Peripheral Arterial Disease Awareness Research Articles

Exploring Understanding of Peripheral Artery Disease among Patients at High-Risk in Saudi Arabia: Results from an Interview-Based Study.

The level of awareness of peripheral artery disease (PAD) in Saudi Arabia, especially among populations at high risk, is not currently well known. Therefore, our objective was to assess the existing level of awareness among patients who are at high risk of PAD, as well as their comprehension of the disease. An interview-based cross-sectional study included 1035 participants with risk factors for PAD and collected data on demographics and knowledge domains related to PAD. The statistical analysis was performed using t-tests and ANOVA. Overall, participants exhibited poor knowledge, with a mean score of 5.7 out of 26. The highest scores were observed in the risk factor and preventive measure domains, with means of 1.8 out of 7 and 1.8 out of 6, respectively. The factors associated with higher knowledge scores included older age, male gender, higher education, healthcare profession, interviews in vascular settings, previous awareness of PAD, and prior cardio-cerebrovascular interventions. This study underscores the inadequate knowledge of PAD among high-risk individuals. Targeted educational initiatives are essential to bridge this knowledge gap, potentially reducing the burden of PAD-related complications and improving patient outcomes. Efforts should focus on raising awareness about PAD, particularly among high-risk populations.

Abstract 17200: PAD Raising Awareness in Sacred Environments “Praise”

Introduction: Atherosclerotic peripheral artery disease (PAD) leads to a great burden of cardiovascular and limb-related morbidity and mortality in African Americans (AA) compared to White Americans. Medical center partnerships with churches may be an effective method to improve PAD awareness and detection in the AA community. Hypotheses: We hypothesized that implementing a medical educational program in partnership with churches would increase PAD familiarity and identify participants with undiagnosed PAD. Aims: To determine (1) PAD familiarity before and after a one-time educational intervention and (2) the prevalence of PAD in older, church-going Nashville residents. Methods: Using a community-engaged research (CER) model, we partnered with 5 churches to enroll participants ≥ 50 years of age. Participants were given a 16-point pre- and post-educational program assessment to determine baseline and post-intervention PAD knowledge. Pre- and post-intervention scores were compared using Wilcoxon signed-rank test. Ankle-brachial index (ABI) testing was used to screen for PAD (ABI < 0.9). Results: We enrolled 120 participants (mean age [SD]: 64.67 [8.33] years, 74% women, 80% AA). The prevalence of PAD was 10.83%. Pre-intervention PAD awareness was low (mean score (MS): 10.89 [4.24]) and improved significantly post-intervention in all participants (MS: 13.88 [2.76; p=2 x 10 -12 ). Participants without PAD (ABI ≥ 0.9-1.39) (MS: 10.81 [4.28] vs. 13.91 [2.79]; p= p=4 x 10 -11 ) and with indeterminate status (ABI>1.4) (MS [SD]: 10.00 [5.03] vs. 14.10 [1.73; p=0.01) showed significant improvement in PAD awareness pre vs post intervention. Participants with PAD (ABI <0.9) (MS: 12.15 [3.26] vs. 13.46 [3.26; p=0.40) did not have significant improvement in their awareness scores. Conclusions: The PRAISE study demonstrates an effective CER partnership with churches as a method to increase PAD awareness and early detection of PAD, specifically among AAs.

Black men’s awareness of peripheral artery disease and acceptability of screening in barbershops: a qualitative analysis

IntroductionPeripheral artery disease (PAD) disproportionately burdens Black Americans, particularly Black men. Despite the significant prevalence and high rate of associated morbidity and mortality, awareness of and treatment initiation for PAD remains low in this demographic group. Given the well-established social cohesion among barbershops frequently attended by Black men, barbershops may be ideal settings for health screening and education to improve awareness, early detection, and treatment initiation of PAD among Black men.MethodsA qualitative study involving 1:1 participant interviews in Cleveland, Ohio assessed perspectives of Black men about barbershop-based screening and education about PAD. Inductive thematic analysis was performed to derive themes directly from the data to reflect perceived PAD awareness and acceptability of screening in a barbershop setting.ResultsTwenty-eight African American/Black, non-Hispanic men completed a qualitative interview for this analysis. Mean age was 59.3 ± 11.2 years and 93% of participants resided in socioeconomically disadvantaged zip codes. Several themes emerged indicating increased awareness of PAD and acceptability of barbershop-based screenings for PAD, advocacy for systemic changes to improve the health of the community, and a desire among participants to increase knowledge about cardiovascular disease.ConclusionsParticipants were overwhelmingly accepting of PAD screenings and reported increased awareness of PAD and propensity to seek healthcare due to engagement in the study. Participants provided insight into barriers and facilitators of health and healthcare-seeking behavior, as well as into the community and the barbershop as an institution. Additional research is needed to explore the perspectives of additional stakeholders and to translate community-based screenings into treatment initiation.

PCR108 Large Gaps in Public Awareness of Peripheral Arterial Disease in Hong Kong: A Cross Sectional Study

Peripheral arterial disease (PAD) is prevalent and associated with significant cardiovascular (CV) mortality. However, awareness of PAD is low in the community, especially in Asian countries. We aimed to assess awareness of PAD relative to CV risk factors and other CV diseases; perceived causes of PAD; and perceived consequences of PAD. Insights into public awareness of PAD will help develop strategies for behavioral change consultations and health promotion.

Lower Extremity Peripheral Artery Disease: Contemporary Epidemiology, Management Gaps, and Future Directions: A Scientific Statement From the American Heart Association.

Lower extremity peripheral artery disease (PAD) affects >230 million adults worldwide and is associated with increased risk of various adverse clinical outcomes (other cardiovascular diseases such as coronary heart disease and stroke and leg outcomes such as amputation). Despite its prevalence and clinical importance, PAD has been historically underappreciated by health care professionals and patients. This underappreciation seems multifactorial (eg, limited availability of the first-line diagnostic test, the ankle-brachial index, in clinics; incorrect perceptions that a leg vascular disease is not fatal and that the diagnosis of PAD would not necessarily change clinical practice). In the past several years, a body of evidence has indicated that these perceptions are incorrect. Several studies have consistently demonstrated that many patients with PAD are not receiving evidence-based therapies. Thus, this scientific statement provides an update for health care professionals regarding contemporary epidemiology (eg, prevalence, temporal trends, risk factors, and complications) of PAD, the present status of diagnosis (physiological tests and imaging modalities), and the major gaps in the management of PAD (eg, medications, exercise therapy, and revascularization). The statement also lists key gaps in research, clinical practice, and implementation related to PAD. Orchestrated efforts among different parties (eg, health care providers, researchers, expert organizations, and health care organizations) will be needed to increase the awareness and understanding of PAD and improve the diagnostic approaches, management, and prognosis of PAD.

Poor patient awareness of peripheral arterial disease, it is time to optimize the clinical visit

IntroductionPeripheral arterial disease (PAD) is a growing public health burden. The development and progression of PAD is influenced by vascular risk factor management and lifestyle changes. However, public awareness of PAD is low compared with other conditions such as heart disease and stroke, which have been the subject of widespread public health campaigns. This study aimed to determine current levels of PAD awareness among hospital patients. MethodsThis cross-sectional, tertiary hospital-based, descriptive study was conducted over 6 months in 2019. Two investigators administered the survey in face-to-face interviews to patients attending 3 different hospital-based settings including vascular clinics (VC), cardiology clinics (CVC), and Emergency Department (ED). ResultsA total of 150 patients were interviewed. Participants demonstrated low overall awareness of vascular disease (32% PAD and 21% AAA) compared to cardiovascular disease including stroke (71%) and myocardial infarction (63%). Awareness of PAD was higher in vascular patients (51%) compared to CVC and ED patients (p=<0.01). Of the total population, 77% and 71% identified the contributory role of smoking and limited exercise to the development of PAD respectively. VC patients were more informed of intermittent claudication (78%) and amputation (80%) (p < 0.01) compared to CVC and ED patients. ConclusionIn the global drive to reduce vascular morbidity, this study highlights the poor knowledge of PAD among the public. In addition, there is poor awareness about the incidence, risk factors and complications of PAD. These results highlight the need for accessible and easily understood information regarding PAD in both the clinic setting and public health campaigns.

Reducing Nontraumatic Lower-Extremity Amputations by 20% by 2030: Time to Get to Our Feet: A Policy Statement From the American Heart Association.

Nontraumatic lower-extremity amputation is a devastating complication of peripheral artery disease (PAD) with a high mortality and medical expenditure. There are ≈150 000 nontraumatic leg amputations every year in the United States, and most cases occur in patients with diabetes. Among patients with diabetes, after an ≈40% decline between 2000 and 2009, the amputation rate increased by 50% from 2009 to 2015. A number of evidence-based diagnostic and therapeutic approaches for PAD can reduce amputation risk. However, their implementation and adherence are suboptimal. Some racial/ethnic groups have an elevated risk of PAD but less access to high-quality vascular care, leading to increased rates of amputation. To stop, and indeed reverse, the increasing trends of amputation, actionable policies that will reduce the incidence of critical limb ischemia and enhance delivery of optimal care are needed. This statement describes the impact of amputation on patients and society, summarizes medical approaches to identify PAD and prevent its progression, and proposes policy solutions to prevent limb amputation. Among the actions recommended are improving public awareness of PAD and greater use of effective PAD management strategies (eg, smoking cessation, use of statins, and foot monitoring/care in patients with diabetes). To facilitate the implementation of these recommendations, we propose several regulatory/legislative and organizational/institutional policies such as adoption of quality measures for PAD care; affordable prevention, diagnosis, and management; regulation of tobacco products; clinical decision support for PAD care; professional education; and dedicated funding opportunities to support PAD research. If these recommendations and proposed policies are implemented, we should be able to achieve the goal of reducing the rate of nontraumatic lower-extremity amputations by 20% by 2030.

International public awareness of peripheral artery disease.

Background: Peripheral artery disease (PAD) of the lower limbs is a common condition with considerable global burden. Some country-specific studies suggest low levels of public awareness. To our knowledge public awareness of PAD has never been assessed simultaneously in several countries worldwide. Patients and methods: This was an international, general public, internet-based quantitative survey assessing vascular health and disease understanding. Questionnaires included 23 closed-ended multiple-choice, Likert scale and binary choice questions. Data were collected from 9,098 survey respondents from nine countries in Europe, North and Latin America during May-June 2018. Results: Overall, familiarity with PAD was low (57% of respondents were "not at all familiar", and 9% were "moderately" or "very familiar"). Knowledge about PAD health consequences was limited, with 55% of all respondents not being aware of limb consequences of PAD. There were disparities in PAD familiarity levels between countries; highest levels of self-reported awareness were in Germany and Poland where 13% reported to be "very" or "moderately" familiar with PAD, and lowest in Scandinavian countries (5%, 3% and 2% of respondents in Norway, Sweden and Denmark, respectively). There were disparities in awareness according to age. Respondents aged 25-34 were most familiar with PAD, with 12% stating that they were "moderately" or "very" familiar with the condition, whereas those aged 18-24 were the least familiar with PAD (7% "moderately" or "very" familiar with PAD). In the 45-54, 55-64 and 65+ age groups, 9% said they were "moderately" or "very" familiar with the term. There was no important gender-based difference in PAD familiarity. Conclusions: On an international level, public self-reported PAD awareness is low, even though PAD is a common condition with considerable burden. Campaigns to increase PAD awareness are needed to reduce delays in diagnosis and to motivate people to control PAD risk factors.

Knowledge and awareness of peripheral arterial disease among the diabetic population in Saudi Arabia

Background: Among the many diabetes mellitus (DM)-related complications, the peripheral arterial disease (PAD) is the leading cause for limb loss in the diabetic population. Awareness is an integral part of preventive measures in those individuals with PAD. This study aims to assess the knowledge and awareness of PAD arterial diseases among diabetic patients in Saudi Arabia. Methods: A cross-sectional study was carried out on 526 diabetic participants. A pre-designed questionnaire comprising 27 items, including socio-demographic characteristics, questions related to knowledge, and awareness regarding PADs, was employed for the study. Results: There were a total number of 526 patients from different provinces in Saudi Arabia. We found that 72.6% (n = 382) were aware of PAD. Furthermore, 36% of the participants reported that the source of their information about chronic limb ischemia (CLI) was from the physicians; 23% from family members, relatives, or friends; and 23% from the media. The awareness regarding CLI among the patients was reported to be 82.3%, and it was found to be more among patients aged less than 50 years (59.9%) compared to patients aged

Is It Time for a National Awareness Campaign for Peripheral Arterial Disease (PAD)?

Objective: There exists a knowledge gap in awareness of peripheral arterial disease (PAD). This encompasses a lack of knowledge of symptoms associated with the disease as well as its risk factors. The aim of this study was to examine knowledge of PAD in patients attending a tertiary hospital.

Knowledge of peripheral artery disease: What do the public, healthcare practitioners, and trainees know?

This systematic review evaluated the knowledge and awareness of peripheral artery disease (PAD) within the general public (including patients with peripheral vascular disease), nonspecialist healthcare professionals (nsHCP), and trainees (medical students and trainee doctors). Relevant articles were identified from electronic databases using key search terms: 'peripheral artery disease'; 'limb ischaemia'; 'intermittent claudication'; 'knowledge'; 'understanding'; 'public'; 'medical professional'. The heterogeneous results were described narratively. A lack of knowledge and understanding of PAD (disease awareness) were identified in all groups. Among nsHCPs, factors which affect knowledge include the level of training, early clinical exposure and the presence of family members with cardiovascular/vascular disease. Within the general public, knowledge and awareness was improved if a family member/friend had a diagnosis, or following a patient-centred consultation with any HCP. Public campaigns are proven effective in improving disease knowledge/awareness in conditions such as stroke alongside sustained patient education. These may provide future avenues to improve PAD knowledge and awareness, in order to effectively manage risk factors and minimise delayed or missed diagnosis of PAD. (PROSPERO registration number: CRD42018117304).

AB031. 223. Poor patient awareness of peripheral arterial disease

AB031. 223. Poor patient awareness of peripheral arterial disease

Peripheral Artery Disease Prevalence and Incidence Estimated From Both Outpatient and Inpatient Settings Among Medicare Fee-for-Service Beneficiaries in the Atherosclerosis Risk in Communities (ARIC) Study.

BackgroundOutpatient ascertainment of peripheral artery disease (PAD) is rarely considered in the measurement of PAD clinical burden; therefore, the clinical burden of PAD likely has been underestimated while contributing to a decreased awareness of PAD in comparison to other circulatory system disorders.Methods and ResultsThe purpose of this study was to estimate the age‐standardized annual period prevalence and incidence of PAD in the outpatient and inpatient settings using data from the Atherosclerosis Risk in Communities (ARIC) study linked with Centers for Medicare and Medicaid Services claims. The majority (>70%) of all PAD encounters occurred in the outpatient setting. The weighted mean age‐standardized prevalence and incidence of outpatient PAD was 11.8% (95% CI 11.5–12.1) and 22.4 per 1000 person‐years (95% CI 20.8–24.0), respectively. Black patients had higher weighted mean age‐standardized prevalence (15.6%; 95% CI 14.6–16.4) compared with white patients (11.4%; 95% CI 11.1–11.7). Black women had the highest weighted mean age‐standardized prevalence (16.9%; 95% CI 16.0–17.8). Black patients also had a higher incidence rate of PAD (31.3 per 1000 person‐years; 95% CI 27.3–35.4) compared with white patients (25.4 per 1000 person‐years; 95% CI 23.5–27.3). PAD prevalence and incidence did not differ by sex alone.ConclusionsThis study provides comprehensive estimates of PAD in the inpatient and outpatient settings where the majority of PAD burden was found. PAD is an important circulatory system disorder similar in prevalence to stroke and coronary heart disease.

Primary care screening for peripheral arterial disease: a cross-sectional observational study

BackgroundEarly identification of peripheral arterial disease (PAD) and subsequent instigation of risk modification strategies could minimise disease progression and reduce overall risk of cardiovascular (CV) mortality. However, the feasibility and value of primary care PAD screening is uncertain.AimThis study (the PIPETTE study — Peripheral arterial disease In Primary carE: Targeted screening and subsequenT managEment) aimed to determine the value of a proposed primary care PAD screening strategy. Outcomes assessed were: prevalence of PAD and agreement of ankle– brachial index (ABI)-defined PAD (ABI ≤0.9) with QRISK®2-defined high CV risk (≥20).Design and settingA cross-sectional observational study was undertaken in a large general practice in Merthyr Tydfil, Wales.MethodIn total, 1101 individuals with ≥2 pre-identified CV risk factors but no known CV disease or diabetes were invited to participate. Participants underwent ABI measurement and QRISK2 assessment, and completed Edinburgh Claudication Questionnaires.ResultsA total of 368 people participated in the study (participation rate: 33%). Prevalence of PAD was 3% (n = 12). The number needed to screen (NNS) to detect one new case of PAD was 31. Refining the study population to those aged ≥50 years with a smoking history reduced the NNS to 14, while still identifying 100% of PAD cases. Of participants with PAD, 33% reported severe lifestyle-limiting symptoms of intermittent claudication that warranted subsequent endovascular intervention, yet had not previously presented to their GP. The QRISK2 score predicted high CV risk in 92% of participants with PAD.ConclusionThe low PAD yield and the fact that QRISK2 was largely comparable to the ABI in predicting high CV risk suggests that routine PAD screening may be unwarranted. Instead, strategies to improve public awareness of PAD are needed.

Knowledge of peripheral arterial disease: Results of an intervention to measure and improve PAD knowledge in Toronto.

Background Prevalence of peripheral arterial disease (PAD) has dramatically increased in both developing, as well as developed countries. However, significant knowledge and practice gaps persist. In Canada, efforts to improve this knowledge level are lacking. In this study, we examine PAD knowledge in Toronto, and evaluate a pilot intervention to address the knowledge gaps. Objectives Measure PAD awareness in Toronto, and evaluate an intervention to improve PAD knowledge among the public. Methods In the context of a community-based awareness campaign, an interview-based survey was used to assess the PAD awareness among general public. A sample of participants was split into two arms: control (survey only) and intervention (survey and education pamphlet), the choice between assigning the site as case or control was random. A follow-up telephone and email-based survey was conducted after 6 weeks to assess the attained knowledge level of PAD. Results Two hundred thirty-seven participants completed the baseline survey. One hundred eighty-eight participants (78.7%) had never heard of PAD. The remaining "PAD-aware" cohort had low overall knowledge of the disease characteristics. Participants from each arm completed the follow-up survey. The level of education, age, and gender were not predictors of knowledge scores; however, age was a predictor of PAD awareness, while gender and level of education were not. Participants in the intervention group showed significant knowledge scores improvement in five PAD domains, while those from control group showed significant improvement in their preventative measures, treatment modalities, and total scores. The impact of the study intervention on average scores was borderline not significant ( p = 0.05). Conclusion PAD knowledge gap in the Canadian public is larger than what was previously reported. Educational campaigns are necessary to address this gap and improve the outcome of PAD patients through patients' activation. Our results are encouraging and warrant a next intervention to explore an educational program impact on PAD knowledge.

Gaps in awareness of peripheral arterial disease in Sri Lanka: a cross sectional study.

BackgroundPeripheral arterial disease (PAD) is an emerging problem in Sri Lanka, particularly with the ageing population. A considerable number of patients are detected at a late stage with severe limb ischemia or chronic non-healing leg ulceration. Public awareness about PAD is important in developing preventive strategies.MethodsA cross sectional study was conducted to assess awareness of PAD among adults aged 40–74 years in a district in Sri Lanka. In total, 2912 adults were selected for the study using a multistage probability proportionate to size sampling technique. Data were collected by an interviewer-administered questionnaire. Participants who were aware of PAD were asked about common risk factors, possible consequences of untreated PAD, and sources of information. Multivariate logistic regression analysis was used to assess the independent predictors of PAD awareness.ResultsWe found that 4.1 % of participants were aware of PAD (95 % confidence interval: 3.4–4.8), which was significantly lower than awareness of other cardiovascular diseases such as cerebrovascular accidents (67.3 %) and myocardial infarction (57.6 %) (p < 0.001). Being male, an urban resident, and having a higher level of education were independent predictors of high PAD awareness.ConclusionsOur findings suggest that a comprehensive PAD awareness program that covers risk factors, consequences, and preventative strategies is needed to enhance public awareness of PAD.

Poor knowledge of peripheral arterial disease among the Saudi population: A cross-sectional study.

Peripheral arterial disease is a marker of severe atherosclerosis with a significantly higher risk of cardiovascular morbidity and mortality. It is often underdiagnosed and undertreated. Public and patients' perception of peripheral arterial disease is influenced by their knowledge of the condition. In this study, we aimed to evaluate the Saudi public's knowledge of peripheral arterial disease and its specific characteristics. We conducted an interview-based cross-sectional survey, and collected data on basic demographics, self-reported peripheral arterial disease awareness, and knowledge of clinical features, risk factors, preventative measures, management strategies, and potential complications of peripheral arterial disease. A total of 866 participants completed the survey (response rate, 94%); two-thirds were females. Only 295 (34%) of the surveyed participants indicated awareness of peripheral arterial disease. Overall peripheral arterial disease knowledge was low among the "peripheral arterial disease aware" group, particularly in the clinical features domain. Age > 40 years, female gender, and higher education were predictors of self-reported awareness of peripheral arterial disease. In conclusion, the Saudi public is largely unaware of peripheral arterial disease. Educational programs are important to address this critical knowledge gap.

An interview-based survey to assess the knowledge of peripheral arterial disease among medical students

Abstract Objectives Physicians have poor knowledge of peripheral arterial disease (PAD). Inadequate exposure to PAD in medical school curricula may by a contributing factor. The objective of this study was to explore the awareness and knowledge of PAD among medical students. Methods We conducted a descriptive cross-sectional study using an interview-based survey of the medical students in the college of medicine of King Saud University Riyadh, KSA. Results Of 350 students, 244 students agreed that they had some knowledge about PAD. More students in their clinical years (3–5) had heard about PAD compared to students in their basic science years (1–2; 76.5% versus 65.4%, respectively); however, the overall scores were low for both groups for recognition of PAD symptoms (mean scores, 2.83 out of 7 for students in years 3–5 versus 1.81 for students in years 1–2; p p p p Conclusion This study has identified an alarmingly low level of PAD knowledge among medical students. Interventions are needed to address this gap in medical schools' curricula to improve care for patients with PAD in future doctors.

Just leg pain? Think again: What health leaders must know about peripheral arterial disease.

Approximately 800,000 Canadians have Peripheral Arterial Disease (PAD). Peripheral arterial disease is also a leading cause of limb amputation. Yet public and clinical awareness of PAD is very limited. This article discusses the "Just Leg Pain? Think Again" awareness campaign the Canadian Association of Wound Care has launched in response. This article also summarizes PAD risk factors, screening, linkage with diabetes, treatment and care interventions, PAD care innovations, and the need for policy leadership on this issue.

Peripheral Artery Disease: A Marked Lack of Awareness in Ireland

Patients with symptomatic peripheral artery disease (PAD) have a 30% risk of death within 5 years. However, public awareness of vascular disease has been shown to be low. The aim of this study was to assess awareness regarding risk factors, significance and potential sequelae of PAD in an Irish population. A cross-sectional, anonymous survey of patients and members of the public. An anonymous questionnaire was developed to collect details on basic demographics, presence of and treatment for risk factors for cardiovascular disease, awareness of PAD and its risk factors and sequelae. The local ethics committee granted ethical approval. Two investigators in face-to-face interviews administered the survey with patients and members of the general public, older than 40 years of age, attending a range of outpatient clinics, day care services and in patients. A total of 336 questionnaires were administered. A post-secondary school course had been completed by 32% of respondents. Only 19% of patients reported familiarity with PAD, a figure considerably lower than those reporting familiarity with stroke (94%), coronary artery disease (78%) or diabetes (98%) (Chi Squared p<0.001). The only independent predictor of awareness of PAD was having a post-secondary school course with an odds ratio or 4.2. This study demonstrates a disturbing lack of awareness of PAD and highlight the need for a meaningful targeted public health awareness campaign on PAD in order to close the gap of knowledge in Irish patients, prior to any prevention campaign.