Section of General Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH; VA Outcomes Group, White River Junction VA Medical Center, White River Junction, VT.
Section of Vascular Surgery, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03756.
Semin Vasc Surg. 2021 Mar;34(1):38-46. doi: 10.1053/j.semvascsurg.2021.02.005. Epub 2021 Feb 5.
Peripheral artery disease (PAD) is the clinical manifestation of atherosclerosis that primarily affects peripheral arteries within the lower extremities. In this brief review, we describe the epidemiology and burden of disease of PAD within the United States, particularly among high-risk populations. Although the prevalence of PAD continues to increase and is typically higher among the elderly as well as men, women in lower socioeconomic strata are affected at rates two times that of men. Among racial/ethnic groups, Black and African-American patients both experience higher rates of disease as well as lower rates of access to preventative care. Moreover, despite an overall decrease in amputation rates among all patients with PAD, high-risk populations remain disproportionally affected. Specifically, patients in rural areas, African-American and Native-American patients, and those of low socioeconomic status carry the highest risk of amputation. Efforts to improve care among PAD patients should target these high-risk populations and offer comprehensive, evidence-based preventative care. Wide adoption and integration of these practices into comprehensive care models may help to mitigate amputation in the highest-risk populations. As our treatment pathways continue to evolve, we must place further emphasis on patient input and quality of life as we work toward continual improvement in the care of patients with PAD.
外周动脉疾病（PAD）是动脉粥样硬化的临床表现，主要影响下肢的外周动脉。在这篇简短的综述中，我们描述了美国 PAD 的流行病学和疾病负担，特别是在高危人群中。尽管 PAD 的患病率持续上升，且在老年人和男性中更为常见，但社会经济地位较低的女性患病的比例是男性的两倍。在不同种族/族裔群体中，黑人和非裔美国患者的疾病发病率都较高，而获得预防保健的机会却较低。此外，尽管所有 PAD 患者的截肢率总体上有所下降，但高危人群仍受到不成比例的影响。具体而言，农村地区、非裔美国人和美洲原住民患者以及社会经济地位较低的患者面临着最高的截肢风险。改善 PAD 患者护理的努力应针对这些高危人群，并提供全面、基于证据的预防保健。广泛采用和整合这些实践到综合护理模式中可能有助于减轻高危人群的截肢风险。随着我们的治疗途径不断发展，我们必须更加重视患者的意见和生活质量，努力不断改善 PAD 患者的护理。
