Peripheral arterial disease: lack of awareness in Canada.

BACKGROUND Peripheral arterial disease (PAD) is a common manifestation of systemic atherosclerosis and is associated with a high risk of stroke, myocardial infarction and cardiovascular death. PAD also fosters major morbidity by causing claudication, functional impairment, disability and amputation. PAD is largely unrecognized and under-treated compared with other cardiovascular diseases. The public health impact of PAD, as a contributor to Canadian national rates of heart attack, stroke, amputation, death and disability, will be challenging to address if the public is unaware of this common cardiovascular disease. OBJECTIVE To assess public knowledge of PAD in Canada. METHODS A cross-sectional, population-based telephone survey of 501 adults 50 years of age and older (mean age 64.4 years) was conducted using random digit dialing. The survey assessed demographics and risk factors of the study population and knowledge of PAD causes and consequences. RESULTS Survey respondents reported a high prevalence of atherosclerotic risk factors including high blood pressure (43%), high blood cholesterol (37%), diabetes (12%) and smoking history (18% current and 49% former smokers). Only 36% of respondents reported familiarity with PAD, which was significantly lower than other cardiovascular diseases or risk factors. Knowledge of perceived consequences of PAD was low and knowledge gaps were more pronounced in older, less educated and lower income respondents. CONCLUSIONS The Canadian public is largely unaware of PAD as a prevalent systemic manifestation of atherosclerosis and its associated morbidity and mortality. National PAD awareness programs should be instituted to increase PAD knowledge to levels comparable with other cardiovascular diseases and risk factors.

[1]  M. Creager,et al.  Mandate for creation of a national peripheral arterial disease public awareness program: an opportunity to improve cardiovascular health , 2004 .

[2]  R. Prescott,et al.  Edinburgh Artery Study: prevalence of asymptomatic and symptomatic peripheral arterial disease in the general population. , 1991, International journal of epidemiology.

[3]  M. Criqui,et al.  Gaps in Public Knowledge of Peripheral Arterial Disease: The First National PAD Public Awareness Survey , 2007, Circulation.

[4]  J. Belch,et al.  Vascular disease public education: the mandate is international. , 2004, International angiology : a journal of the International Union of Angiology.

[5]  M. Criqui.  Peripheral arterial disease - epidemiological aspects , 2001, Vascular medicine.

[6]  M. Al-Omran,et al.  Perceptions of Canadian Vascular Surgeons toward Pharmacological Risk Reduction in Patients with Peripheral Arterial Disease , 2006, Annals of vascular surgery.

[7]  F. McAlister,et al.  The Canadian Hypertension Education Program (CHEP) recommendations: launching a new series , 2005, Canadian Medical Association Journal.

[8]  K. Furie,et al.  Heart disease and stroke statistics--2007 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. , 2008, Circulation.

[9]  J. Tu,et al.  Lack of awareness of heart disease and stroke among Chinese Canadians: results of a pilot study of the Chinese Canadian Cardiovascular Health Project. , 2008, The Canadian journal of cardiology.

[10]  Elizabeth Selvin,et al.  Prevalence of and Risk Factors for Peripheral Arterial Disease in the United States: Results From the National Health and Nutrition Examination Survey, 1999–2000 , 2004 .

[11]  Sonia S Anand,et al.  Patterns of medical therapy in patients with peripheral artery disease in a tertiary care centre in Canada. , 2007, The Canadian journal of cardiology.

[12]  J. Brick,et al.  BIAS IN LIST-ASSISTED TELEPHONE SAMPLES , 1995 .

[13]  Rodney A. White,et al.  ACC/AHA 2005 Practice Guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric, and abdominal aortic): a collaborative report from the American Association for Vascular Surgery/Society for Vascular Surgery, Society for Cardiovascular Angiography , 2006, Circulation.

[14]  H. Ismail,et al.  Diagnosis and Treatment of Peripheral Arterial Disease Compared with Other Atherosclerotic Vascular Diseases in a University Primary Care Clinic , 2006, Journal of Investigative Medicine.

[15]  Eric J Topol,et al.  Critical issues in peripheral arterial disease detection and management: a call to action. , 2003, Archives of internal medicine.

[16]  John V. White,et al.  Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II). , 2007, European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery.

[17]  J. Allenberg,et al.  High prevalence of peripheral arterial disease and co-morbidity in 6880 primary care patients: cross-sectional study. , 2004, Atherosclerosis.

[18]  A. Chugh,et al.  Intermittent claudication: an overview. , 2006, Atherosclerosis.

[19]  Hanna Tolonen,et al.  25-year Trends and Socio-demographic Differences in Response Rates: Finnish Adult Health Behaviour Survey , 2006, European Journal of Epidemiology.

[20]  M. Criqui,et al.  Peripheral Arterial Disease Detection, Awareness, and Treatment in Primary Care , 2001 .

[21]  J. Mckenney,et al.  National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) , 2002 .

[22]  J. Allenberg,et al.  High prevalence of peripheral arterial disease and low treatment rates in elderly primary care patients with diabetes. , 2004, Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association.

[23]  M. Al-Omran,et al.  Commentary: one-year cardiovascular event rates in outpatients with atherothrombosis. Steg PG, Bhatt DL, Wilson PW, et al; REACH Registry Investigators. JAMA. 2007;297: 1197-1206. , 2007, Perspectives in vascular surgery and endovascular therapy.

[24]  M. Eliasziw,et al.  Large Increases in Hypertension Diagnosis and Treatment in Canada After a Healthcare Professional Education Program , 2006, Hypertension.

[25]  Deepak L. Bhatt,et al.  One-year cardiovascular event rates in outpatients with atherothrombosis. , 2007, JAMA.

[26]  F. McAlister,et al.  Canadian Cardiovascular Society Consensus Conference: peripheral arterial disease - executive summary. , 2005, The Canadian journal of cardiology.

[27]  P Whelton,et al.  Trends in the prevalence, awareness, treatment, and control of hypertension in the adult US population. Data from the health examination surveys, 1960 to 1991. , 1995, Hypertension.

[28]  P. Whelton,et al.  Trends in the prevalence, awareness, treatment, and control of cardiovascular disease risk factors among noninstitutionalized patients with a history of myocardial infarction and stroke. , 2006, American journal of epidemiology.

[29]  L. Mosca,et al.  Tracking Women’s Awareness of Heart Disease: An American Heart Association National Study , 2004, Circulation.

[30]  L. Potvin,et al.  Knowledge of cardiovascular disease risk factors among the Canadian population: relationships with indicators of socioeconomic status. , 2000, CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne.

[31]  N. Unwin,et al.  Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) Detection, Evaluation, and Treatment of High Blood Cholesterol Education Program (NCEP) Expert Panel on Executive Summary of the Third Report of the National , 2009 .

[32]  R. Langer,et al.  Mortality over a period of 10 years in patients with peripheral arterial disease. , 1992, The New England journal of medicine.

[33]  Daniel W. Jones,et al.  The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. , 2003, JAMA.

[34]  Peter Libby,et al.  Diabetes and atherosclerosis: epidemiology, pathophysiology, and management. , 2002, JAMA.

[35]  Chi-Ming Chow,et al.  Increasing Internet use among cardiovascular patients: new opportunities for heart health promotion. , 2005, The Canadian journal of cardiology.

[36]  Rodney A. White,et al.  ACC/AHA 2005 guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric, and abdominal aortic): executive summary a collaborative report from the American Association for Vascular Surgery/Society for Vascular Surgery, Society for Cardiovascular Ang , 2006, Journal of the American College of Cardiology.

[37]  M. Becker,et al.  The Health Belief Model: A Decade Later , 1984, Health education quarterly.

[38]  R. Langer,et al.  Ethnic-specific prevalence of peripheral arterial disease in the United States. , 2007, American journal of preventive medicine.

[39]  R. Petrella,et al.  Awareness and misconception of hypertension in Canada: results of a national survey. , 2005, The Canadian journal of cardiology.