Cardiovascular risks underestimated in PAD

GPs have renewed calls to include peripheral arterial disease (PAD) in the quality framework.

The call comes after the Reach study, a worldwide health survey of 68,236 patients in 44 countries, revealed that patients with stable atherothrombosis need to be managed more effectively to reduce the risk of future cardiovascular events.

The study, which is the first of its kind to look at the cross-risk between different cardiovascular events, showed that one in five patients with a history of PAD will have a major cardiovascular event within one year.

West London GP Dr Sarah Jarvis, a member of the Primary Care Cardiovascular Society (PCCS), said there was a tendency to underestimate the risk of a cardiovascular event in one part of the body increasing the risk in another.
‘GPs tend to think of it in isolation, as a pain in the leg, but patients with PAD are as likely to experience MI or a stroke as those with angina,’ she said.

‘Figures have shown 60 per cent of PAD patients will die of MI and another 12 per cent of stroke, yet PAD patients are not included in the quality framework for any intervention at all.’

Consequently, they are hugely under-treated in terms of BP, cholesterol and anti-platelet therapy, said Dr Jarvis.

Dr Terry McCormack, PCCS chairman and a GP in Whitby, North Yorkshire, said the study confirmed how important it was to provide secondary prevention for patients with PAD as well as those with IHD and stroke.

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