Hirsch A T, Halverson S L, Treat-Jacobson D, Hotvedt P S, Lunzer M M, Krook S, Rajala S, Hunninghake D B
Vascular Medicine Program, Minnesota Vascular Diseases Center, University of Minnesota Medical School, Minneapolis 55455, USA.
Vasc Med. 2001;6(2):87-96. doi: 10.1177/1358836X0100600204.
The Minnesota Regional Peripheral Arterial Disease Screening Program was designed to define the efficacy of community PAD detection efforts, to assess the disease-specific and health-related morbidity, to assess PAD awareness rates, and to determine the magnitude of atherosclerosis disease risk factors and the intensity of their management. The target population was recruited via mass media efforts directed at individuals over 50 years of age and those with leg pain with ambulation. Screening sessions included assessments of the ankle-brachial index, blood pressure, fasting lipid profile, and use of validated tools to detect symptomatic claudication (by the Modified WHO-Edinburgh Claudication Questionnaire), walking impairment (Walking Impairment Questionnaire - WIQ), quality of life (MOS SF-36), PAD awareness, and the intensity of PAD medical therapeutic interventions. PAD was defined as any ankle-brachial index < or =0.85 or a history of lower extremity revascularization. The program evaluated 347 individuals and identified 92 subjects with PAD and 255 subjects without PAD, yielding a detection rate of 26.5%. Individuals with PAD were older, tended to have higher blood pressures, and had a significant walking impairment and an impaired health-related quality of life compared with the non-PAD subjects. Current rates of tobacco use were low. Lipid-lowering, estrogen replacement, anti-platelet, and antihypertensive medications and exercise therapies were underutilized in the PAD cohort. Peripheral arterial disease awareness was low in these community-identified patients. This Program demonstrated that individuals with PAD can be efficiently identified within the community, but that current standards of medical care are low. These data can assist in the future development of PAD awareness, education, and treatment programs.
明尼苏达地区外周动脉疾病筛查项目旨在确定社区外周动脉疾病（PAD）检测工作的成效，评估疾病特异性和与健康相关的发病率，评估PAD知晓率，并确定动脉粥样硬化疾病危险因素的程度及其管理强度。目标人群是通过针对50岁以上人群以及行走时腿痛人群的大众媒体宣传招募而来。筛查环节包括评估踝臂指数、血压、空腹血脂谱，以及使用经过验证的工具检测症状性跛行（通过改良的世界卫生组织 - 爱丁堡跛行问卷）、行走障碍（行走障碍问卷 - WIQ）、生活质量（MOS SF - 36）、PAD知晓情况，以及PAD医学治疗干预的强度。PAD定义为任何踝臂指数≤0.85或有下肢血运重建史。该项目评估了347人，确定92名患有PAD的受试者和255名未患PAD的受试者，检出率为26.5%。与未患PAD的受试者相比，患有PAD的个体年龄更大，血压往往更高，行走障碍明显，与健康相关的生活质量受损。目前吸烟率较低。在PAD队列中，降脂、雌激素替代、抗血小板和抗高血压药物以及运动疗法的使用不足。在这些社区确诊的患者中，外周动脉疾病知晓率较低。该项目表明，在社区内可以有效地识别出患有PAD的个体，但目前的医疗护理标准较低。这些数据有助于未来PAD知晓、教育和治疗项目的开展。
