Management of patients with peripheral arterial disease in primary care

• Verfasst von: Kröger, Knut [VerfasserIn]
• Verfasst von: Schwertfeger, M. [VerfasserIn]
• Verfasst von: Pittrow, D. [VerfasserIn]
• Verfasst von: Diehm, Curt [VerfasserIn]
• Titel: Management of patients with peripheral arterial disease in primary care
• Titelzusatz: a cross-sectional study in Germany
• Verf.angabe: K. Kröger, M. Schwertfeger, D. Pittrow, C. Diehm
• E-Jahr: 2010
• Jahr: 17 May 2010
• Umfang: 10 S.
• Fussnoten: Gesehen am 06.03.2023
• Titel Quelle: Enthalten in: The international journal of clinical practice
• Ort Quelle: London : Hindawi Limited, 2004
• Jahr Quelle: 2010
• Band/Heft Quelle: 64(2010), 7, Seite 875-884
• ISSN Quelle: 1742-1241
• DOI: doi:10.1111/j.1742-1241.2010.02337.x
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1838178147

Abstract

Background: Studies in the primary care setting are of high interest for assessing the management situation of patients with manifestations of atherothrombosis. Aims: Therefore, we documented diagnostic procedures, characteristics, and management of patients with symptomatic and asymptomatic peripheral arterial disease (PAD). Materials & Methods: Prospective cross-sectional study in primary care practices throughout Germany. Results: A total of 671 patients with newly diagnosed PAD were included (mean age 69.1 years; 62.1% men). Cardiovascular risk factors were highly prevalent in the total PAD group: arterial hypertension in 84.2%, hyperlipidaemia in 75.5%, present smoking in 45.0% and diabetes mellitus in 47.3%. Atherothrombotic comorbidities were also frequent: coronary artery disease in 44.9% and cerebrovascular disease in 28.1%. For confirmation of diagnosis, patients were referred to specialists in 66.9% of cases. Overall, ankle brachial index was measured in 89.0%, and a clinical PAD score assessed in 66.6% (agreement of both measures with Cohen’s kappa only, κ = 0.039; p = 0.209). Drug treatment of risk factors (as secondary prophylaxis) in line with current guidelines was reported in a high percentage of patients: 88.6% with any antiplatelet drug, 69.3% with statins, 62.4% with angiotensin converting enzyme inhibitors, 23.5% with AT1 receptor blockers and 43.9% with beta-blockers. Between asymptomatic and symptomatic PAD, differences in the risk factor/comorbidity profiles were small; however, the latter group received intensified treatment. Conclusion: Our findings confirm that patients with PAD pose a substantial challenge to physicians because of their high number of comorbidities. Compared with previous studies, management of such patients appears to have improved.