Disparities in Diagnosis, Treatment and Outcomes of Peripheral Artery Disease JACC Scientific Statement

被引:22
作者
Mcdermott, Mary M. [1 ]
Ho, Karen J. [1 ]
Alabi, Olamide [2 ]
Criqui, Michael H. [3 ]
Goodney, Philip [4 ]
Hamburg, Naomi [5 ]
Mcneal, Demetria M. [6 ]
Pollak, Amy [7 ]
Smolderen, Kim G. [8 ]
Bonaca, Marc [6 ]
机构
[1] Northwestern Univ, Feinberg Sch Med, 750 N Lake Shore Dr,10th Floor, Chicago, IL 60611 USA
[2] Emory Univ, Sch Med, Atlanta, GA USA
[3] Univ Calif San Diego, Med Sch, La Jolla, CA USA
[4] Dartmouth Sch Med, Hanover, NH USA
[5] Boston Med Ctr, Boston, MA USA
[6] Univ Colorado, Sch Med, Anschutz Med Campus, Aurora, CO USA
[7] Mayo Clin, Jacksonville, FL USA
[8] Yale Univ, Sch Med, New Haven, CT USA
关键词
disparities; PAD; peripheral artery disease; CARDIOVASCULAR RISK-FACTORS; ANKLE-BRACHIAL INDEX; CRITICAL LIMB ISCHEMIA; SEX-DIFFERENCES; FUNCTIONAL DECLINE; SOCIOECONOMIC-STATUS; RACIAL DISPARITIES; CLINICAL CHARACTERISTICS; WALKING EXERCISE; LEG SYMPTOMS;
D O I
10.1016/j.jacc.2023.09.830
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Disparities by sex, race, socioeconomic status, and geography exist in diagnosis, treatment, and outcomes for people with lower extremity peripheral artery disease (PAD). PAD prevalence is similar in men and women, but women have more atypical symptoms and undergo lower extremity revascularization at older ages compared to men. People who are Black have an approximately 2-fold higher prevalence of PAD, compared to people who are White and have more atypical symptoms, greater mobility loss, less optimal medical care, and higher amputation rates. Although fewer data are available for other races, people with PAD who are Hispanic have higher amputation rates than White people. Rates of amputation also vary by geography in the United States, with the highest rates of amputation in the southeastern United States. To improve PAD outcomes, intentional actions to eliminate disparities are necessary, including clinician education, patient education with culturally appropriate messaging, improved access to high-quality health care, science focused on disparity elimination, and health policy changes. (J Am Coll Cardiol 2023;82:2312-2328) (c) 2023 by the American College of Cardiology Foundation.
引用
收藏
页码:2312 / 2328
页数:17
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