Peripheral Arterial Disease in the Elderly Recognition and Management

Peripheral arterial disease (PAD) is a common but frequently overlooked vascular disease, often affecting the lower extremities. The prevalence of PAD increases exponentially with age, and this is of particular concern among the elderly population because this condition frequently signals disease in other vascular beds, including the coronary arteries and/or cerebral vasculature. In addition to the increased risk of cardiovascular disease and stroke, patients with PAD may also experience functional impairment and decreased quality of life. The ankle-brachial index is the most effective and widely used screening tool for detecting PAD and should be performed when PAD is suspected, based on the medical history or physical examination. Current treatment guidelines recommend risk factor modification, including exercise therapy and smoking cessation interventions, combined with pharmacologic measures for secondary prevention and management of symptoms of PAD. Antiplatelet therapy is an integral component of global cardiovascular risk reduction strategies in patients with PAD. Current guidelines provide a significant opportunity for practitioners to detect and treat patients with PAD in a timely and effective manner, thereby improving the overall mortality, morbidity, and quality of life associated with this disease.