Peripheral Artery Disease: Low Use of Medication and Lifestyle Counseling

HealthDay News — Patients with peripheral artery disease (PAD) have low use of medication therapy and lifestyle counseling, according to a study published in the Journal of the American College of Cardiology.

Jeffrey S Berger, MD, from the New York University School of Medicine in New York City, and Joseph A Ladapo, MD, PhD, from the David Geffen School of Medicine at the University of California, Los Angeles, examined trends in medication use and lifestyle counseling for 1982 outpatient visits among patients with PAD from 2005 through 2012.

The researchers found that in 24.3% of visits, comorbid coronary artery disease (CAD) was present. There was low medication use for cardiovascular prevention and symptoms of claudication: any antiplatelet therapy in 35.7%, statin in 33.1%, angiotensin-converting enzyme inhibitor (ACEI)/angiotensin receptor blocker (ARB) in 28.4%, and cilostazol in 4.7% of visits. In 22% of visits, exercise or diet counseling was used. Smoking cessation counseling or medication was used during 35.8% of visits among current smokers with PAD. Over time there was no significant change in medication use or lifestyle counseling. Compared to patients with PAD alone, those with comorbid CAD and PAD were more likely to be prescribed antiplatelet therapy, statins, ACEI/ARB, and smoking cessation counseling (odds ratios, 2.6, 2.6, 2.6, and 4.4, respectively).

“The use of guideline-recommended therapies in patients with PAD was much lower than expected,” the researchers write.

One researcher disclosed financial ties to the pharmaceutical industry.

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Berger JS, Ladapoo JA. Underuse of prevention and lifestyle counseling in patients with peripheral artery disease. J Am Coll Cardiol. 2017 May 9;69(18):2293-2300. doi: 10.1016/j.jacc.2017.02.064.