a co-ordinated approach to management. Br J Diabetes Vasc Dis2003 ;3:92-6.
3.
Hiatt WR, Hirsch AT, Regensteiner JG, Brass EP, the Vascular Clinical Triallists. Clinical trials for claudication. Assessment of exercise performance, functional status and clinical end points . Circulation1995;92: 614-21.
4.
Weitz JI, Byrne J., Clagett GP et al. Diagnosis and treatment of chronic arterial insufficiency of the lower extremities: a critical review. Circulation1996;94:3026-49.
5.
Santilli JD, Santilli SMChronic critical limb ischemia: diagnosis, treatment and prognosis . Am Fam Physician1999;59:1899-908.
6.
Criqui MH, Langer RD, Fronek A. et al. Mortality over a period of 10 years in patients with peripheral arterial disease. N Engl J Med1992;326:381-6.
7.
Criqui MH, Denenberg JOThe generalised nature of atherosclerosis: how peripheral arterial disease may predict adverse events from coronary artery disease. Vasc Med1998;3:241-5.
8.
Simons PC, Algra A., Eikelboom BC et al. Carotid artery stenosis in patients with peripheral arterial disease: the SMART Study. J Vasc Surg1999 ;30:519-25.
9.
Novo S.Classification, epidemiology, risk factors, and natural history of peripheral arterial disease. Diabetes Obes Metab2002 ;4(suppl 2):S1-S6.
10.
Hirsch AT, Criqui MH, Treat-Jacobson D. et al. Peripheral arterial disease detection, awareness, and treatment in primary care. JAMA2003;286. 1317-24.
11.
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 Epidemiol1991;20:384-92.
12.
Elhadd TA, Robb R., Jung RT, Stonebridge PA, Belch JJA Pilot study of prevalence of asymptomatic peripheral arterial occlusive disease in patients with diabetes attending a hospital clinic. Pract Diabetes Int2003;16:163-6.
13.
MacGregor AS , Price JF, Hau CM et al. Role of systolic blood pressure and plasma triglycerides in diabetic peripheral arterial disease . Diabetes Care1999;22:453-8.
14.
Jude EB, Oyibo SO, Chalmers N., Boulton AJPeripheral arterial disease in diabetic and nondiabetic patients. Diabetes Care2001;24:1433-7.
15.
Boulton AJWhy bother educating the multi-disciplinary team and the patient - the example of prevention of lower extremity amputation in diabetes. Patient Educ Couns1995;26:183-8.
16.
Tierney S., Fennessy F., Hayes DBABC of arterial and vascular disease. Secondary prevention of peripheral vascular disease. BMJ2000;320: 1262-5.
17.
Aronow WS, Ahn C.Prevalence of coexistence of coronary artery disease, peripheral arterial disease, and atherothrombotic brain infarction in men and women ≥ 62 years of age. Am J Cardiol1994;74:64-5.
18.
Petersen S., Peto V., Rayner M.Coronary Heart Disease Statistics. http://www.heartstats.org/datapage.asp?id=1652 , 2003 (last accessed 8 June 2004).
19.
Fowkes FG, Price JF, Leng GCTargeting subclinical atherosclerosis has the potential to reduce coronary events dramatically. BMJ1998;316: 1764-70.
20.
Vowden P., Vowden K.Doppler assessment and ABPI: Interpretation in the management of leg ulceration . http://www.worldwidewounds.com/2001/march/Vowden/Doppler-assessment-and-ABPI.html , 2001 (last accessed 8 June 2004).
21.
Papamichael CM, Lekakis JP, Stamatelopoulos KS, Papaioannou TG, Alevizaki MKAnkle-brachial index as a predictor of the extent of coronary atherosclerosis and cardiovascular events in patients with coronary artery disease. Am J Cardiol2000;86:615-18.
22.
Belch J., Topol E., Agnelli G., Bertrand M.Critical issues in peripheral arterial disease detection and management . Arch Intern Med2003;163:88492.
23.
Shaw JE, Zimmet PZThe epidemiology of diabetic neuropathy. Diabetes Reviews1999;7:245-52.
Hiatt WR, Hoag S., Hamman RFEffect of diagnostic criteria on the prevalence of peripheral arterial disease . Circulation1995;91:1472-9.
26.
Criqui MH, Fronek A., Barrett-Connor E. et al. The prevalence of peripheral arterial disease in a defined population . Circulation1985;71:510-15.
27.
Fowkes FGR.Epidemiology of atherosclerotic arterial disease in the lower limbs. Eur J Vasc Surg1988;2:283-91.
28.
Hiatt WRMedical treatment of peripheral arterial disease and claudication . N Engl J Med2001;344:1608-21.
29.
Department of Health.National Service Framework for Coronary Heart Disease. http://www.dh.gov.uk/assetRoot/04/01/91/20/04019120.pdf , 2000 (last accessed 8 June 2004).
30.
Boyle R.DoH explains thinking behind national service framework for coronary heart disease. BMJ2000;321:1083.
31.
Williams B. , Poulter NR, Brown MJ et al. Guidelines for management of hypertension: report of the fourth working party of the British Hypertension Society, 2004-BHS IV. J Hum Hypertens2004;18:139-85.
32.
CAPRIE Steering Committee.A randomised, blinded, trial of clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE). Lancet1996;348:1329-39.