Use arterial disease as CVD risk indicator

At-risk patients should be screened for peripheral arterial disease (PAD) and the results should be incorporated into cardiovascular risk tools, a US expert has claimed.

The recommendation follows analysis of data from US National Health and Nutrition Surveys over three consecutive years, which showed that prevalence of PAD in asymptomatic patients in the US is rising.

A previous study showed that one in five people with PAD will have a major cardiovascular event (GP, 30 March).

Now data from the US shows that prevalence of PAD among the asymptomatic population has increased from 3.7 per cent in 1999/2000 to 4.6 per cent in 2003/4. The increase was most pronounced in women, rising from 4.1 to 6.3 per cent in four years. This coincided with a rise in obesity among females with PAD, from 32.4 to 47 per cent.

Lead researcher Dr Andrew Sumner, from Lehigh Valley Hospital in Pennsylvania, said: 'PAD is a marker of high cardiovascular risk. Even if they're asymptomatic, risk reduction therapies need to be more aggressive than in patients without PAD.

'It identifies a group of patients at high risk for further heart and vascular events,' he added.

Including a PAD score in a cardiovascular risk assessment tool, such as Framingham, could improve identification of high-risk individuals, said Dr Sumner.

AHA scientific sessions 4-7 November 2007, Orlando, Florida

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