Peripheral arterial disease - screening in general practice

Aust Fam Physician. 2013 Jun;42(6):391-5.

Abstract

Background: As a manifestation of systemic atherosclerosis, peripheral arterial disease (PAD) signifies an increased risk of cardiovascular events. Peripheral arterial disease has received less attention than other atherosclerotic diseases, leading to under-diagnosis and under-treatment. Peripheral arterial disease affects approximately 10-15% of the general population, and approximately 50% of PAD patients are asymptomatic.

Objective: This article aims to review the literature on the rationale for screening for lower extremity PAD in the general practice setting, and to identify the barriers to screening for PAD experienced by general practitioners, with a focus on the Australian context.

Discussion: Screening for asymptomatic PAD among high risk groups has been recommended by major PAD authorities to increase early diagnosis. Screening for PAD using the ankle-brachial index can detect asymptomatic patients. Research into the effect of cardiovascular risk reduction therapies for asymptomatic patients is lacking, and available evidence is inconclusive. The prevalence of screening and barriers to screening experienced by Australian GPs has not yet been studied. Available data on the benefits of PAD screening is inconclusive, and further research is required to determine a survival benefit with treatment of asymptomatic PAD.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Ankle Brachial Index
  • Asymptomatic Diseases
  • Australia
  • General Practice
  • Humans
  • Mass Screening / methods*
  • Peripheral Arterial Disease / diagnosis*
  • Peripheral Arterial Disease / therapy