外周动脉疾病在初级保健中诊断不足
WESTPORT, CT (Reuters Health) - Peripheral arterial disease (PAD) is underdiagnosed in US clinical practice, according to a report in The Journal of the American Medical Association for September 19.
Dr. Alan T. Hirsch from the University of Minnesota Medical School, in Minneapolis, and colleagues collected data on 6417 patients with a history of cigarette smoking and/or diabetes as part of a 27-center, community-based PAD detection program. Sixty-two percent of the patients were 70 years of age or older and the rest were between 50 and 69 years of age.
Patients underwent measurement of the Doppler ankle-brachial index, and any history of PAD or cardiovascular disease was investigated by patient interview and chart review. PAD was detected in 29% of the patients. Twenty-four percent of the patients had CVD alone, 13% had PAD alone and 16% had both PAD and CVD, the researchers report. "Among patients with PAD, classic claudication was distinctly uncommon (11%)."
Among patients with PAD alone, 55% were newly diagnosed during the study, as were 35% of those with both PAD and CVD. Most patients (83%) with a prior diagnosis of PAD were aware of their diagnosis, but when questioned on the day of screening, only 49% of their physicians indicated an awareness of the diagnosis, Dr. Hirsch's group found.
Patients with PAD alone were less likely to be treated for hypertension or hyperlipidemia, or to receive antiplatelet medication, compared with patients with CVD only (p, 百拇医药
Dr. Alan T. Hirsch from the University of Minnesota Medical School, in Minneapolis, and colleagues collected data on 6417 patients with a history of cigarette smoking and/or diabetes as part of a 27-center, community-based PAD detection program. Sixty-two percent of the patients were 70 years of age or older and the rest were between 50 and 69 years of age.
Patients underwent measurement of the Doppler ankle-brachial index, and any history of PAD or cardiovascular disease was investigated by patient interview and chart review. PAD was detected in 29% of the patients. Twenty-four percent of the patients had CVD alone, 13% had PAD alone and 16% had both PAD and CVD, the researchers report. "Among patients with PAD, classic claudication was distinctly uncommon (11%)."
Among patients with PAD alone, 55% were newly diagnosed during the study, as were 35% of those with both PAD and CVD. Most patients (83%) with a prior diagnosis of PAD were aware of their diagnosis, but when questioned on the day of screening, only 49% of their physicians indicated an awareness of the diagnosis, Dr. Hirsch's group found.
Patients with PAD alone were less likely to be treated for hypertension or hyperlipidemia, or to receive antiplatelet medication, compared with patients with CVD only (p, 百拇医药