Hirsch Alan T, Murphy Timothy P, Lovell Marge B, Twillman Gwen, Treat-Jacobson Diane, Harwood Eileen M, Mohler Emile R, Creager Mark A, Hobson Robert W, Robertson Rose Marie, Howard W James, Schroeder Paul, Criqui Michael H
Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Ste 300, 1300 S 2nd St, Minneapolis, MN 55454, USA.
Circulation. 2007 Oct 30;116(18):2086-94. doi: 10.1161/CIRCULATIONAHA.107.725101. Epub 2007 Sep 17.
Lower-extremity peripheral arterial disease (PAD) is associated with decreased functional status, diminished quality of life, amputation, myocardial infarction, stroke, and death. Nevertheless, public knowledge of PAD as a morbid and mortal disease has not been previously assessed.
We performed a cross-sectional, population-based telephone survey of a nationally representative sample of 2501 adults > or = 50 years of age, with oversampling of blacks and Hispanics. The survey instrument measured the demographic, risk factor, and cardiovascular disease characteristics of the study population; prevalent leg symptoms; PAD awareness relative to atherosclerosis risk factors and other cardiovascular and noncardiovascular diseases; perceived causes of PAD; and perceived systemic and limb consequences of PAD. Respondents were 67.2+/-12.6 years of age with a high prevalence of risk factors but only a modest burden of known coronary or cerebrovascular disease. Twenty-six percent of respondents expressed familiarity with PAD, a rate significantly lower than that for any other cardiovascular disease or atherosclerosis risk factor. Within the "PAD-aware" cohort, knowledge was poor. Half of these individuals were not aware that diabetes and smoking increase the risk for PAD; 1 in 4 knew that PAD is associated with increased risk of heart attack and stroke; and only 14% were aware that PAD could lead to amputation. All knowledge domains were lower in individuals with lower income and education levels.
The public is poorly informed about PAD, with major knowledge gaps regarding the definition of PAD, risk factors that lead to PAD, and associated limb symptoms and amputation risk. The public is not aware that PAD imposes a high short-term risk of heart attack, stroke, and death. For the national cardiovascular disease burden to be reduced, public PAD knowledge could be improved by national PAD public education programs designed to reduce critical knowledge gaps.
下肢外周动脉疾病（PAD）与功能状态下降、生活质量降低、截肢、心肌梗死、中风及死亡相关。然而，此前尚未评估公众对PAD作为一种致病和致死性疾病的认知情况。
我们对2501名年龄≥50岁的具有全国代表性的成年人样本进行了一项基于人群的横断面电话调查，其中黑人和西班牙裔人群为过度抽样。该调查工具测量了研究人群的人口统计学、危险因素及心血管疾病特征；常见的腿部症状；相对于动脉粥样硬化危险因素及其他心血管和非心血管疾病的PAD知晓情况；对PAD病因的认知；以及对PAD的全身和肢体后果的认知。受访者年龄为67.2±12.6岁，危险因素患病率高，但已知的冠心病或脑血管疾病负担较轻。26%的受访者表示熟悉PAD，这一比例显著低于任何其他心血管疾病或动脉粥样硬化危险因素。在“知晓PAD”的队列中，知识水平较差。这些人中一半不知道糖尿病和吸烟会增加患PAD的风险；四分之一的人知道PAD与心脏病发作和中风风险增加有关；只有14%的人知道PAD会导致截肢。在收入和教育水平较低的个体中，所有知识领域的知晓情况都更低。
公众对PAD的了解不足，在PAD的定义、导致PAD的危险因素以及相关的肢体症状和截肢风险方面存在重大知识缺口。公众并未意识到PAD会带来心脏病发作、中风和死亡的高短期风险。为了减轻国家心血管疾病负担，可通过旨在减少关键知识缺口的全国性PAD公众教育项目来提高公众对PAD的认知。
