Study Reveals Peripheral Artery Disease is Frequently Misdiagnosed and Ineffectively Treated

A recent study conducted by Intermountain Health has illuminated a significant issue regarding the underdiagnosis and undertreatment of peripheral artery disease (PAD), affecting over 10 million Americans aged 40 and older. This vascular condition, characterized by narrowed arteries that impede blood flow to the limbs, poses a grave health risk, with findings indicating that patients have a more than 50% mortality rate associated with the disease.

Peripheral artery disease impacts nearly 10% of the U.S. population. The condition is a manifestation of atherosclerotic cardiovascular disease and is recognized as the third leading cause of mortality related to such diseases. The research highlights a concerning disparity in treatment, particularly among women, who are less likely to receive guideline-directed medical therapy compared to their male counterparts.

Dr. Viet T. Le, the primary investigator of the study, emphasized the alarming rate of untreated PAD cases and the associated high mortality rates. He noted that these findings present a crucial opportunity for healthcare systems to enhance screening protocols and treatment strategies, especially for female patients.

The analysis involved 7,522 patients diagnosed with symptomatic PAD at various Intermountain Health facilities from January 2006 to December 2021. Among these patients, 38% were women and 62% were men. Researchers evaluated the adherence to guideline-directed medical therapies, which include antiplatelet agents, statins, and other relevant treatments, alongside the patients' risk of experiencing major cardiac events or limb amputations.

Shockingly, only 29.6% of women and 33.5% of men received comprehensive treatment according to established guidelines. While women had comparable referral rates to specialists, they were more frequently directed to primary care providers. Interestingly, women exhibited slightly lower rates of major cardiac events and limb amputations than men.

Despite the equal treatment referrals, the study revealed a stark reality: approximately half of all patients diagnosed with PAD faced a significant risk of death. Dr. Le pointed out that every individual in these demographics should have received at least antiplatelet therapy and statin medications. However, the current treatment rates signify a pressing need for improved identification and management of peripheral artery disease.

The study's findings suggest that the low prescription rates may not stem from a lack of awareness or concern among healthcare providers, but rather from the challenges inherent in diagnosing and treating PAD as opposed to other atherosclerotic diseases. Leg pain, a common symptom, is often considered vague and can be attributed to various health issues, complicating accurate diagnosis and appropriate treatment.

Moreover, cardiologists may prioritize treatments for heart disease or stroke prevention, mistakenly believing these approaches will inherently address peripheral artery disease. Dr. Le advocates for a more focused screening and treatment paradigm for PAD, stressing that the current mortality rate should not be tolerated.

Common symptoms of PAD include cold extremities, pain or cramping in the legs during physical activity, and leg ulcers. Although the disease cannot be cured, effective management through lifestyle modifications, medication, and surgical interventions can alleviate symptoms, enhance the quality of life for patients, and slow the disease's progression.