BY AMERICAN HEART ASSOCIATION NEWS
ORLANDO, Florida – A risk reduction plan dramatically reduced the risk of amputations, heart attack, stroke or death for people with peripheral artery disease, according to new research presented Monday at the 2015 American Heart Association Scientific Sessions.
PAD affects the legs the same way that coronary artery disease and stroke affect the heart and brain: it clogs blood vessels and reduces the flow of blood, which can lead to pain and permanent damage. In severe cases, PAD can lead to ulcers, gangrene and foot and leg amputations.
Seven years after enrolling in the program at Toronto General Hospital, patients dropped their risk of heart attack, stroke or death by 36 percent and lowed heart failure hospitalization by 27 percent, compared to patients not in the program. Their need for arterial bypass surgery was 53 percent lower. Their risk of major amputation was 53 percent lower and the risk of minor amputation was 74 percent lower.
According to lead study author Mohamad Hussain, M.D., PAD poses a significant public health burden, with 8-12 million people in the U.S. and more than 202 million people around the world living with the disease. He said there’s a general lack of awareness about PAD and its risk factors.
“Many studies have shown that the risk factors for PAD aren’t optimally managed, although they’re the same for coronary artery disease,” said Hussain, a vascular surgery resident at the University of Toronto.
The study compared 290 PAD patients who enrolled in the program from 2004 – 2007 to 501 patients treated at other academic hospitals in Ontario, but not in risk reduction programs.
Program participants had baseline measurements of smoking status, high blood pressure, high cholesterol, blood sugar and diabetes, weight and body mass index, and their use of medications for reducing risk.
Medical professionals talked to patients about making lifestyle changes and reinforced the information in personalized letters. This included advice about quitting smoking, losing weight, getting regular physical activity, and encouraging them to take medication prescribed for blood pressure, high cholesterol or diabetes.
Letters also went to the patients’ family physicians with instructions for using science-based guidelines to better manage PAD.
Additional follow-up was done at the discretion of the vascular surgeon or family physician.
“These results reiterated the fact that by adequately managing the risk factors of our patients, it can significantly reduce hospitalization, reduce disability and possibly reduce hospital costs,” Hussain said.
He said more formal programs are needed to reduce PAD, which the research team plans to do in Ontario and throughout Canada.
Although the study didn’t evaluate how the program affected the participants’ quality of life, Hussain said preventing even a few amputations could make a significant difference. Future research will help answer questions about quality of life, utilization of healthcare services and costs associated with reducing the risks of PAD.