Social Deprivation and Peripheral Artery Disease.

Abstract

The link between peripheral artery disease and socioeconomic status is complex. The objective of this narrative review is to explore that relationship in detail, including how social factors affect the development, management, and outcomes of peripheral artery disease. Although the current literature on this topic is limited, some patterns do emerge. Populations of low socioeconomic status appear to be at increased risk for the development of peripheral artery disease, owing to factors such as increased prevalence of cardiovascular risk factors (eg, cigarette smoking) and decreased access to care. However, variables that are more difficult to quantify, such as chronic stress and health literacy, also likely play a significant role. Among those who are living with peripheral artery disease, socioeconomic status can affect disease management as well. Secondary prevention strategies, such as medication use, smoking cessation, and exercise therapy, are underutilised in socially deprived populations. This underutilisation of evidence-based management leads to adverse outcomes in these groups, including increased rates of amputation and decreased postoperative survival. The recognition of the importance of social factors in prognosis is an important first step toward addressing this health disparity. Moving forward, interventions that help to identify those who are at high risk and improve access to care in populations of low socioeconomic status will be critical to improving outcomes.