Underuse of Prevention and Lifestyle Counseling in Patients With Peripheral Artery Disease
Open accessAbstract
Background Little is known about patterns of medication use and lifestyle counseling in patients with peripheral artery disease (PAD) in the United States. Objective We sought to evaluate trends in both medical therapy and lifestyle counseling for PAD patients in the United States from 2005 through 2012. Methods Data from 1,982 outpatient visits among patients with PAD were obtained from the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey, a nationally representative assessment of office-based and hospital outpatient department practice. We evaluated trends in the proportion of visits with medication use (antiplatelet therapy, statins, ACE-inhibitors [ACE-I] or angiotensin receptor blockers [ARB], and cilostazol) and lifestyle counseling (exercise or diet counseling and smoking cessation). Results Over the 8-year period, the average annual number of ambulatory visits in the U.S. for PAD was 3,883,665. Across all visits, mean age was 69.2 years, 51.8% were female and 56.6% were Non-Hispanic white. Comorbid coronary artery disease (CAD) was present in 24.3% of visits. Medication use for cardiovascular prevention and symptoms of claudication was low: any antiplatelet therapy in 35.7% (standard error [SE] 2.7), statin 33.1% (SE, 2.4), ACE-I/ARB 28.4% (SE, 2.0), and cilostazol in 4.7% (SE, 1.0) of visits. Exercise or diet counseling was used in 22% (SE, 2.3) of visits. Among current smokers with PAD, smoking cessation counseling or medication was used in 35.8% (SE, 4.6) of visits. There was no significant change in medication use or lifestyle counseling over time. Compared to visits for patients with PAD alone, comorbid PAD and CAD were more likely to be prescribed antiplatelet therapy (OR 2.6 [1.8–3.9]), statins (OR 2.6 [1.8–3.9]), ACE-I/ARB (OR 2.6 [1.8–3.9]), and smoking cessation counseling (OR 4.4 [2.0–9.6]). Conclusions The use of guideline-recommended therapies in patients with PAD was much lower than expected, which highlights an opportunity to improve the quality of care in these high-risk patients.
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In an administrative dataset study, overall undertreatment with medication therapy of patients with PAD did not appear to vary by race, although all non-White groups were bundled together.
“In an administrative dataset study, there was overall undertreatment with medication therapy of patients with PAD that did not appear to vary by race, 82 although all non-White groups were bundled together making it challenging to fully assess heterogeneity in individual groups.”
From Racial and Ethnic Disparities in Peripheral Artery Disease (2021) · cites this paper as [82]
The Discussion reports underuse of cardiovascular prevention medication in patients with PAD and says race/ethnicity did not affect secondary-prevention use in the multivariable analysis. But the Methods (Other Measures; page unavailable) say patients were characterized as non-Hispanic White, non-Hispanic Black, Hispanic, or other race, so the claim that all non-White groups were bundled together is not supported by the paper’s stated categories. (LLM, conf=0.87)
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Cites
Heart Disease and Stroke Statistics—2017 Update: A Report From the American Heart Association
Benjamin, E. J., Blaha, M. J., Chiuve, S. E., Cushman, M., Das, S. R., Deo, R., de Ferranti, S. D., Floyd, J., Fornage, M., Gillespie, C., et al. (2017) · Circulation · doi:10.1161/cir.0000000000000485 · Cited by 12,591 · see citing works
Heart Disease and Stroke Statistics—2016 Update: A Report From the American Heart Association
Mozaffarian, D., Benjamin, E. J., Go, A. S., Arnett, D. K., Blaha, M. J., Cushman, M., Das, S. R., de Ferranti, S., Després, J.-P., Fullerton, H. J., et al. (2016) · Circulation · doi:10.1161/cir.0000000000000350 · Cited by 6,596 · see citing works
Fowkes, F. G. R., Rudan, D., Rudan, I., Aboyans, V., Denenberg, J. O., McDermott, M. M., Norman, P. E., Sampson, U. K., Williams, L. J., Mensah, G. A., et al. (2013) · The Lancet · doi:10.1016/s0140-6736(13)61249-0 · Cited by 3,508 · cited 1× · see citing works
“P eripheral artery disease (PAD) is a highly prevalent atherosclerotic syndrome with an estimated global population burden of w200 million people (1).”
Background2016 AHA/ACC Guideline on the Management of Patients With Lower Extremity Peripheral Artery Disease
Gerhard-Herman, M. D., Gornik, H. L., Barrett, C., Barshes, N. R., Corriere, M. A., Drachman, D. E., Fleisher, L. A., Fowkes, F. G. R., Hamburg, N. M., Kinlay, S., et al. (2017) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2016.11.007 · Cited by 1,941 · see citing works
Epidemiology of Peripheral Artery Disease
Criqui, M. H., & Aboyans, V. (2015) · Circulation Research · doi:10.1161/circresaha.116.303849 · Cited by 1,785 · cited 1× · see citing works
“Patients with PAD are at heightened risk for adverse cardiovascular and limb events, and impaired quality of life (4).”
BackgroundGerhard‐Herman, M. D., Gornik, H. L., Barrett, C., Barshes, N. R., Corriere, M. A., Drachman, D. E., Fleisher, L. A., Fowkes, F. G. R., Hamburg, N. M., Kinlay, S., et al. (2016) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2016.11.008 · Cited by 570 · see citing works
The effectiveness of interventions to change six health behaviours: a review of reviews
Jepson, R., Harris, F., Platt, S., & Tannahill, C. (2010) · BMC Public Health · doi:10.1186/1471-2458-10-538 · Cited by 441 · cited 1× · see citing works
“Although we are unable to determine the reason for the underuse of secondary prevention and lifestyle counselling, interventions to optimize secondary prevention, such as physician note “checklists” or other systematic prescription programs, would likely improve medication use and lifestyle counselling (20,21).”
BackgroundPande, R. L., Perlstein, T. S., Beckman, J. A., & Creager, M. A. (2011) · Circulation · doi:10.1161/circulationaha.110.003954 · Cited by 406 · see citing works
A Call to Action: Women and Peripheral Artery Disease
Hirsch, A. T., Allison, M., Gomes, A. S., Corriere, M. A., Duval, S., Ershow, A. G., Hiatt, W. R., Karas, R. H., Lovell, M. B., McDermott, M. M., et al. (2012) · Circulation · doi:10.1161/cir.0b013e31824c39ba · Cited by 351 · see citing works
Electronic Health Records and Quality of Diabetes Care
Cebul, R. D., Love, T. E., Jain, A., & Hebert, C. J. (2011) · New England Journal of Medicine · doi:10.1056/nejmsa1102519 · Cited by 332 · cited 1× · see citing works
“Although we are unable to determine the reason for the underuse of secondary prevention and lifestyle counselling, interventions to optimize secondary prevention, such as physician note “checklists” or other systematic prescription programs, would likely improve medication use and lifestyle counselling (20,21).”
BackgroundAssociation Between Advanced Age and Vascular Disease in Different Arterial Territories
Savji, N., Rockman, C. R., Skolnick, A. H., Guo, Y., Adelman, M. A., Riles, T. S., & Berger, J. S. (2013) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2013.01.054 · Cited by 324 · cited 1× · see citing works
“and risk factor trends, the prevalence of PAD is increasing (2,3).”
BackgroundSelf-citationCacoub, P., Abola, M. T., Baumgartner, I., Bhatt, D. L., Creager, M., Liau, C., Goto, S., Röther, J., Steg, P., & Hirsch, A. (2009) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2008.10.023 · Cited by 261 · cited 2× · see citing works
“This analysis suggests that use of secondary prevention and lifestyle counseling in patients with PAD has not become a widely disseminated practice in the United States, a finding consistent with a global pattern (9,11,12).”
BackgroundResultArmstrong, E. J., Chen, D. C., Westin, G. G., Singh, S., McCoach, C. E., Bang, H., Yeo, K. K., Anderson, D. R., Amsterdam, E. A., & Laird, J. R. (2014) · Journal of the American Heart Association · doi:10.1161/jaha.113.000697 · Cited by 247 · cited 1× · see citing works
“Although some, but not all, prior studies have reported comparatively higher rates of secondary prevention in patients with PAD, many of these studies focused on selected patients whose use of secondary prevention might be higher than that in the physician office setting assessed here (9,11,22).”
ResultComparing Generalist and Specialty Care
Donohoe, M. (1998) · Archives of Internal Medicine · doi:10.1001/archinte.158.15.1596 · Cited by 193 · cited 1× · see citing works
“Because quality of care can be dependent by physician type (19), we sought to investigate medication use and lifestyle counseling by practicing physician.”
BackgroundSubherwal, S., Patel, M. R., Køber, L., Peterson, E. D., Jones, W. S., Gislason, G., Berger, J. S., Torp-Pedersen, C. T., & Fosbøl, E. L. (2012) · Circulation · doi:10.1161/circulationaha.112.108787 · Cited by 168 · see citing works
Self-citationPhysician Decision Making and Trends in the Use of Cardiac Stress Testing in the United States
Ladapo, J. A., Blecker, S., & Douglas, P. S. (2014) · Annals of Internal Medicine · doi:10.7326/m14-0296 · Cited by 161 · cited 1× · see citing works
“We used visit diagnoses and reasons for visit from our prior work to identify patients with other risk factors for adverse cardiovascular events, including hypertension, dyslipidemia, cigarette smoking, obesity, diabetes, chronic kidney disease, chronic obstructive pulmonary disease, CAD, and stroke (16,17).”
MethodSelf-citationSubherwal, S., Patel, M. R., Kober, L., Peterson, E. D., Bhatt, D. L., Gislason, G. H., Olsen, A.-M. S., Jones, W. S., Torp-Pedersen, C., & Fosbol, E. L. (2015) · European Journal of Preventive Cardiology · doi:10.1177/2047487313519344 · Cited by 129 · cited 1× · see citing works
“a coronary artery disease (CAD) risk equivalent (5).”
BackgroundHivert, M., Arena, R. A., Forman, D. E., Kris‐Etherton, P. M., McBride, P. E., Pate, R. R., Spring, B. J., Trilk, J., Horn, L. V., & Kraus, W. E. (2016) · Circulation · doi:10.1161/cir.0000000000000442 · Cited by 115 · see citing works
Medical Therapy in Peripheral Artery Disease
Berger, J. S., & Hiatt, W. R. (2012) · Circulation · doi:10.1161/circulationaha.111.033886 · Cited by 82 · see citing works
Self-citationCacoub, P., Zeymer, U., Limbourg, T., Baumgärtner, I., Poldermans, D., Röther, J., Bhatt, D. L., & Steg, P. G. (2011) · Heart · doi:10.1136/hrt.2010.213710 · Cited by 67 · see citing works
Use of Preoperative Testing and Physicians’ Response to Professional Society Guidance
Sigmund, A., Stevens, E. R., Blitz, J. D., & Ladapo, J. A. (2015) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2015.2081 · Cited by 47 · cited 1× · see citing works
“We used visit diagnoses and reasons for visit from our prior work to identify patients with other risk factors for adverse cardiovascular events, including hypertension, dyslipidemia, cigarette smoking, obesity, diabetes, chronic kidney disease, chronic obstructive pulmonary disease, CAD, and stroke (16,17).”
MethodSelf-citation
Flagged first, then by citations
1 of the 22 references couldn’t be matched to a known paper.
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Anand, S. S., Bosch, J., Eikelboom, J. W., Connolly, S. J., Diaz, R., Widimsky, P., Aboyans, V., Alings, M., Kakkar, A. K., Keltai, K., et al. (2018) · The Lancet · doi:10.1016/s0140-6736(17)32409-1 · Cited by 879 · see citing works
“4,25,26 Consistent benefits in the reduction of major adverse cardiovascular events and major adverse limb events occurred with combination of rivaroxaban 2·5 mg plus aspirin compared with aspirin alone but did not occur to the same extent with the rivaroxaban 5 mg twice a day regimen.”
Connolly, S. J., Eikelboom, J. W., Bosch, J., Dagenais, G., Dyal, L., Lanas, F., Metsarinne, K., O'Donnell, M., Dans, A. L., Ha, J.-W., et al. (2018) · The Lancet · doi:10.1016/s0140-6736(17)32458-3 · Cited by 754 · see citing works
Kim, M. S., Hwang, J., Yon, D. K., Lee, S. W., Jung, S. Y., Park, S., Johnson, C. O., Stark, B. A., Razo, C., Abbasian, M., et al. (2023) · The Lancet Global Health · doi:10.1016/s2214-109x(23)00355-8 · Cited by 273 · see citing works
Evidence-Based Medical Management of Peripheral Artery Disease
Bevan, G. H., & Solaru, K. W. (2020) · Arteriosclerosis Thrombosis and Vascular Biology · doi:10.1161/atvbaha.119.312142 · Cited by 228 · see citing works
Lower extremity arterial disease in patients with diabetes: a contemporary narrative review
Nativel, M., Potier, L., Alexandre, L., Baillet‐Blanco, L., Ducasse, E., Velho, G., Marre, M., Roussel, R., Rigalleau, V., & Mohammedi, K. (2018) · Cardiovascular Diabetology · doi:10.1186/s12933-018-0781-1 · Cited by 195 · see citing works
Contemporary Medical Management of Peripheral Artery Disease
Bonaca, M. P., Hamburg, N. M., & Creager, M. A. (2021) · Circulation Research · doi:10.1161/circresaha.121.318258 · Cited by 164 · see citing works
Creager, M. A., Matsushita, K., Arya, S., Beckman, J. A., Duval, S., Goodney, P. P., Gutierrez, J. A. T., Kaufman, J. A., Joynt Maddox, K. E., Pollak, A. W., et al. (2021) · Circulation · doi:10.1161/cir.0000000000000967 · Cited by 164 · see citing works
Salata, K., Syed, M. H., Hussain, M. A., de Mestral, C., Greco, E., Mamdani, M., Tu, J. V., Forbes, T. L., Bhatt, D. L., Verma, S., et al. (2018) · Journal of the American Heart Association · doi:10.1161/jaha.118.008657 · Cited by 153 · see citing works
Racial and Ethnic Disparities in Peripheral Artery Disease
Hackler, E. L., Hamburg, N. M., & White Solaru, K. T. (2021) · Circulation Research · doi:10.1161/circresaha.121.318243 · Cited by 141 · see citing works
Flores, A. M., Demsas, F., Leeper, N. J., & Ross, E. (2021) · Circulation Research · doi:10.1161/circresaha.121.318224 · Cited by 133 · see citing works
Major Adverse Limb Events and 1-Year Outcomes After Peripheral Artery Revascularization
Hess, C. N., Rogers, R. K., Wang, T. Y., Fu, R., Gundrum, J. D., LaPointe, N. M. A., & Hiatt, W. R. (2018) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2018.06.041 · Cited by 116 · see citing works
Kreutzburg, T., Peters, F., Rieß, H. C., Hischke, S., Marschall, U., Kriston, L., L’Hoest, H., Sedrakyan, A., Debus, E. S., & Behrendt, C. (2019) · European Journal of Vascular and Endovascular Surgery · doi:10.1016/j.ejvs.2019.08.006 · Cited by 101 · see citing works
Fanaroff, A. C., Yang, L., Nathan, A. S., Khatana, S. A. M., Julien, H. M., Wang, T. Y., Armstrong, E. J., Treat‐Jacobson, D., Glaser, J. D., Wang, G., et al. (2021) · Journal of the American Heart Association · doi:10.1161/jaha.121.021456 · Cited by 97 · see citing works
Saxon, J. T., Safley, D. M., Mena-Hurtado, C., Heyligers, J., Fitridge, R., Shishehbor, M., Spertus, J., Gosch, K., Patel, M., & Smolderen, K. (2020) · Journal of the American Heart Association : Cardiovascular and Cerebrovascular Disease · doi:10.1161/jaha.119.012541 · Cited by 56 · see citing works
Applications of artificial intelligence for patients with peripheral artery disease.
Lareyre, F., Behrendt, C., Chaudhuri, A., Lee, R., Carrier, M., Adam, C., Lê, C. D., & Raffort, J. (2022) · Journal of Vascular Surgery · doi:10.1016/j.jvs.2022.07.160 · Cited by 56 · see citing works
Antithrombotic Therapy for Peripheral Artery Disease
Hussain, M. A., Al-Omran, M., Creager, M. A., Anand, S. S., Verma, S., & Bhatt, D. L. (2018) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2018.03.483 · Cited by 69 · see citing works
Disparities in Diagnosis, Treatment, and Outcomes of Peripheral Artery Disease
McDermott, M. M., Ho, K. J., Alabi, O., Criqui, M. H., Goodney, P. P., Hamburg, N. M., McNeal, D. M., Pollak, A. W., Smolderen, K. G. E., & Bonaca, M. P. (2023) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2023.09.830 · Cited by 65 · see citing works
Patel, K., Jones, P. G., Ellerbeck, E. F., Buchanan, D. M., Chan, P. S., Pacheco, C. M., Moneta, G. L., Spertus, J. A., & Smolderen, K. G. E. (2018) · Journal of the American Heart Association · doi:10.1161/jaha.118.010076 · Cited by 60 · see citing works
Rammos, C., Steinmetz, M., Lortz, J., Mahabadi, A. A., Petrikhovich, O., Kirsch, K., Hering, R., Schulz, M., & Rassaf, T. (2021) · The Lancet Regional Health - Europe · doi:10.1016/j.lanepe.2021.100113 · Cited by 54 · see citing works
“In PAD, the underuse of guideline recommended therapy has been described in studies of administrative and procedural databases [10-12], but up-to date nation-wide and detailed real-world data on physician-care patterns and medically managed patients are lacking.”
BackgroundResultContemporary Management of Dyslipidemia
Ferraro, R., Leucker, T. M., Martin, S. S., Banach, M., Jones, S. R., & Toth, P. P. (2022) · Drugs · doi:10.1007/s40265-022-01691-6 · Cited by 56 · see citing works
McBride, C., Akeroyd, J. M., Ramsey, D., Nambi, V., Nasir, K., Michos, E., Bush, R., Jneid, H., Morris, P., Bittner, V., et al. (2018) · Vascular Medicine · doi:10.1177/1358863x18758914 · Cited by 53 · see citing works
Statins and Peripheral Arterial Disease: A Narrative Review
Jansen-Chaparro, S., López-Carmona, M., Cobos-Palacios, L., Sanz-Cánovas, J., Bernal-López, M., & Gómez-Huelgas, R. (2021) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2021.777016 · Cited by 38 · see citing works
Messiha, D., Petrikhovich, O., Lortz, J., Mahabadi, A. A., Hering, R., Schulz, M., Rassaf, T., & Rammos, C. (2022) · European Journal of Vascular and Endovascular Surgery · doi:10.1016/j.ejvs.2022.02.007 · Cited by 42 · see citing works
Association Between Statin Use and Cardiovascular Events After Carotid Artery Revascularization
Hussain, M. A., Saposnik, G., Raju, S., Salata, K., Mamdani, M., Tu, J. V., Bhatt, D. L., Verma, S., & Al-Omran, M. A. (2018) · Journal of the American Heart Association · doi:10.1161/jaha.118.009745 · Cited by 42 · see citing works
Liu, W., Yang, C., Chen, Z., Lei, F., Qin, J., Liu, H., Ji, Y., Zhang, P., Cai, J., Liu, Y.-M., et al. (2022) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2022.03.002 · Cited by 41 · see citing works
Berger, J. S., Abramson, B. L., Lópes, R. D., Heizer, G., Rockhold, F. W., Baumgärtner, I., Fowkes, F. G. R., Held, P., Katona, B. G., Norgren, L., et al. (2018) · Vascular Medicine · doi:10.1177/1358863x18775594 · Cited by 40 · see citing works
Self-citationKrawisz, A. K., Natesan, S., Wadhera, R. K., Chen, S., Song, Y., Yeh, R. W., Jaff, M. R., Giri, J. S., Julien, H. M., & Secemsky, E. A. (2022) · Circulation · doi:10.1161/circulationaha.122.058998 · Cited by 40 · see citing works
Concordance With Screening and Treatment Guidelines for Chronic Kidney Disease in Type 2 Diabetes
Edmonston, D., Lydon, E., Mulder, H., Chiswell, K., Lampron, Z. M., Marsolo, K., Goss, A., Ayoub, I., Shah, R. C., Chang, A. R., et al. (2024) · JAMA Network Open · doi:10.1001/jamanetworkopen.2024.18808 · Cited by 34 · see citing works
Altin, S. E., Castro‐Dominguez, Y., Kennedy, K. F., Orion, K. C., Lansky, A. J., Abbott, J. D., & Aronow, H. D. (2020) · JACC: Cardiovascular Interventions · doi:10.1016/j.jcin.2020.08.036 · Cited by 37 · see citing works
The impact of current smoking on outcomes after infrainguinal bypass for claudication
Kalbaugh, C. A., Gonzalez, N. J., Luckett, D. J., Fine, J. P., Brothers, T. E., Farber, M. A., Beck, A. W., Hallett, J. W., Marston, W. A., & Vallabhaneni, R. (2018) · Journal of Vascular Surgery · doi:10.1016/j.jvs.2017.10.091 · Cited by 35 · see citing works
Peripheral vascular disease risk in diabetic individuals without coronary heart disease
Wilcox, T., Newman, J. D., Maldonado, T. S., Rockman, C. R., & Berger, J. S. (2018) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2018.04.026 · Cited by 38 · see citing works
Self-citationMufarreh, A. J., Shah, A. J., Vaccarino, V., & Kulshreshtha, A. (2023) · JAMA Network Open · doi:10.1001/jamanetworkopen.2022.51156 · Cited by 33 · see citing works
Kim, E. S. H., Arya, S., Bryce, Y. C. D., Gornik, H. L., Long, C. A., McDermott, M. M., Pollak, A. W., Rowe, V. L., Sullivan, A. E., & Whipple, M. O. (2025) · Circulation · doi:10.1161/cir.0000000000001310 · Cited by 33 · see citing works
“132,133 137 Some studies reported lower adherence rates to statin or antiplatelet therapy in women compared with men.”
McBane, R. D., Murphree, D. H., Liedl, D., López-Jiménez, F., Attia, I., Arruda-Olson, A., Scott, C., Prodduturi, N., Nowakowski, S. E., Rooke, T., et al. (2023) · medRxiv · doi:10.1161/jaha.123.031880 · Cited by 20 · see citing works
“Compared to coronary artery disease patients, PAD patients are often half as likely to receive statin therapy, antiplatelet agents, tobacco cessation management, or hypertension control to goal (3-6).”
BackgroundPacha, H. M., Mallipeddi, V. P., Afzal, N., Moon, S., Kaggal, V. C., Kalra, M., Oderich, G. S., Wennberg, P. W., Rooke, T. W., Scott, C. G., et al. (2018) · JAMA Network Open · doi:10.1001/jamanetworkopen.2018.5547 · Cited by 30 · see citing works
Arruda-Olson, A. M., Afzal, N., Mallipeddi, V. P., Said, A., Pacha, H. M., Moon, S., Chaudhry, A. P., Scott, C. G., Bailey, K. R., Rooke, T. W., et al. (2018) · Journal of the American Heart Association · doi:10.1161/jaha.118.009680 · Cited by 27 · see citing works
“demonstrate underuse of guideline-recommended strategies for secondary prevention in patients with PAD, including antiplatelet therapy.(24,34,35) Incomplete ascertainment caused by over-the-counter aspirin availability is another potential contributor.”
BackgroundKanazawa, N., Yamada, S., & Fushimi, K. (2021) · Circulation Reports · doi:10.1253/circrep.cr-21-0018 · Cited by 29 · see citing works
Hua, S., Isasi, C. R., Kizer, J. R., Matsushita, K., Allison, M. A., Tarraf, W., Qi, Q., Ponce, S. G., Daviglus, M., & Kaplan, R. C. (2020) · Journal of the American Heart Association · doi:10.1161/jaha.119.015451 · Cited by 28 · see citing works
Alushi, K., Hinterseher, I., Peters, F., Rother, U., Bischoff, M. S., Mylonas, S., Grambow, E., Gombert, A., Busch, A., Gray, D. E., et al. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11030498 · Cited by 28 · see citing works
Søgaard, M., Nielsen, P. B., Skjøth, F., Eldrup, N., & Larsen, T. B. (2020) · Circulation · doi:10.1161/circulationaha.120.047994 · Cited by 26 · see citing works
Adegbola, A., Behrendt, C., Zyriax, B., Windler, E. E. T., & Kreutzburg, T. (2021) · Clinical Nutrition · doi:10.1016/j.clnu.2021.11.005 · Cited by 25 · see citing works
Devrome, A. N., Aggarwal, S., McMurtry, M. S., Southern, D. A., Hauer, T., Lamb, B., Arena, R. A., Moore, R. D., Wilton, S. B., Stone, J. A., et al. (2019) · International Journal of Cardiology · doi:10.1016/j.ijcard.2019.02.070 · Cited by 25 · see citing works
Sex and Racial Disparities in Peripheral Artery Disease
Divakaran, S., Krawisz, A. K., Secemsky, E. A., & Kant, S. (2023) · Arteriosclerosis Thrombosis and Vascular Biology · doi:10.1161/atvbaha.123.319399 · Cited by 23 · see citing works
Trends in Discharge Rates for Acute Pulmonary Embolism in U.S. Emergency Departments
Watson, N., Carroll, B., Krawisz, A. K., Schmaier, A. A., & Secemsky, E. A. (2024) · Annals of Internal Medicine · doi:10.7326/m23-2442 · Cited by 23 · see citing works
Krantz, M. J., Debus, S. E., Hsia, J. A., Patel, M. R., Anand, S. S., Nehler, M. R., Hess, C. N., Capell, W. H., Bracken, T., Szarek, M. J., et al. (2021) · European Heart Journal · doi:10.1093/eurheartj/ehab408 · Cited by 23 · see citing works
“tive outpatient population among which 25% of patients with PAD were >_80 years of age, just 38% were treated with aspirin.(4) One po-”
BackgroundReynolds, K., Mues, K., Harrison, T. N., Qian, L., Chen, S., Hsu, J.-W. Y., Philip, K., Monda, K., Reading, S., & Brar, S. (2019) · Vascular Medicine · doi:10.1177/1358863x19871100 · Cited by 18 · see citing works
Emery, C., Torreton, E., Brière, J., Evers, T., & Fagnani, F. (2020) · Journal of Medical Economics · doi:10.1080/13696998.2020.1715415 · Cited by 21 · see citing works
Tern, P. J. W., Kujawiak, I., Saha, P., Berrett, T. B., Chowdhury, M. M., & Coughlin, P. A. (2018) · European Journal of Vascular and Endovascular Surgery · doi:10.1016/j.ejvs.2018.07.020 · Cited by 22 · see citing works
Antithrombotic Therapy in Peripheral Artery Disease
Jones, W. S., & Patel, M. R. (2018) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2017.11.021 · Cited by 21 · see citing works
“Recent data have shown that PAD patients remain significantly undertreated with proven therapies (41).”
Lipid-lowering therapies in peripheral artery disease: A review
Skeik, N., Nowariak, M. E., Smith, J. E., Alexander, J. Q., Manunga, J. M., Mirza, A. K., & Sullivan, T. M. (2020) · Vascular Medicine · doi:10.1177/1358863x20957091 · Cited by 21 · see citing works
Association of healthy lifestyle and all‐cause mortality according to medication burden
Kelly, N. A., Soroka, O., Onyebeke, C. O., Pinheiro, L. C., Banerjee, S., Safford, M. M., & Goyal, P. (2021) · Journal of the American Geriatrics Society · doi:10.1111/jgs.17521 · Cited by 22 · see citing works
Cornelis, N., Nassen, J., Buys, R., Fourneau, I., & Cornelissen, V. (2019) · European Journal of Vascular and Endovascular Surgery · doi:10.1016/j.ejvs.2018.12.014 · Cited by 20 · see citing works
Statin use and high-dose statin use after ischemic stroke in the UK: a retrospective cohort study
Yang, Z., Edwards, D., Massou, E., Saunders, C. L., Brayne, C., & Mant, J. (2019) · Clinical Epidemiology · doi:10.2147/clep.s201983 · Cited by 19 · see citing works
“The absence of other cardiovascular comorbidities such as diabetes, hypertension, and CKD was consistently associated with lower probability of statin use and high-intensity statin use after stroke, which differs from studies of CHD and PAD populations.(28,29,37) This, together with the strong association of statin us…”
ResultAnti-hypertensive treatment in peripheral artery disease
Tsioufis, C. P., Andrikou, I., Siasos, G., Filis, K., & Tousoulis, D. M. (2018) · Current Opinion in Pharmacology · doi:10.1016/j.coph.2018.01.009 · Cited by 19 · see citing works
Racial and Socioeconomic Health Disparities in Peripheral Artery Disease
Thomas, V. E., & Beckman, J. A. (2024) · Journal of the American Heart Association · doi:10.1161/jaha.123.031446 · Cited by 18 · see citing works
“46,47 Uncontrolled hypertension treatment and management continues to be a healthcare disparity issue affecting Black patients, which further provokes the PAD adverse outcomes.”
Nastasi, D. R., Smith, J., Moxon, J. V., Trollope, A. F., & Golledge, J. (2018) · Stroke · doi:10.1161/strokeaha.118.022922 · Cited by 18 · see citing works
Disparities in Advanced Peripheral Arterial Disease Presentation by Socioeconomic Status
de Jager, E. C., Gunnarsson, R. K., & Ho, Y. (2022) · World Journal of Surgery · doi:10.1007/s00268-022-06513-0 · Cited by 17 · see citing works
“In the USA, one study in a hospital outpatient setting for PAD found that only 33% of patients received antiplatelets, 33% received statins, and 36% of smokers received smoking cessation counselling [42].”
BackgroundBurden of hospitalization in clinically diagnosed peripheral artery disease: A community-based study
Arruda-Olson, A. M., Pacha, H. M., Afzal, N., Abram, S., Lewis, B. R., Isseh, I. N., Haddad, R. A., Scott, C. G., Bailey, K. R., Liu, H., et al. (2017) · Vascular Medicine · doi:10.1177/1358863x17736152 · Cited by 17 · see citing works
Cardiovascular disease in nonagenarians: Prevalence and utilization of preventive therapies
Mostaza, J. M., Lahoz, C., Salinero-Fort, M. Á., & Cárdenas‐Valladolid, J. (2018) · European Journal of Preventive Cardiology · doi:10.1177/2047487318813723 · Cited by 17 · see citing works
The Treatment Gap in Peripheral Artery Disease
Hiatt, W. R., & Rogers, R. K. (2017) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2017.03.024 · Cited by 17 · see citing works
Ahden, S., Ngo, V., Hoskin, J., Mach, V., Magharious, S., Tambar, A., Brooks, D., Hébert, A.-A., & Marzolini, S. (2021) · Heart Lung and Circulation · doi:10.1016/j.hlc.2020.12.018 · Cited by 16 · see citing works
Howard, R., Albright, J., Powell, C., Osborne, N., Corriere, M., Laveroni, E., Sukul, D., Goodney, P., & Henke, P. (2022) · Journal of Vascular Surgery · doi:10.1016/j.jvs.2022.05.016 · Cited by 14 · see citing works
Foussard, N., Dari, L., Ducasse, É., Rigalleau, V., Mohammedi, K., & Caradu, C. (2023) · La Presse Médicale · doi:10.1016/j.lpm.2023.104164 · Cited by 16 · see citing works
Peripheral Artery Disease: Overview of Diagnosis and Medical Therapy.
Bierowski, M. J., Galanis, T., Majeed, A., & Mofid, A. (2023) · The Medical clinics of North America · doi:10.1016/j.mcna.2023.05.007 · Cited by 10 · see citing works
Thaarup, M., Jacobsen, S., Nielsen, P. B., Nicolajsen, C. W., Eldrup, N., Petersen, C. N., Behrendt, C., Dahl, M., Højen, A. A., & Søgaard, M. (2024) · European Journal of Vascular and Endovascular Surgery · doi:10.1016/j.ejvs.2024.02.002 · Cited by 15 · see citing works
Nicolajsen, C. W., Søgaard, M., Eldrup, N., Jensen, M. B., Larsen, T. B., Goldhaber, S. Z., & Nielsen, P. B. (2022) · European Journal of Preventive Cardiology · doi:10.1093/eurjpc/zwac105 · Cited by 15 · see citing works
Mohammed, M., GOSCH, K. L., Safley, D. M., Jelani, Q., Aronow, H. D., Mena, C. I., Shishehbor, M. H., Spertus, J. A., Abbott, J. D., & Smolderen, K. G. E. (2020) · International Journal of Cardiology · doi:10.1016/j.ijcard.2020.05.042 · Cited by 14 · see citing works
Peripheral Arterial Disease: Supervised Exercise Therapy Through Cardiac Rehabilitation.
Thomas, S. G., Marzolini, S., Lin, E., Nguyen, C. H., & Oh, P. (2019) · Clinics in Geriatric Medicine · doi:10.1016/j.cger.2019.07.009 · Cited by 10 · see citing works
A thought-provoking statement regarding the treatment of patients with peripheral arterial disease
Søgaard, M., Nordanstig, J., Eldrup, N., & Behrendt, C. (2023) · VASA · doi:10.1024/0301-1526/a001055 · Cited by 13 · see citing works
Entering Cardiac Rehabilitation With Peripheral Artery Disease
Nguyen, C. H., Marzolini, S., Oh, P., & Thomas, S. G. (2020) · Journal of Cardiopulmonary Rehabilitation and Prevention · doi:10.1097/hcr.0000000000000475 · Cited by 13 · see citing works
Chaudhry, A. P., Afzal, N., Abidian, M. M., Mallipeddi, V. P., Elayavilli, R. K., Scott, C. G., Kullo, I. J., Wennberg, P. W., Pankratz, J. J., Liu, H., et al. (2018) · Mayo Clinic Proceedings Innovations Quality & Outcomes · doi:10.1016/j.mayocpiqo.2018.02.001 · Cited by 13 · see citing works
“However, this category of antihypertensive agent has been evaluated by other studies as a quality metric for patients with PAD 6,15,16 and therefore was also evaluated for the study herein.”
Hackam, D., & Vyas, M. (2018) · American Journal of Medicine · doi:10.1016/j.amjmed.2018.07.006 · Cited by 12 · see citing works
Rezvani, F., Pelt, M., Härter, M. C., & Dirmaier, J. (2022) · PLoS ONE · doi:10.1371/journal.pone.0273747 · Cited by 13 · see citing works
Bhagirath, V. C., Nash, D., Wan, D., & Anand, S. S. (2022) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2022.02.004 · Cited by 12 · see citing works
A Bon VOYAGER for Peripheral Artery Disease
Creager, M. A. (2020) · New England Journal of Medicine · doi:10.1056/nejme2007274 · Cited by 12 · see citing works
Mueller, L., Engelbertz, C. M., Reinecke, H., Freisinger, E., Malyar, N. M., Meyborg, M., Brix, T. J., Varghese, J., & Gebauer, K. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11226838 · Cited by 11 · see citing works
Coca-Martínez, M., Girsowicz, E., Doonan, R. J., Obrand, D. I., Bayne, J. P., Steinmetz, O. K., MacKenzie, K. S., Carli, F., Martínez‐Palli, G., & Gill, H. L. (2023) · Annals of Vascular Surgery · doi:10.1016/j.avsg.2023.09.101 · Cited by 11 · see citing works
Diagnostic Test Accuracy of Pedal Acceleration Time to Identify Peripheral Artery Disease
Sommerset, J., Teso, D., Mills, J. L., Sebastian, M. G., Kayssi, A., Leask, S., Rounsley, R., & Tehan, P. E. (2025) · European Journal of Vascular and Endovascular Surgery · doi:10.1016/j.ejvs.2025.03.007 · Cited by 11 · see citing works
Liang, J., Zhang, H., Sun, X., Liao, L., Li, X., Hu, X., Du, J., Zhuang, X., & Liao, X. (2020) · Journal of Cardiology · doi:10.1016/j.jjcc.2020.04.002 · Cited by 11 · see citing works
Krawisz, A. K., Raja, A., & Secemsky, E. A. (2021) · Progress in Cardiovascular Diseases · doi:10.1016/j.pcad.2021.02.004 · Cited by 11 · see citing works
The use of evidence-based medical therapy in patients with critical limb-threatening ischaemia
Bager, L. G. V., Petersen, J. K., Havers‐Borgersen, E., Resch, T. A., Smolderen, K. G. E., Mena‐Hurtado, C., Eiberg, J., Køber, L., & Fosbøl, E. L. (2023) · European Journal of Preventive Cardiology · doi:10.1093/eurjpc/zwad022 · Cited by 11 · see citing works
Cornelis, N., Buys, R., Dewit, T., Benoit, D., Claes, J., Fourneau, I., & Cornelissen, V. (2021) · JMIR Rehabilitation and Assistive Technologies · doi:10.2196/18739 · Cited by 11 · see citing works
Peripheral arterial disease and hypertension
Gupta, A., & Patel, R. A. G. (2022) · Current Opinion in Cardiology · doi:10.1097/hco.0000000000000983 · Cited by 5 · see citing works
Antithrombotic therapy in peripheral arterial disease
Espinola–Klein, C., Weißer, G., Schmitt, V. H., Schwaderlapp, M., & Münzel, T. F. (2022) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2022.927645 · Cited by 10 · see citing works
“In addition, patients with PAD are often treated less consistently compared to other manifestations of atherosclerosis such as coronary artery disease (CAD) (4, 5).”
BackgroundInfluentialPaskiewicz, A., Wang, F. M., Ishigami, J., Pang, Y., Sang, Y., Ballew, S. H., Grams, M. E., HEISS, G. M., Coresh, J., & Matsushita, K. (2024) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2024.118558 · Cited by 10 · see citing works
Kubiak, T., Sitruk, J., Durivage, A., Khider, L., Mohamedi, N., Detriche, G., Messas, E., Mirault, T., & Goudot, G. (2023) · Frontiers in Public Health · doi:10.3389/fpubh.2023.1070403 · Cited by 9 · see citing works
“Only about a third of patients with PAD in the US receive guidelinerecommended medical therapy or smoking-cessation counseling, and even fewer are advised about diet and exercise (20, 21).”
BackgroundOral factor Xa inhibitor underutilization following lower extremity peripheral vascular intervention
Bhuta, S., Ariss, R. W., Ding, L., Nazir, S., Magee, G. A., Garg, P. K., & Gupta, R. (2023) · Journal of Vascular Surgery · doi:10.1016/j.jvs.2023.04.026 · Cited by 8 · see citing works
Khariton, Y., Patel, K., Chan, P. S., Pokharel, Y., Wang, J., Spertus, J. A., Safley, D. M., Hiatt, W. R., & Smolderen, K. G. E. (2018) · Clinical Cardiology · doi:10.1002/clc.23087 · Cited by 9 · see citing works
“Statin prescription was only noted in 62% of the patient cohort studied in REACH,(23) and Berger et al documented the persistent underuse of statins in PAD patients treated at multispecialty outpatient clinics.(24) Finally, an analysis examining the adoption of the 2013 ACC/AHA cholesterol guidelines described an unde…”
Duwayri, Y. M., Woo, K., Aiello, F. A., Adams, J. G., Ryan, P. C., Tracci, M. C., Hurie, J., Davies, M. G., Shutze, W. P., McDevitt, D. T., et al. (2020) · Journal of Vascular Surgery · doi:10.1016/j.jvs.2020.08.131 · Cited by 9 · see citing works
“40 In addition to the concern regarding the low rate of medical therapy usage, signi fi cant geographic variations were found in the perioperative and long-term outcomes for patients with PAD, indicating the potential for improved value through periprocedural standardization.”
BackgroundThe Safety of Paclitaxel-Coated Devices for Patients with Peripheral Artery Disease
Krawisz, A. K., & Secemsky, E. A. (2021) · Current Cardiology Reports · doi:10.1007/s11886-021-01477-4 · Cited by 9 · see citing works
Amadid, H., Rønn, P. F., Dunbar, M. B., Knudsen, J. S., Carstensen, B., Persson, F., & Jørgensen, M. E. (2021) · Diabetes Obesity and Metabolism · doi:10.1111/dom.14478 · Cited by 8 · see citing works
Prevalence and Associations of Peripheral Arterial Disease in China: The Beijing Eye Study
Wang, Y. X., Wang, Q., Jonas, R. A., & Jonas, J. B. (2023) · American Journal of Ophthalmology · doi:10.1016/j.ajo.2023.10.016 · Cited by 8 · see citing works
Søgaard, M., Skjøth, F., Behrendt, C., Nicolajsen, C. W., Højen, A. A., Dahl, M., Petersen, C. N., & Ørskov, M. (2025) · European Journal of Vascular and Endovascular Surgery · doi:10.1016/j.ejvs.2025.09.015 · Cited by 8 · see citing works
Robbins, R., Seixas, A. A., Jean‐Louis, G., Parthasarathy, S., Rapoport, D. M., Ogedegbe, G. G., & Ladapo, J. A. (2018) · PLoS ONE · doi:10.1371/journal.pone.0196981 · Cited by 8 · see citing works
Self-citationViscogliosi, G., Donfrancesco, C., Noce, C. L., Vanuzzo, D., Carle, F., Giampaoli, S., & Palmieri, L. (2020) · Rejuvenation Research · doi:10.1089/rej.2019.2268 · Cited by 8 · see citing works
James, S., Zhu, A., Kritharides, L., & Aitken, S. (2025) · European Journal of Vascular and Endovascular Surgery · doi:10.1016/j.ejvs.2025.11.014 · Cited by 7 · see citing works
Hsu, C., Chen, W., Lin, H., Chen, H., Yang, Y.-H., Chen, W., Chen, C.-M., & Hsiao, F. (2023) · BMJ Open · doi:10.1136/bmjopen-2022-064219 · Cited by 7 · see citing works
Zhou, X., Wu, L., Chen, Y., Xiao, H., Huang, X., Li, Y., Xiao, H., & Cao, X. (2020) · Journal of Diabetes Investigation · doi:10.1111/jdi.13472 · Cited by 7 · see citing works
Hrubá, R., & Sadílek, T. (2022) · Journal of International Food & Agribusiness Marketing · doi:10.1080/08974438.2022.2056558 · Cited by 6 · see citing works
“…lifestyles as a preventive measure against disease (Gibson and Shepherd, 2005; European Food Safety Authority, 2008; Cencic & Chingwaru, 2010; Sonnenberg, 2011; Chomistek et al., 2015; Berger & Ladapo, 2017; Petrides, Collins, Kowalski, Sepede, & Vermeulen, 2019; Marras, Canning, & Goldman, 2019).”
de Launay, D., Paquet, M., Kirkham, A. M., Graham, I. D., Fergusson, D. A., Nagpal, S., Shorr, R., Grimshaw, J., & Roberts, D. J. (2024) · BMJ Open · doi:10.1136/bmjopen-2023-076795 · Cited by 6 · see citing works
- Authors
- Berger, J. S., & Ladapo, J. A.
- Affiliations
- NYU Langone Health (US)
- University of California, Los Angeles (US)
- Corresponding author
- Berger, Jeffrey S.
- Ladapo, Joseph A.
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2017-05
- Volume
- 69
- Issue
- 18
- Pages
- 2293-2300
- ISSN
- 0735-1097 (ISSN-L)
- PMC
- PMC5497594
- OpenAlex
- W2611241853
- Semantic Scholar
- 017b4cb92809f09ced5ed389d0a65423e0070a1c
- Cited by
- 183
- References
- 22
- Citations by year
- 2026: 9 · 2025: 17 · 2024: 16 · 2023: 25 · 2022: 21 · 2021: 30 · 2020: 24 · 2019: 11 · 2018: 25 · 2017: 5
- FWCI
- 18.19
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- AstraZeneca
- National Institutes of Health (5k23hl116787-05, K23 HL116787)
- National Heart, Lung, and Blood Institute (K23-HL116787, R01HL114978)
- Topics
- Health Sciences › Medicine › Surgery › Peripheral Artery Disease Management
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Keywords
- peripheral arterial disease, cardiovascular disease prevention, lifestyle counseling, antiplatelet therapy, statins, ACE inhibitors, angiotensin receptor blockers, cilostazol, smoking cessation counseling, claudication, drug use trends, outpatient visits, United States
- MeSH terms
- Aged, Aged, 80 and over, Female, Humans, Life Style, Male, Middle Aged, Office Visits, Directive Counseling, Risk Reduction Behavior, Secondary Prevention, Peripheral Arterial Disease
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